[Etiology, diagnosis and treatment analysis of 37 cases with orbital fistula].

ABSTRACT

OBJECTIVE: To present some instruction in diagnosis and treatment of the orbital fistula by analyze the clinical manifestation. METHOD: The clinical data for 37 cases with orbital fistula treated during 1980 to 2007 were analyzed retrospectively. RESULTS: Among 37 cases with orbital fistula, there are 21 cases caused by foreign bodies, including 17 cases by retained wooden bodies, 3 cases by iatrogenic foreign bodies and 1 case by firecrackers. There are 9 cases caused by orbital cysts, including 5 cases dermoid cysts, 3 cases epidermoid cysts and 1 case frontal mucopyocele. There are 6 cases orbital infection inflammation, including 5 cases osteomyelitis and 1 case orbital abscess. There is 1 case eosinophilic granuloma. Different etiologies have characteristic features. Medical history, fistula examinations and imaging examinations must be analyzed synthetically in order to make proper etiological diagnosis. Eradicate etiologies and resect fistula are most important. It is necessary to make an ancillary therapy, such as ENT treatment. CONCLUSIONS: The common etiologies of orbital fistula are retained foreign body, dermoid cysts and osteomyelitis. The pathogenesis include infective inflammation, congenital heteroplasia, operation and tumor. B-scan ultrasonography, CT, and MRI can be used for the localization and qualitation diagnosis. There are comprehensive approaches for diagnosis and management of this type of injury. In order to give an effective therapy, we must make an accurate diagnosis and analyze the features of fistula.