Percutaneous ultrasound-guided intraorbital foreign body removal

Percutaneous ultrasound-guided intraorbital foreign body removal was successfully performed for removal of an intraorbital wooden foreign body. A 13-month-old boy presented with left periorbital cellulitis, which developed 3 days after a fall from an all-terrain vehicle. Orbital CT showed preseptal and postseptal orbital cellulitis, and an 11 x 2 mm linear foreign body in the medial compartment of the left eye. Surgical exploration of the left eye was performed, with no foreign body identified. Following surgery, diagnostic sonography demonstrated a linear foreign body adjacent to the medial rectus muscle, with sonographic characteristics compatible with wood. The percutaneous procedure was performed with intravenous deep sedation. With sonographic guidance, a Hartmann forceps was advanced in the medial soft tissues of the orbit, and the foreign body was removed intact. Ophthalmologic follow-up over 6 months revealed no evidence of visual loss, nerve injury, or impairment of extraocular muscle function.