[Endoscopic transnasal or transorbital removal of intraorbital foreign bodies: a single-center case series and literature review].

Objective: To analyze cases of intraorbital foreign bodies (IOFBs) removed via endoscopic transnasal or transorbital approaches from a single center and relevant literature reports, to summarize surgical techniques and diagnostic and therapeutic experiences, and to provide clinical references for endoscopic management of IOFBs. Methods: A total of 10 cases of IOFBs admitted to the Department of Otorhinolaryngology Head and Neck Surgery of the Affiliated Hospital of Qingdao University from September 2016 to September 2024 were collected. All patients were male, with the age of 47.00 (40.00, 66.50) years [M (Q1, Q3)]. Additionally, 20 related cases were retrieved via a comprehensive literature search. Surgical methods (endoscopic transnasal or transorbital approaches) for the removal of IOFBs were described, and clinical features, imaging findings, and therapeutic outcomes were analyzed. Descriptive statistical analysis was performed using Microsoft Excel 2019 software. Results: Most IOFBs removed via endoscopic transnasal or transorbital approaches were located deep in the orbit, and the majority of patients (6 from our single-center series and 15 from the literature review) presented with symptoms of orbital apex injury, including vision loss and limited ocular motility. The density of wooden IOFBs increased over time: initially, they appeared as low-density lesions on CT scans with Hounsfield units (HU) ranging from -330 to -120; after prolonged retention, they converted to hyperdense lesions with CT values of 90-200 HU. Patients with no light perception preoperatively showed poor visual recovery, while most cases of vision loss and limited ocular motility improved postoperatively. Infections and other related symptoms were effectively alleviated. Conclusion: Endoscopic transnasal or transorbital approaches are effective therapeutic methods for deep IOFBs.