[SavageGlow]

A patient with a stab wound in the right orbit, penetrating into the maxillary sinus on the right.

[kellyhound]

On 09.03.2011 at 20:10, a 22-year-old patient V. was admitted to the intensive care unit of the Rybinsk Central District Hospital with a diagnosis of a stab wound in the right orbit, penetrating into the maxillary sinus on the right. Alcohol intoxication.

About an hour ago, the patient was stabbed in the right eye. The ambulance crew delivered to the surgical department. Examined by the surgeon on duty.
On objective examination:
vesicular breathing is carried out in all fields, heart sounds are clear, rhythmic, heart rate is 88 in 1 min. BP 130/80 mm r. Art.

Local status: conscious, a knife handle and partly a blade about 3 cm protrude from the right eye socket. Blood is moderately leaking from the wound. No paresis, no paralysis.

Local status: conscious, a knife handle and partly a blade about 3 cm protrude from the right eye socket. Blood is moderately leaking from the wound. No paresis, no paralysis.
On the x-ray of the skull, a foreign body of the bones of the facial skull on the right is a knife 15 cm long, about 2.3 cm wide, passing through the right orbit, the right maxillary sinus of the nose, the posterior edge of the hard palate and penetrating into the oral cavity. It is located in the cranial cavity at a depth of about 12 cm.
The patient is shown an emergency operation - removal of a foreign body from the facial skull under anesthesia.

Operation: under anesthesia, after processing the surgical field, a knife was removed from the region of the right eye socket. The wound is approximately 3 x 1.5 cm with smooth edges from the upper eyebrow of the right eye through the “meat” (inner edge of the eye), the eyeball is not damaged. Partial damage to the lower eyelid, the wound channel goes from top to bottom. Further, during the revision, there is a gap from the knife hole in the maxillary sinus on the right. Blood is coming out of the right nasal passage. Soft tissues, upper and lower eyelids are sutured with suggestive sutures, the right nasal passage is plugged. No lesions were found in the oral cavity.

Treatment is antibacterial, analgesic therapy.
Postoperative period without complications.
Examined by an otolaryngologist - deviated septum (twice fractured nose in history).
ophthalmologist - Penetrating wound of the appendages of the eye. Traumatic blepharoconjunctivitis. Contusion of the right eyeball of moderate severity.
Neurologist - signs of early contusion of the 1st branch of the trigeminal nerve on the right, glossopharyngeal nerve on the right.
The course of the injury is favorable: the pain syndrome was stopped, the vision of the right eye was preserved, the neurological status was normalized, the wound healed by primary intention.

Discharged 18.03.2011 in a satisfactory condition under the supervision of an ophthalmologist, otolaryngologist.
Surgeon Shneiderman Vadim Lvovich - head of the surgical department, doctor of the highest category.
Assistant Turoshev Vladimir Alekseevich - surgeon.
The patient after discharge was observed by an ophthalmologist, an otolaryngologist. Vision was preserved, pathology from the ENT organs was not detected.

[marcos_69]

Didn't even hurt the eyeball...good for him.