Abstract：
BACKGROUND: Removal of orbital foreign bodies is a surgical challenge. The purpose of this study is to report our experience in the removal of orbital foreign bodies and to evaluate the usefulness of various technological aids in their removal.
METHODS: We conducted a single-center retrospective study at Nice University Hospital (France) from January 2017 to December 2023. All patients undergoing surgery for an orbital foreign body during the study period were included. Data recorded included the nature of the orbital foreign body, its size, location, surgical route, outcome (success, partial success, failure), and technological aids used (intraoperative navigation, intraoperative imaging scope, orbital magnet). Concurrently, we designed a dedicated orbital magnet, which was tested in the anatomy laboratory and in two of our patients.
RESULTS: Six patients, all young men, were included during the study period. Removal was successful, partially successful, or unsuccessful in one-third of cases, respectively. Failure was associated with orbital foreign bodies located in the intraconal or posterior orbital space. Preoperatively, the use of a \"low-artifact\" scanner allowed us to better determine the exact size and shape of the orbital foreign body. Intraoperative navigation was not accurate enough, due to the mobility of the orbital bodies within the orbital fat. In our experience, intraoperative scope imaging was more accurate. The use of a dedicated orbital magnet was successfully tested in the anatomy laboratory and allowed the removal of a small orbital foreign body in one of our patients. Intraoperative surgical videos are provided.
CONCLUSIONS: Vegetal orbital foreign bodies must be systematically removed. Removal of non-vegetal orbital foreign bodies should be considered on a case-by-case basis based on their size, best assessed using a \"low artifact\" scanner, their location, and their intrinsic ferromagnetism. Intraoperative navigation does not appear useful, while intraoperative scope imaging does. A dedicated orbital magnet might be helpful in removing ferromagnetic orbital foreign bodies. However, an orbital magnet may be ineffective in removing intraorbital bullets, since they are made primarily of an alloy of copper and lead.
METHODS: We conducted a single-center retrospective study at Nice University Hospital (France) from January 2017 to December 2023. All patients undergoing surgery for an orbital foreign body during the study period were included. Data recorded included the nature of the orbital foreign body, its size, location, surgical route, outcome (success, partial success, failure), and technological aids used (intraoperative navigation, intraoperative imaging scope, orbital magnet). Concurrently, we designed a dedicated orbital magnet, which was tested in the anatomy laboratory and in two of our patients.
RESULTS: Six patients, all young men, were included during the study period. Removal was successful, partially successful, or unsuccessful in one-third of cases, respectively. Failure was associated with orbital foreign bodies located in the intraconal or posterior orbital space. Preoperatively, the use of a \"low-artifact\" scanner allowed us to better determine the exact size and shape of the orbital foreign body. Intraoperative navigation was not accurate enough, due to the mobility of the orbital bodies within the orbital fat. In our experience, intraoperative scope imaging was more accurate. The use of a dedicated orbital magnet was successfully tested in the anatomy laboratory and allowed the removal of a small orbital foreign body in one of our patients. Intraoperative surgical videos are provided.
CONCLUSIONS: Vegetal orbital foreign bodies must be systematically removed. Removal of non-vegetal orbital foreign bodies should be considered on a case-by-case basis based on their size, best assessed using a \"low artifact\" scanner, their location, and their intrinsic ferromagnetism. Intraoperative navigation does not appear useful, while intraoperative scope imaging does. A dedicated orbital magnet might be helpful in removing ferromagnetic orbital foreign bodies. However, an orbital magnet may be ineffective in removing intraorbital bullets, since they are made primarily of an alloy of copper and lead.
摘要：
背景：去除眼眶异物是一项手术挑战。这项研究的目的是报告我们在去除眼眶异物方面的经验，并评估各种技术辅助手段在去除眼眶异物方面的有用性。
方法：我们于2017年1月至2023年12月在尼斯大学医院（法国）进行了一项单中心回顾性研究。包括在研究期间接受眼眶异物手术的所有患者。记录的数据包括轨道异物的性质，它的大小,location,手术路线,结果(成功，部分成功,failure),和使用的技术辅助工具(术中导航，术中成像范围,轨道磁体）。同时,我们设计了一个专门的轨道磁铁，在解剖学实验室和我们的两名患者中进行了测试。
结果：6名患者，所有的年轻人,包括在研究期间。删除成功，部分成功,或者在三分之一的案例中失败，分别。失败与位于眼眶内或眼眶后间隙的眼眶异物有关。术前,“低伪影”扫描仪的使用使我们能够更好地确定眼眶异物的确切大小和形状。术中导航不够准确,由于眶内脂肪的眶体的流动性。根据我们的经验,术中范围成像更准确。在解剖实验室中成功测试了专用轨道磁体的使用，并允许在我们的一名患者中去除小的轨道异物。提供了术中手术视频。
结论：必须系统地清除植物眼眶异物。非植物眼眶异物的切除应根据其大小逐案考虑,最好使用“低工件”扫描仪进行评估，他们的位置,以及它们内在的铁磁性。术中导航似乎没有用，而术中范围成像。专用轨道磁体可能有助于去除铁磁轨道异物。然而,轨道磁铁可能无法有效移除轨道内子弹，因为它们主要由铜和铅的合金制成。
方法：我们于2017年1月至2023年12月在尼斯大学医院（法国）进行了一项单中心回顾性研究。包括在研究期间接受眼眶异物手术的所有患者。记录的数据包括轨道异物的性质，它的大小,location,手术路线,结果(成功，部分成功,failure),和使用的技术辅助工具(术中导航，术中成像范围,轨道磁体）。同时,我们设计了一个专门的轨道磁铁，在解剖学实验室和我们的两名患者中进行了测试。
结果：6名患者，所有的年轻人,包括在研究期间。删除成功，部分成功,或者在三分之一的案例中失败，分别。失败与位于眼眶内或眼眶后间隙的眼眶异物有关。术前,“低伪影”扫描仪的使用使我们能够更好地确定眼眶异物的确切大小和形状。术中导航不够准确,由于眶内脂肪的眶体的流动性。根据我们的经验,术中范围成像更准确。在解剖实验室中成功测试了专用轨道磁体的使用，并允许在我们的一名患者中去除小的轨道异物。提供了术中手术视频。
结论：必须系统地清除植物眼眶异物。非植物眼眶异物的切除应根据其大小逐案考虑,最好使用“低工件”扫描仪进行评估，他们的位置,以及它们内在的铁磁性。术中导航似乎没有用，而术中范围成像。专用轨道磁体可能有助于去除铁磁轨道异物。然而,轨道磁铁可能无法有效移除轨道内子弹，因为它们主要由铜和铅的合金制成。
