MODERN EDUCATION AND DEVELOPMENT
Выпуск журнала №-23
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239
CASE REPORT: ENDONASAL-ENDOSCOPIC REMOVAL OF A
FOREIGN BODY (PEN TIP AND SPRING) FROM THE LEFT ORBITAL
CAVITY
Navoi State University, Faculty of Medicine
Navoi City "Laser Med Center" Diagnostic and Treatment Center
Authors:
Ophthalmologist: Mahmudov Shukhratillo Inatilloevich
Otorhinolaryngologist: Tursinboev Vokhidjon Urinboevich
Introduction
Injuries among children, unfortunately, remain a common occurrence in
modern society. According to statistical data, injuries to the eye and its surrounding
structures account for approximately 20% of all pediatric trauma cases. This is
particularly prevalent among preschool-aged children, who, due to lack of parental
supervision, often accidentally injure themselves or their peers with sharp or cutting
objects. Such incidents are frequently observed in daily medical practice.
Orbital (eye socket) injuries are classified as mild, moderate, or severe. In
some cases, trauma to the orbital region can also involve adjacent structures, such as
the facial bones, nasal cavities, and even the skull and brain. Injuries to the orbit may
also affect surrounding anatomical structures, including the lacrimal sac, frontal sinus,
maxillary sinus, and ethmoid sinus. In such cases, diagnostic imaging such as X-rays,
MRI, or MSCT is essential, and a multidisciplinary approach involving
ophthalmologists, otorhinolaryngologists, neurosurgeons, and maxillofacial surgeons
is required for effective treatment.
This case report presents the successful management of a foreign div (pen
tip and spring) lodged in the left orbital cavity of a pediatric patient, highlighting the
importance of timely and specialized care.
Case Presentation
MODERN EDUCATION AND DEVELOPMENT
Выпуск журнала №-23
Часть–2_ Март –2025
240
Patient:
P.A.,
born
in
2019.
Chief Complaint:
Swelling and redness of the lower eyelid of the left eye,
accompanied by nasal discharge.
History of Present Illness:
The patient's mother reported that 22 days prior,
the child was studying at home when he accidentally injured his left lower eyelid with
the tip of a pen while playing. Following the injury, emergency services (103) were
contacted, and the child was transported to an ophthalmology clinic. The wound was
cleaned, and the patient was prescribed topical eye drops for outpatient treatment.
Over the next few weeks, the family sought care at several private clinics and was
eventually referred to our center for further evaluation.
Materials and Methods
Diagnostic Workup:
1.
Ophthalmic Examination:
o
Visual acuity: OD 1.0, OS 0.1.
o
Intraocular pressure: OD 18.0 mmHg, OS 17.0 mmHg.
o
Slit-lamp examination: Right eye (OD) showed clear optical media and
normal fundus. Left eye (OS) exhibited redness and swelling of the lower eyelid, with
a visible penetrating wound at the inner canthus. Conjunctival injection and chemosis
were noted.
o
Fundoscopy: Optic disc margins were slightly blurred, with mild
hyperemia.
2.
Imaging Studies:
o
X-ray and MSCT scans revealed a foreign div (pen tip and spring)
lodged in the left orbital cavity, extending into the adjacent sinus.
3.
Laboratory Tests:
o
Complete blood count, urinalysis, biochemical profile, hepatitis B and C
screening, and antibiotic sensitivity testing were performed.
Consultations:
The patient was evaluated by a pediatrician and an anesthesiologist to ensure
readiness for surgery.
MODERN EDUCATION AND DEVELOPMENT
Выпуск журнала №-23
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241
Treatment
After obtaining informed consent from the parents, the patient was prepared
for surgery under general anesthesia. The foreign div was successfully removed
using an endonasal-endoscopic approach. Postoperatively, the patient received
systemic and topical antibiotic therapy, as well as supportive care.
Postoperative Course
Day 1 Post-Op:
The left lower eyelid wound was clean, with reduced
chemosis and conjunctival injection. Visual acuity: OD 1.0, OS 0.6.
Day 5 Post-Op:
The patient was in good general condition. The wound
had healed completely, with minimal residual redness. Visual acuity: OD 1.0, OS 1.0.
Discussion
This case underscores the importance of timely and specialized care in
managing ocular and orbital injuries, particularly in pediatric patients. The use of
advanced diagnostic imaging (MSCT) and a multidisciplinary surgical approach
enabled the successful removal of the foreign div and prevention of potential
complications, such as infection or damage to adjacent structures.
The high incidence of injuries among children highlights the need for
preventive measures, including parental education and public awareness campaigns.
Healthcare providers, educators, and parents must work together to minimize the risk
of such accidents.
Conclusion
Orbital injuries require urgent and specialized care to prevent long-term
complications.
MODERN EDUCATION AND DEVELOPMENT
Выпуск журнала №-23
Часть–2_ Март –2025
242
A
multidisciplinary
approach
involving
ophthalmologists,
otorhinolaryngologists, and other specialists is essential for optimal outcomes.
Preventive measures, including public education and awareness, are
critical to reducing the incidence of pediatric injuries.
