Endoscopic Removal of Bullet in Orbit

Survey

Synopsis

  • A 65-year-old male with bullet lodged in left orbit. After one year, normal vision began to deteriorate and patient developed eye pain. A decision was made to attempt endoscopic trans-nasal removal of the bullet.

Highlights:

  • Creation of large maxillary antrostomy for access
  • Opening into orbit through roof of maxillary sinus
  • Identification of inferior rectus muscle
  • Dissection with blunt instrumentation to free bullet from surrounding orbital contents