Surgical Removal of a Foreign Body Located From the Orbit to the Pterygomandibular Space

This case report describes an elderly female who developed blurred vision and limited mouth opening 15 days after sustaining facial trauma. Computed tomography revealed a rare tubular foreign body extending from the right orbit to the pterygomandibular space, positioned in immediate proximity to major vascular structures with associated infection. Utilizing digital surgical technology, the surgical team meticulously planned a dual-incision approach through a right subpalpebral and transparotid route. Innovatively leveraging the hollow nature of the foreign body, a medical guide wire was introduced from the infraorbital approach and threaded through its lumen until it exited through the transparotid incision. A multiorifice silicone drainage tube was then secured to the wire and, through retrograde traction, both the tube and the foreign body were retrieved en bloc. The silicone tube was subsequently maintained within the original sinus tract to establish dependent drainage. The patient recovered well, with resolved infection, and was discharged following suture removal. This case demonstrates that for deep, complex foreign bodies with prolonged retention, associated infection, and proximity to vital neurovascular structures, preoperative planning based on high-precision 3D CT reconstruction and ingenious surgical design enables minimally invasive, complete removal, effective infection control, and efficient drainage.