Figure 1
Imaging findings in case 1. (a), An umbrella rib entered the orbit from the upper eyelid in the patient. (b), The coronal CT showed that a high-density foreign body had penetrated the left orbit and diagonally down successively through the left nasopharynx, pharynx, right neck, and finally into the right chest, with gas in the soft tissue surrounding the foreign body. (c), About 40 cm of the umbrella rib was inserted into the body.
Imaging findings in case 2. (d), A Chinese rose branch was inserted into the right orbit from the temporal side of the orbit in the patient. (e), An axial CT showed two columns of low-density foreign bodies penetrating from the temporal side of the right orbit, passing through the inner wall of the right maxillary sinus and the posterior of the nasal septum, and extending to the left side of the nasopharynx. (f), Approximately 12 cm of the Chinese rose branch was inserted into the body.
Table 1 The details of five patients with multiorgan-penetrating trauma to the head and neck
Characteristics
Case 1
Case 2
Case 3
Case 4
Case 5
Sex
Female
Male
Male
Female
Female
Age (years)
56
55
53
2
41
Cause
By accident
Suicide
Intentional injury
By accident
By accident
Nature of the foreign bodies
Umbrella rib
Chinese rose branch
Chopsticks
Pencil
Brake lever
Parts involved
Left eye, pharyngeal, neck, right chest
Right eye, right maxillary sinus, nasal septum, left nasopharyngeal wall
Left eye to parapharyngeal space
Right orbital, right ethmoid sinus
Left eye; the left side of the maxillary, ethmoid, and sphenoid sinuses; left frontal lobe
Time from injury to medical treatment
3 hours
4 hours
16 hours
3 hours
3 hours
Length of preoperative hospitalization
3 hours
10 hours
5 hours
7 hours
5 hours
Operation method
Tracheotomy, right neck exploration; removal of a foreign body under thoracoscopic and nasal endoscopic visualization; repair of lung rupture; debridement and suture of eyelid laceration
DSA of right common carotid artery; removal of a right intraorbital foreign body plus ophthalmoscopy; removal of a nasal foreign body under nasal endoscopy; hemostasis of epistaxis
DSA of bilateral common carotid artery; removal of a left orbital craniofacial foreign body
Removal of an ethmoid sinus foreign body
Removal of an intracranial foreign body; suture of the left eyeball rupture; eyelid laceration suture; lumbar puncture and catheter drainage
Multidisciplinary team
Otolaryngology, ophthalmology, thoracic surgery
Ophthalmology, otolaryngology, interventional department
Otolaryngology, ophthalmology, interventional department
Otolaryngology, ophthalmology,
Ophthalmology, neurosurgery, otolaryngology
Sequela
No
No
No
No
Vision loss in the left eye
Outcome
Recovery
Recovery
Recovery
Recovery
Recovery