Description

A 47-year-old man fell and got a chopstick stuck in his upper left eyelid. The patient presented with decreased visual acuity, upper eyelid closure injury, ptosis, and ocular fixation. His pupil was moderately dilated without light response. Magnetic resonance imaging revealed a linear hypointensity region lateral to the upper rectus muscle, extending to upper optic foramen (Figure 1). He was diagnosed to have intraorbital foreign body. Emergency foreign body extraction was performed using the intraoperative electromagnetic navigation system and nasal endoscope. The long piece of the chopstick was extracted first, and then multiple tiny sawdust along wound tract, noticed via high-resolution magnifying and lighting endoscopy, was extracted, including those inserted into fracture seam and attached to dura mater (Figure 2). Thanks to the advanced surgery devices, we extracted the whole foreign body without any complications, including secondary damage, cerebrospinal fluid leakage, incomplete extraction, and delayed infection.

Figure 1: MRI-arrow

Figure 2: Broken chopsticks