Retained foreign body in the orbit and cavernous sinus with delayed presentation of superior orbital fissure syndrome: case report.
Reports of delayed onset of neurological symptoms after penetrating intracranial trauma are rare. We present the case of a patient who presented with superior orbital fissure syndrome 72 hours after reported trauma to the right eye. Subsequent workup revealed a foreign body located within the orbit, passing through the superior orbital fissure and into cavernous sinus, impinging on the right cavernous carotid artery. Evidence of an intraorbital abscess was also present. Surgical management consisted of a combination of frontopterional and orbital approaches to fully expose both the cavernous sinus and the orbital contents. The foreign body was removed and the abscess was drained. The carotid artery was found to be intact. At 10-month follow-up examination, a slight ptosis and medial gaze of the right eye persist. All other symptoms have resolved.
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Division of Skull Base Surgery, Cedars-Sinai Medical Center, 8635 West Third Street, Suite 490W, Los Angeles, California 90048, USA.
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Shahinian
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D000038:Abscess / Q000209:etiology / Q000601:surgery; D000328:Adult; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002426:Cavernous Sinus / Q000293:injuries* / Q000601:surgery; D005129:Eye Foreign Bodies / Q000150:complications / Q000601:surgery*; D020197:Head Injuries, Penetrating / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D009915:Orbit / Q000293:injuries* / Q000601:surgery; D011859:Radiography; D013577:Syndrome