[Clinical analysis of 25 cases of intraorbital nonmetallic foreign bodies]

To evaluate the clinical features, diagnostic methods and treatment of intraorbital nonmetallic foreign body injuries.

In a retrospective study, the records of 25 consecutive cases with nonmetallic foreign bodies in the orbit confirmed by surgery were analyzed with special attention to the types of injury, history, clinical manifestations, imaging findings, treatment and follow-up results.

Among 25 cases with nonmetallic foreign bodies, 23 cases were caused by trauma, including 11 cases with wooden bodies, 3 cases with glass, grease, or stone, 2 cases with plastic pen point, and one case with fire crackers. The remaining two cases had iatrogenic foreign bodies. The distinctive clinical manifestation was the periorbital fistula recorded in 11 (44%) cases, mostly in patients with wooden foreign bodies. The CT findings were different in various foreign bodies. The wooden foreign bodies showed low density in the acute stage and the density increased gradually from the acute to the chronic stage. CT images with lower windows could distinguish a wooden foreign body better. The grease was seen as low density mimicking orbital fat on CT. The stone or glass showed as masses with high density. Wooden foreign bodies displayed low signals on both MRI T1- and T2-weighted images. The surrounding pus was seen as a ring with high signal on T2-weighted images. The inflammatory infiltration showed marked enhancement. The grease displayed high signal on both T1- and T2-weighted images and showed lower signal than that of the fat. All patients underwent surgical removal of retained foreign bodies and the surrounding decomposed tissues. The infected wounds were not sutured at one stage operation. After follow-up for 6 months, all wounds healed normally and all patients recovered well. No complications were encountered.

There are various types of intraorbital nonmetallic foreign bodies. The clinical manifestations of these different foreign bodies are complex. CT is the preferred examination for this condition. With the combination of correct diagnosis, proper surgical skills, and complete removal of foreign bodies and surrounding decomposed tissues, nonmetallic foreign bodies can be treated efficiently.