Intranasal migration of a 35-year-old orbital plate presenting as unilateral epiphora

Abstract

Migration of orbital implants is a rare complication, which can present many years after initial placement and with a wide variety of symptoms. We describe a case of the oldest nasal foreign body in the literature in a 69-year-old male who presented with unilateral epiphora 35 years after a facial trauma. In-office examination revealed a fungal ball in the middle meatus surrounding a migrated silicone orbital floor plate. Our patient improved after removal of the foreign body and treatment for chronic bacterial and fungal sinusitis. He later underwent dacryocystorhinostomy for continued epiphora related to complications from his prior facial fractures. Although migration of orbital implants is a rare complication, any ocular or nasal symptoms should raise suspicion for complications of facial implant migration, even with a very remote history of trauma. Keywords: Orbital implant migration, Orbital implant extrusion, Nasal foreign body, Epiphora, Dacrocystitis, Chronic sinusitis