[Necrosis and reconstruction of the inferior oblique muscle after removal of a wooden intra-orbital foreign body].
A 39-year-old patient presented 3 days after a bicycle accident with a progressive left periorbital inflammatory swelling and diplopia in upgaze. On the day of the accident, a cranial x-ray did not reveal a fracture or an orbital foreign body, and the 2.5 cm skin wound on the left lower eyelid was sutured. For further evaluation, computer tomography) was performed. This did not show a radio-opaque, orbital foreign body. An explorative orbitotomy was carried out and revealed a 3.7 cm long wooden fragment medial to the inferior oblique muscle (OI). The extraconal portion of OI was found to be necrotic. Complete reconstruction of the OI was not possible due to the extent of the necrosis. The residual muscle was fixated to the orbital septum. Recovery was good and the diplopia resolved after 6 months. This case emphasizes the importance of a meticulous inspection of skin wounds with a high risk of remaining wooden foreign bodies and shows the possibility of functional recovery of extraocular muscles following partial reconstruction.
Huber
K K
KK
Klinik für Augenheilkunde, Universitätsklinikum, RWTH Aachen, Pauwelsstrasse 30, 52057, Aachen. khuber@ukaachen.de
Hartmann
K
K
Vobig
M
M
Krombach
G A
GA
D000328:Adult; D004172:Diplopia / Q000209:etiology / Q000601:surgery*; D005129:Eye Foreign Bodies / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D009336:Necrosis / Q000209:etiology / Q000601:surgery; D009801:Oculomotor Muscles / Q000473:pathology* / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome