Transorbital orbito-cranial foreign bodies have been previously reported. Their removal is often required to prevent meningitis, orbital cellulitis, intracranial abscess, haemorrhage and vascular injuries. In addition, orbital cerebrospinal fluid (CSF) leakage may occur because of dural tears and bony fractures of the orbital roof. The repair of this leakage presents a significant challenge to the surgeon, particularly where the location involves the posterior orbital roof and/or superior orbital fissure. Traditionally, a frontal or subfrontal craniotomy combined with a possible supraorbital osteotomy was performed. We describe a case in which an orbital CSF leakage following foreign body removal was successfully repaired by an endoscopic transorbital approach.
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