On the difficulties of diagnostics and tactics of removing a giant foreign body from the orbit
https://doi.org/10.21516/2072-0076-2024-17-4-95-100
Abstract
A clinical case of removal of a giant foreign body (FB) from the orbit one year after a traumatic pistol injury simultaneously with enucleation of the eyeball is described. Particular attention is paid to the difficulties of diagnosis and surgical technique in removing giant FBs. Computed tomography (CT) is the main method of examination for such injuries, but it should be borne in mind that FBs, especially bullets from traumatic pistols, can consist of various materials, including X-ray negative ones. In addition, large metal fragments produce significant artifacts that complicate the interpretation of the CT image.
Keywords
Supporting agencies: no author has a financial or property interest in any material or method mentioned
About the Authors
I. A. Filatova
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
Irina A. Filatova — Dr. of Med. Sci., professor, head of the department of plastic surgery and ocular prosthetics, professor of chair of continuing medical education.
14/19, Sadovaya-Chernogriazskaya St., Moscow, 105062
A. P. Tishkova
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
Antonina P. Tishkova — radiologist at the department of x-ray diagnostics and radiotherapy.
14/19, Sadovaya-Chernogriazskaya St., Moscow, 105062
References
1. Polyak B.L. Military field ophthalmology. Leningrad; Medgiz, 1957 (In Russ.).
2. Gundorova R.A., Stepanov A.V., Kurbanova N.F. Modern ophthalmotraumatology. Moscow: Meditsina publischers, 2007 (In Russ.).
3. Danilichev V.F., Shishkin M.M. Modern tactics of surgical treatment of combat gunshot eye injuries. Military Medical Journal. 1997; 318 (5): 22–6 (In Russ.).
4. Danilichev V.F. Modern combat gunshot wounds of the eyes : A lecture for listeners of the 1st and 6th faculties. S. M. Kirov Military Medical Akademy. VMA; 1991 (In Russ.).
5. Popov V.E., Mai R.B., Manzhos P.I. A penetrating cranio-orbital gunshot wound in a 12-year-old girl. Neirokhirurgiya i nevrologiya detskogo vozrasta. 2018; 57 (3): 53–9 (In Russ.).
6. Gundorova R.A., Kataev M.G., Bykov V.P., et al. Eye injuring by rubber bullets. Clinical ophthalmology. 2008. 9 (3): 98–101 (In Russ.).
7. Lavy T, Asleh SA. Ocular rubber bullet injuries. Eye (Lond). 2003; 17 (7): 821–4. https://doi.org/10.1038/sj.eye.6700447
8. Neroev V.V., Gundorova R.A. Diagnostics and removal of foreign bodies. Analysis of the Institute's developments for 40 years. Ophthalmology. 2010; 7 (2): 7–10 (In Russ.).
9. Neroev V.V., Bykov V.P., Kataev M.G., et al. Some aspects of the clinic and treatment of modern bullet wounds of the organ of vision. Medicine of catastrophes. 2014; 88 (4): 33–5 (In Russ.).
10. Neroev V.V., Gundorova R.A., Kvasha O.I., Al-Darwish D. Bullet wounds to the eye and orbit in peacetime. Moscow: GEOTAR-Media, 2017 (In Russ.).
11. Mikhailova E.A., Nikolaenko V.P. A giant foreign body of the orbit and maxillary sinus. Ofthalmologicheskie vedomosty. 2013; 4 (1): 78–81 (In Russ.).
12. Kasatkina O.M., Nikolaenko V.P., Kasymov F.O., Panova T.Y. Penetrating cranial injury with giant intraorbital foreign body. Oftalmologicheskie vedomosty. 2016; 9 (1): 77–82 (In Russ.). doi: 10.17816/OV9177-82
13. Filatova I.A. Giant foreign body of the orbit. A clinical case. Oftalmologicheskie vedomosty. 2023; 16 (1): 91–8 (In Russ.). https://doi.org/10.17816/OV109283
14. Korotkikh S.A., Bobykin E.V., Stepanyants A.B., Pudov V.I. Complex diagnostics of fragment injuries of the eye and orbit. Vestnik oftal’mologii. 2008; 124 (6): 17–21 (In Russ.).
15. Fulcher TP, McNab AA, Dullivan TJ. Clinical features and management of intraorbital foreign bodies. Ophthalmology. 2002; 109 (3): 494–500. doi: 10.1007/s00330-001-1167-3
16. Chen J, Shen T, Wu Y. Clinical characteristics and surgical treatment of intraorbital foreign bodies in a territoriary eye center. J Craniofacial Surg. 2015; 26 (6): 486–9. doi: 10.1097/SCS.0000000000001973
17. Gundorova R.A., Brovkina A.F., Bagaturia T.G., Val’sky V.V., Bykov V.P. Diagnostic value of computed tomography in the posttraumatic surgery of complicated eye injuries. Vestnik ofhal’mologii. 1986; 102 (6): 45–7 (In Russ.).
18. Stepanyants A.B. The possibilities of magnetic resonance imaging and computed tomography in the diagnosis of damage to the visual organ. Vestnik oftal’mologii. 2006; 122 (4): 46–9 (In Russ.).
19. Davydov D.V., Serova N.S., Pavlova O.Y. Forecasting the risk of developing posttraumatic enophthalmos on the basis of calculations of orbital volumes according to multispiral computed tomography. Oftal’mologicheskie vedomosti. 2018; 11 (3): 26–33 (In Russ.). doi: 10.17816/OV11326-33
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For citations:
Filatova I.A., Tishkova A.P. On the difficulties of diagnostics and tactics of removing a giant foreign body from the orbit. Russian Ophthalmological Journal. 2024;17(4):95-100. (In Russ.) https://doi.org/10.21516/2072-0076-2024-17-4-95-100
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