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Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body

CPT4 code

Name of the Procedure:

Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body

Summary

An orbitotomy without bone flap is a surgical procedure used to remove a foreign object from the eye socket (orbit) using either a frontal or transconjunctival approach. The procedure does not involve removing any bone, making it less invasive.

Purpose

This procedure is performed to address the presence of a foreign body in the eye socket, which could be causing pain, vision problems, or other complications. The main goal is to safely remove the object, alleviate symptoms, and prevent further damage to the eye or surrounding structures.

Indications

  • Presence of a foreign object in the eye socket
  • Pain or discomfort in the orbital area
  • Vision impairment caused by the foreign body
  • Swelling or infection due to the foreign object

Preparation

  • Fasting for at least 6-8 hours before the procedure
  • Adjustments to medications, especially blood thinners, as advised by the doctor
  • Pre-operative imaging tests like CT scans or MRIs to locate the foreign body

Procedure Description

  1. The patient is given local or general anesthesia to ensure comfort during the procedure.
  2. A small incision is made either on the frontal part of the orbit or through the conjunctiva (inner surface of the eyelid).
  3. Specialized surgical tools are used to carefully locate and remove the foreign body.
  4. The incision is then closed, and sterile dressings are applied to the area.

Duration

The procedure typically takes 1-2 hours, depending on the complexity and location of the foreign body.

Setting

The procedure is usually performed in a hospital operating room or a specialized surgical center.

Personnel

  • Ophthalmic surgeon or oculoplastic surgeon
  • Surgical nurses
  • Anesthesiologist

Risks and Complications

  • Infection
  • Bleeding
  • Injury to surrounding tissues including the eye
  • Vision changes
  • Scarring
  • Adverse reactions to anesthesia

Benefits

  • Relief from pain and discomfort
  • Restoration of normal vision
  • Prevention of potential complications like infections or further tissue damage
  • Improved quality of life

Recovery

  • Use of prescribed antibiotics or anti-inflammatory medications
  • Application of cold compresses to reduce swelling
  • Avoidance of strenuous activities for several days
  • Follow-up appointments to monitor healing and ensure no complications

Alternatives

  • Non-surgical removal, if the foreign body is superficial
  • Use of medications to reduce symptoms
  • Observation, in cases where the foreign body is not causing immediate harm Compared to these alternatives, orbitotomy provides a definitive solution for deeper or more problematic foreign bodies.

Patient Experience

  • Patients may experience mild discomfort or pain post-surgery, manageable with prescribed medications.
  • Swelling and bruising around the surgical site are common and typically resolve within a few days.
  • Vision may be temporarily affected but usually returns to normal as healing progresses.
  • Follow-up care ensures continuous monitoring and timely management of any complications.

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