Introduction: Traditionally retrobulbar lesions localized in the medial part of the orbit are removed using rather extensive extracranial approaches. A few cases were recently reported in which lesions of a certain type were removed using a transnasal endoscopic approach. We describe a patient in whom we managed to remove a sizable piece of wood from the orbit endoscopically after two former unsuccessful attempts.
Case report: A 30-year-old male with a wooden foreign body localized medially behind the globe was operated on 5 days after trauma. His vision was preserved but motility of the eye globe was heavily restricted. An endoscopic transnasal, transethmoidal approach with neuronavigated tools was used to remove the foreign body successfully, using a "bimanual technique." The patient was discharged on day 1 postoperatively with intact vision. Movement restriction gradually resolved, and after 2 weeks he recovered completely.
Conclusion: Foreign bodies localized close to the medial wall of the orbit can be safely removed using an endoscopic transnasal approach. The use of neuronavigation is essential for the precision, safety, and effectiveness of the procedure.
Georg Thieme Verlag KG Stuttgart · New York.