Optik sinire uzanım gösteren tahta bir yabancı cismin transkonjonktival medial anterior orbitotomi ile çıkarılması: Bir olgu sunumu

Öz

İntraorbital yabancı cisimler kimyasal içeriklerine göre organik ve inorganik olarak sınıflandırılabilirler. Tahta inorganik yapıda ve intraorbital yabancı cisim yaralanmalarının nadir fakat şiddetli bir formudur. İntraorbital tahta yabancı cisim yaralanmalarının değerlendirilmesi ve yönetimi oldukça zordur ve ciddi orbital komplikasyonlara yol açabilir. Bu yazıda, otuz-üç yaşındaki erkek hastanın sol orbitasına tahta bir yabancı cisim ile olan penetran yaralanmasını sunuyoruz. Bilgisayarlı tomografi ile sol supraorbital bölgeden intrakonal bölgeye uzanım gösteren doğrusal bir yabancı cisim görüntülendi. Yabancı cismin ucu optik sinire yapısal bütünlüğünü bozmadan temas etmekteydi. Hastaya transkonjonktival medial anterior orbitotomi uygulandı ve tahta yabancı cisim intrakonal bölgede optik sinire çok yakın lokalize olarak bulundu. Kontrollü traksiyonla 7 cm’lik bir tahta parçası tamamen çıkartıldı. Postoperatif dönem normal oftalmik muayeneyle sorunsuzdu. Transkonjonktival medial anterior orbitotomi intrakonal bölgelerdeki tahta yabancı cisimlerin çıkartılması için kullanışlı ve etkili bir yöntemdir.

Anahtar Kelimeler

• tahta yabancı cisim,intrakonal,intraorbital,optik sinir,orbitotomi

Transconjunctival medial anterior orbitotomy for the removal of a wooden intraorbital foreign body extending to the optic nerve: A case report

Abstract

Intraorbital foreign bodies can be classified into organic or inorganic according to their chemical composition. Wooden is inorganic in nature and is a rare, but serious form of intraorbital foreign body injuries. Evaluation and management of intraorbital wooden foreign bodies are highly challenging and can lead to severe orbital complications. In this paper, we report a case of a 33-year old man who presented with a penetrating wooden foreign body injury to the left orbit. Computed tomography revealed a linear shaped foreign body extending from left supraorbital ridge to the intraconal area. The tip of the foreign body was touching to the optic nerve without disrupting its integrity. The patient underwent transconjunctival medial anterior orbitotomy and the wooden foreign body was found to be located close proximity to the optic nerve in intraconal space. A 7cm wooden stick was removed completely with controlled traction. Postoperative recovery was uneventful with normal ophthalmic examination. Transconjunctival medial anterior orbitotomy is a useful and effective method for the removal of intraorbital wooden foreign bodies located in intraconal space.

Keywords

• wooden foreign body,intraconal,intraorbital,optic nerve,, orbitotomy

Kaynakça

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