PMC9527848_01
The cutaneous wound on the left inferior eyelid
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The clinical evaluation revealed a small wound (<1 cm) in the left inferior eyelid, associated with anisocoria and loss of left eye vision [Figure 1].
Preoperative CT scan showing the pencil crossing the left orbit toward the brain
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The computed tomography (CT) scan revealed the presence of a completely retained pencil crossing the optic canal into the skull base [Figure 2].
Angiography showing the embolised petrous part of the left ICA
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Since the cerebral perfusion was supplied by the left anterior and left posterior communicating arteries, the petrous part of the left ICA was embolised to prevent massive bleeding during the surgical extraction of the pencil [Figure 3].
The pencil after removal in theatre
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The maxillofacial surgeons proceeded to remove the foreign object through the cutaneous wound in the eyelid [Figure 4].
Postoperative CT scan showing left parietal cranioplasty
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An immediate postoperative CT scan [Figure 5] showed no evidence of bleeding or retained fragments of the foreign body.
Frontal view of the patient 1 year after surgery
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The 1-year follow-up was uneventful, and the child showed good aesthetic outcomes [Figure 6].