Intraorbital wooden foreign body: clinical analysis of 32 cases, a 10-year experience

BACKGROUND: We aimed to describe herein the clinical features, diagnosis and treatment of intraorbital wooden foreign body injuries.
METHODS: A case series review of orbital injuries managed at Trakya University Faculty of Medicine between 2002 and 2012 was performed retrospectively. The clinical analysis of 32 intraorbital wooden foreign body injuries was reviewed.
RESULTS: Among the 32 cases, injuries in 16 were caused by a tree branch, in 10 by a pencil, in 5 by a stick, and in 1 by a bush. With respect to preoperative vision, postoperative vision was improved in 69% of patients. Time lapse from injury to presentation was correlated with the size of the foreign body. The subjects were comparable in etiological factor, and distribution of injury according to orbit was as follows: superior 28%, medial 25%, lateral 22%, inferior 16%, and posterior 9%. Computerized tomography (CT) for foreign body was definitive in 72% (n=23) and suggestive in 28% (n=9).
CONCLUSION: The diagnosis of orbital wooden foreign body is difficult because it may be missed clinically and from the imaging perspective. If a foreign body is suspected, optimal patient management should be done. Prior to the surgery, imaging modalities should be maximally utilized. A careful preoperative evaluation, imaging studies, which are event-specific, a high index of suspicion, and rigorous surgery and postoperative care are the keys in the management of orbital wooden foreign body injuries.

Ýntraorbital tahta cisim yaralanmalarý: Otuz iki olgunun klinik analizi, 10 yýllýk deneyim

AMAÇ: Bu yazýda, intraorbital tahta cisim yaralanmalarýnýn klinik özellikleri, taný ve tedavi rejimlerini tanýmlamak amaçlandý.
GEREÇ VE YÖNTEM: 2002 ile 2012 yýllarý arasýnda Trakya Üniversitesi Týp Fakültesine baþvuran orbital yaralanmalar geriye dönük olarak incelendi. Tespit edilen 32 intraorbital tahta cisim yaralanmasý deðerlendirildi.
BULGULAR: Otuz iki yaralanmanýn, 16’sý aðaç kabuðu, 10 tanesi kalem, 5 tanesi çubuk, 1 tanesi ise çalýdan kaynaklanmaktaydý. Ameliyat öncesi görme keskinliði ameliyat sonrasý genelikle arttý (%69). Yaralanma zamaný ile baþvuru zamanlamasý arasýndaki süre, yabancý cisimin boyut ile kolere bulundu. Yaralanma lokalizasyonu, yaralanmanýn etiyolojisi ile iliþkili olup, %28’i superior, %25’i medial, %22’si lateral, %16’sý inferior, %9’u ise posterior orbita yerleþimliydi. Bilgisayarlý tomografi olgularýn %72’sinde tanýda tek baþýna yeterli iken, kalan %28’inde muhtemel yabancý cisim kanýsý verdi.
TARTIÞMA: Ýntraorbital tahta cisim yaralanmalarýnýn tanýsý, klinik ve radyolojik olarak fark edilmesi güç olduðundan zordur. Alýnan anamnezde eðer bir þüphe varsa, optimal hasta yönetimi gerçekleþtirilmelidir. Cerrahi öncesi, görüntüleme yöntemlerinden maksimum faydalanmalýdýr. Dikkatli bir ameliyat öncesi deðerlendirme ve görüntüleme, yüksek klinik þüphe, titiz cerrahi ve ameliyat sonrasý bakým intraorbital tahta cisim yaralanmalarýnýn anahtar noktalarýdýr.