[Large foreign bodies inside the orbit and maxillary sinus (clinical observation)]

The great variety of orbital traumas can surprise and challenge specialists attempting to cure its consequences with the best possible outcome. This article presents a clinical case of a patient diagnosed with cicatricial deformity of the free edge and trichiasis of the upper eyelid in the lateral angle area, keratopathy, enophthalmos on the left side; posttraumatic defect of the inferior orbital wall; multiple foreign bodies in the orbit and maxillary sinus on the left side. Patient examination included conventional ophthalmological study methods, as well as multislice computed tomography with 3D-reconstruction. Surgical treatment required involvement of an ophthalmologist, an otorhinolaryngologist and a maxillofacial surgeon. The first stage of surgical treatment addressed the deformity of the lateral part of the upper eyelid margin including resection of its fragment, trichiasis surgery, and lateral canthoplasty. In the second stage, the multidisciplinary team of surgeons removed foreign bodies through combined subciliary and endonasal access with placement of a mandibular autograft onto the inferior orbital wall. Radiological examination should be done in all patients with trauma to the orbital area in order to detect latent injuries. When choosing a treatment strategy, specialists should be aware of trauma complicity and necessity to enlist a multidisciplinary medical team. Patients should be informed that sometimes the consequences of the trauma may not be treated completely.