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NR 7-9/2009
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Zastosowanie
nowoczesnych technik neurochirurgicznych podczas usuwania ciał
obcych z oczodołu – opis dwóch przypadków
Modern neurosurgical
techniques to remove intraorbital foreign bodies – report of two
cases
Katarzyna J. Napora1, Iwona
Obuchowska1, Tomasz Łysoń2, Andrzej
Sieśkiewicz3, Maciej Bień2, Zofia Mariak1,
Zenon Mariak2
1 Z Kliniki Okulistyki Uniwersytetu Medycznego w
Białymstoku
Kierownik: prof. dr hab. n. med. Zofia Mariak
2 Z Kliniki Neurochirurgii Uniwersytetu Medycznego w
Białymstoku
Kierownik: prof. dr hab. n. med. Zenon Mariak
3 Z Kliniki Otolaryngologii Uniwersytetu Medycznego w
Białymstoku
Kierownik: prof. dr hab. n. med. Marek Rogowski |
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| Summary: |
Purpose: To
indicate the usefulness of modern neurosurgical
techniques to remove intraorbital foreign bodies, not
removed during primary ophthalmological surgical
intervention.
Patient 1: A 29-year-old man, struck with a bottle, with
a piece of glass located at the top of the right orbit.
During the primary ophthalmological intervention –
orbitotomy accessed through the conjunctiva of the
fornix of the upper eyelid and the second cut through
the wound in the eyelid – the foreign body was not
removed. The patient was moved to the Department of
Neurosurgery, where 3 days after the injury the 30 mm x
7 mm piece of glass was successfully removed with the
aid of neuronavigation system. The surgical approach was
through a cut in the right eyebrow and the foreign body
was found to be located in the back-top part of the
orbit.
Patient 2: A 30-year-old man, hit with a piece of wood,
with an organic foreign body (wood), located in the
mid-lower and medial part of the right orbit. During the
primary ophthalmological operation – orbitotomy accessed
through the conjunctiva of the fornix of the lower
eyelid – the foreign body was not removed. The patient
was moved to the Department of Neurosurgery, where the
surgeon unsuccesfuly attempted to remove the foreign
body through the wound in the conjunctiva of the fornix
of the lower eyelid with the aid of neuronavigation. In
this situation the endoscopic technique with access
through the nose was used. The mid part of the medial
orbit wall was removed and partially fragmented piece of
wood was located with the use of the neuronavigation.
The foreign body was located in the middle part of the
orbit, near the medial wall. It was removed in four
pieces measuring: 8 mm x 3 mm, 8 mm x 4 mm, 15 mm x 5
mm, 18 mm x 6 mm. |
| Słowa kluczowe: |
ciało obce
wewnątrzoczodołowe, technika neuronawigacji, endoskopia. |
| Key words: |
intraorbital foreign body,
neuronavigation technique, endoscopy. |
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