Endoscopic Removal of Bullet in Orbit

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