RESUMEN
BACKGROUND: We present the case of a 51-year-old male with an occult transorbital intracranial injury after a car accident. The identified foreign object was a windshield wiper handle. To our knowledge, this is the first case reported. CASE DESCRIPTION: Multidisciplinary treatment with maxillofacial and otorhinolaryngology departments was planned. A bifrontal craniotomy with removal of the foreign object and posterior orbital reconstruction were performed. A review of the literature was done, in order to highlight certain general principles in decision making despite the variability in case presentation. CONCLUSIONS: Occult TII is a rare subtype of penetrating brain injury. Diagnosis requires high suspicion as it can be missed during physical examination. Computed tomography (CT) scan, CT angiogram, and magnetic resonance imaging should be performed in order to design the optimal treatment for each patient. Magnetic resonance imaging should be avoided when metallic density on CT is observed. The use of a broad-spectrum antibiotic regimen is critical.
Asunto(s)
Cuerpos Extraños/diagnóstico por imagen , Cuerpos Extraños/cirugía , Traumatismos Penetrantes de la Cabeza/diagnóstico por imagen , Traumatismos Penetrantes de la Cabeza/cirugía , Órbita/lesiones , Accidentes de Tránsito , Cuerpos Extraños/etiología , Traumatismos Penetrantes de la Cabeza/etiología , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Neuroquirúrgicos/métodos , Órbita/diagnóstico por imagen , Órbita/cirugía , Resultado del TratamientoRESUMEN
Introducción y objetivos: La inflamación crónica del conducto lacrimonasal con la consiguiente obstrucción del flujo de la lágrima es llamada dacriocistitis crónica. Mediante la dacriocistorrinostomía por vía endoscópica, es posible resolver esta obstrucción poniendo en comunicación el saco lacrimal directamente con la luz de la fosa nasal, sin cicatrices externas y de una forma relativamente sencilla y segura. Métodos: Se realiza una revisión de los casos intervenidos mediante esta técnica entre enero de 1996 y junio de 2008. Se estudian las características epidemiológicas de los pacientes, así como los resultados obtenidos, tanto en mejoría sintomática (subjetiva) como en mejoría del drenaje comprobada por el cirujano a la exploración (objetiva). Resultados: Un total de 76 dacriocistorrinostomías fueron realizadas en este período. De ellas, el 75% se trataba de pacientes mujeres. La edad media fue de 52,4 años. En un 80,3% de las intervenciones el paciente refería mejoría (total o parcial) de los síntomas, lo que se asemeja a los resultados arrojados por otras series. Conclusiones: La dacriocistorrinostomía realizada por vía endoscópica endonasal constituye una técnica sencilla y segura para el tratamiento de la dacriocistitis crónica, aportando unas tasas de curación/mejoría similares o superiores a las de otras técnicas. Las tasas de mejoría observadas en nuestra serie coinciden con las observadas en otros estudios (AU)
Introduction: Chronic inflammation of nasolacrimal duct determines obstruction of the lacrimal flow and is called chronic dacryocystitis. Endoscopic dacryocystorhinostomy (DCR) can solve this obstruction by opening the lacrimal sac directly to the nasal cavity, avoiding external scars in a simple, safe way. Material and method: We reviewed all cases operated using this technique between January 1996 and June 2008. We focused on demographic characteristics as well as the results obtained (subjective and objective improvements). Results: We reviewed 76 Endoscopic DCR that were performed during aforementioned period of time. Of these cases, 75% were females; mean age was 52.4 years old. Improvement in symptoms was reported by 80.3% of the patients. These data are similar to the results seen in other studies. Conclusions: Endoscopic dacryocystorhinostomy is a simple, safe technique for treating chronic dacryocystitis, which provides similar or even better rates of improvement than other techniques used for this condition. In our patients, the results are not different from those observed in other studies. Our outcomes are comparable to those observed in other studies (AU)
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Dacriocistorrinostomía/métodos , Dacriocistorrinostomía , Endoscopía/métodos , Obstrucción Nasal/complicaciones , Obstrucción Nasal/cirugía , Anestesia General , Sonda de Prospección , Prótesis e Implantes , Cavidad Nasal/patología , Cavidad Nasal/cirugía , Cavidad Nasal , Mortalidad/estadística & datos numéricosRESUMEN
INTRODUCTION: Chronic inflammation of nasolacrimal duct determines obstruction of the lacrimal flow and is called chronic dacryocystitis. Endoscopic dacryocystorhinostomy (DCR) can solve this obstruction by opening the lacrimal sac directly to the nasal cavity, avoiding external scars in a simple, safe way. MATERIAL AND METHOD: We reviewed all cases operated using this technique between January 1996 and June 2008. We focused on demographic characteristics as well as the results obtained (subjective and objective improvements). RESULTS: We reviewed 76 Endoscopic DCR that were performed during aforementioned period of time. Of these cases, 75% were females; mean age was 52.4 years old. Improvement in symptoms was reported by 80.3% of the patients. These data are similar to the results seen in other studies. CONCLUSIONS: Endoscopic dacryocystorhinostomy is a simple, safe technique for treating chronic dacryocystitis, which provides similar or even better rates of improvement than other techniques used for this condition. In our patients, the results are not different from those observed in other studies. Our outcomes are comparable to those observed in other studies.
