Skull Base 2008; 18(6): 417-422
DOI: 10.1055/s-0028-1087223
CASE REPORT

© Thieme Medical Publishers

Transnasal Endoscopic Removal of Orbital, Ethmoid Sinus, and Anterior Skull Base Foreign Body with Mucocele Formation

Colin D. Pero1 , Daniel W. Nuss1
  • 1Department of Otolaryngology–Head and Neck Surgery, LSUHSC–New Orleans, New Orleans, Louisiana
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
11. Oktober 2008 (online)

ABSTRACT

Objectives: 1. Case report of foreign body and associated orbitoethmoid and skull base mucocele following orbital blowout fracture repair. 2. Literature review of orbital fracture repair complications and endoscopic removal of paranasal sinus and anterior skull base foreign body. Design: Case report and literature review. Setting: Tertiary-care academic otolaryngology practice. Results: Foreign body involvement of the orbit, paranasal sinuses, and skull base are relatively rare entities. In contrast, orbital blowout fractures are relatively common facial fractures. We report skull base involvement of a previously placed orbital floor implant complicated by mucocele formation and exophthalmos. Successful endoscopic removal and decompression of foreign body and associated mucocele were accomplished. Review of orbital floor fracture repair complications and paranasal sinus and skull base foreign body endoscopic removal were also performed. Conclusions: Transnasal endoscopic removal of complicated foreign bodies involving the orbit, paranasal sinuses, and anterior skull base can be successfully accomplished given appropriate patient selection and careful technique.

REFERENCES

  • 1 Ozturk S, Sengezer M, Isik S, Turegun M, Deveci M, Cil Y. Long-term outcomes of ultra-thin porous polyethylene implants used in orbital floor defects.  J Craniofac Surg. 2005;  16 973-977
  • 2 Neves R B, Yeatts R P, Martin T J. Pneumo-orbital cyst after orbital fracture repair.  Am J Ophthalmol. 1998;  125 879-880
  • 3 Schmidt B L, Lee C, Young D M, O'Brien J. Intraorbital squamous epithelial cyst: an unusual complication of Silastic.  J Craniofac Surg. 1998;  9 452-455 discussion 456-458
  • 4 Nagase D Y, Courtemanche D J, Peters D A. Plate removal in traumatic facial fractures.  Ann Plast Surg. 2005;  55 608-611
  • 5 Morrison A D, Sanderson R C, Moos K F. The use of silastic as an orbital implant for reconstruction of orbital wall defects: review of 311 cases treated over 20 years.  J Oral Maxillofac Surg. 1995;  53 412-417
  • 6 Folkestad L, Westin T. Long-term sequelae following surgery for orbital floor fractures.  Otolaryngol Head Neck Surg. 1999;  120 914-921
  • 7 Reiter E R, August M, Varvares M A, Curtin H D. Mucocele of the infratemporal fossa as an unusual complication of midface fracture.  Ann Otol Rhinol Laryngol. 2000;  109 522-525
  • 8 Jordan D R, St Onge P, Anderson R L, Patrinely J R, Nerad A. Complications associated with alloplastic implants used in orbital fracture repair.  Ophthalmology. 1992;  99 1600-1608
  • 9 Kwiatkowski T J, Magardino T M, Austin M. Management of orbital-sinus foreign bodies.  J Craniomaxillofac Trauma. 1998;  4 24-29
  • 10 Brown A E, Banks P. Late extrusion of alloplastic orbital floor implants.  Br J Oral Maxillofac Surg. 1993;  31 154-157
  • 11 Nam S B, Bae Y C, Moon J S, Kang Y S. Analysis of the postoperative outcome in 405 cases of orbital fracture using 2 synthetic orbital implants.  Ann Plast Surg. 2006;  56 263-267
  • 12 Kim K S, Kim E S, Hwang J H. Combined transcutaneous transethmoidal/transorbital approach for the treatment of medial orbital fractures.  Plast Reconstr Surg. 2006;  117 1947-1955
  • 13 Buchel P, Rahal A, Seto I, Iizuka T. Reconstruction of orbital floor fracture with polyglactin910/polydiaxanon patch: a retrospective study.  J Oral Maxillofac Surg. 2005;  63 646-650
  • 14 Ng S G, Madill S A, Inkster C F, Maloof A J, Leatherbarrow B. Medpor porous polyethylene implants in orbital blowout fracture repair.  Eye. 2001;  15(Pt 5) 578-582
  • 15 Rosen C E. Late migration of an orbital implant causing orbital hemorrhage with sudden proptosis and diplopia.  Ophthal Plast Reconstr Surg. 1996;  12 260-262
  • 16 Gregory G F. Silicone-associated tissue reaction: a dilemma for oral and maxillofacial surgeons.  Br J Oral Maxillofac Surg. 1995;  33 180-184
  • 17 Stewart M G, Patrinely J R, Appling W D, Jordan D R. Late proptosis following orbital floor fracture repair.  Arch Otolaryngol Head Neck Surg. 1995;  121 649-652
  • 18 Yeakley J W, Ghorayeb B Y. Orbital blowout fractures as a cause of sinonasal obstructive disease.  J Comput Assist Tomogr. 1992;  16 774-778
  • 19 Mauriello Jr J A, Flanagan J C, Peyster R G. An unusual late complication of orbital floor fracture repair.  Ophthalmology. 1984;  91 102-107
  • 20 Schmidt B L, Lee C, Young D M, O'Brien S. Intraorbital squamous epithelial cyst: an unusual complication of Silastic implantation.  J Craniofac Surg. 1998;  9 452-455 discussion 456-458
  • 21 Jin H R. Foreign body in the orbit associated with blowout fracture.  Plast Reconstr Surg. 2006;  117 1050-1051
  • 22 Roy D. The removal of foreign bodies from within the eyeball and orbit: report of cases.  Trans Am Ophthalmol Soc. 1917;  15 56-73
  • 23 Tsao Y H, Kao C H, Wang H W, Chin S C, Moe K S. Transorbital penetrating injury of paranasal sinuses and anterior skull base by a plastic chair glide: management options of a foreign body in multiple anatomic compartments.  Otolaryngol Head Neck Surg. 2006;  134 177-179
  • 24 Tsirbas A, Kazim M, Close L. Endoscopic approach to orbital apex lesions.  Ophthal Plast Reconstr Surg. 2005;  21 271-275
  • 25 Khan-Lim D, Ellis J, Saleh H, Ram B. Endoscopic transnasal removal of orbital foreign body.  Eye. 1999;  13(Pt 5) 667-668
  • 26 Presutti L, Marchioni D, Trani M, Ghidini A. Endoscopic removal of ethmoido-sphenoidal foreign body with intracranial extension.  Minim Invasive Neurosurg. 2006;  49 244-246
  • 27 Dodson K M, Bridges M A, Reiter E R. Endoscopic transnasal management of intracranial foreign bodies.  Arch Otolaryngol Head Neck Surg. 2004;  130 985-988
  • 28 Dancey A L, Perry M J. Late presentation of alloplastic implant extrusion.  Plast Reconstr Surg. 2004;  113 1081-1082

Colin D PeroM.D. 

Fellow, Department of Otolaryngology, Head and Neck Surgery, VIC; 1855 West Taylor St.

MC 648, Chicago IL 60611

eMail: colinpero@yahoo.com

    >