Abstract
Orbitofrontal foreign-body injuries comprise a major cause of all facial injuries
referred to a neurosurgeon. The authors hereby present an unusual case of a pressure
regulator of a domestic pressure cooker impacted into the orbit and extending through
the orbital roof into the basifrontal cortex. The globe was intact externally with
no obvious sign of such a large object impacted behind the globe. On imaging, the
foreign body was found to have fractured the orbital roof with one end protruding
into the basifrontal cortex. A transcranial approach was taken to remove the object
with removal of the orbital rim and roof to reach the object. After successful retrieval
of the metallic body, all displaced bone fragments were removed and the dural closure
was done in a watertight manner. The vision could not be salvaged, most likely due
to damage to the optic nerve. However, the globe was left intact and the ocular movements
were normal. An important factor to consider in removal of such foreign bodies is
that the bone fragments that get impacted should be meticulously removed and the dural
tears should be sealed to prevent any intracranial infections and cerebrospinal fluid
leaks. Removal of the orbital rim helps in adequate exposure of the retro-orbital
space and the basifrontal dura.
Keywords
pressure cooker - foreign body - orbitofrontal - pressure regulator
