[Neurosurgical therapy of transorbital intracranial foreign bodies: review of 28 cases].
OBJECTIVE
To discuss the benefits and complications of the neurosurgical therapy in transorbital intracranial foreign bodies.


METHODS
The clinical data of 28 cases of transorbital intracranial foreign bodies, metallic in 13 cases, vegetal 5 cases, and vitreous, plastic and other kinds in 10 cases, were analyzed retrospectively. Optic nerve injury was found in 13 cases, orbital apex syndrome in 11 cases; CSF rhinorrhea in 13 cases, CSF orbital leak in 3 cases, and hemiplegia in 2 cases. All the patients underwent head CT scan, and orbital horizontal and coronal CT scan. The patients with metallic foreign bodies had DSA exams, and the non-metallic cases had MRA scans. 22 cases had orbital-frontal craniotomy and foreign body resection, and 6 cases had direct foreign body extraction. All the cases received antibiotic and nerve nutritional therapy postoperatively.


RESULTS
The cases in which the foreign bodies came from the orbital roof into the skull recovered well postoperatively; and the cases in which the foreign bodies came from the superior orbital fissure into the skull showed hemiplegia (n = 2) or orbital apex syndrome (n = 6) postoperatively.


CONCLUSIONS
Transorbital intracranial foreign body should be diagnosed in early stage to avoid missed diagnosis. Omission should be avoided during resection of the foreign body. The relationship between the foreign body and internal carotid artery should be examined carefully before the extraction. Direct extraction of foreign body causes less injury, and patients' condition should be followed up.
Liu
Hao-Cheng
HC
Department of Neurosurgery, Beijing Tongren Hospital, Capital University of Medical Sciences, Beijing 100730, China.
Qiu
E
E
Zhang
Tian-Ming
TM
Zhao
Jing-Wu
JW
Song
Wei-Xian
WX
Fu
Ji-Di
JD
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005129:Eye Foreign Bodies / Q000601:surgery*; D005260:Female; D020197:Head Injuries, Penetrating / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D009915:Orbit / Q000293:injuries; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult