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Orbital apex

Sarah M Jacobs, Colin P McInnis, Matthew Kapeles, Shu-Hong Chang
PURPOSE: Severe vision loss is a risk of orbital surgery which physicians should counsel patients about, but the overall risk rate is unknown. This research was conducted to determine the risk of severe vision loss related to orbital surgery. DESIGN: Retrospective review. PARTICIPANTS: Patients who underwent orbital surgery at either of 2 academic medical centers between January 1994 and December 2014. METHODS: A billing database search was conducted to identify all patients who had orbital surgery during the study period, cross-checked against diagnostic codes related to vision loss...
March 15, 2018: Ophthalmology
Houda Lajmi, Wassim Hmaied, Wady Ben Jalel, Khaoula Ben Romdhane, Zied Chelly, Lamia El Fekih
Backgroud: The fronto-ethmoidal mucocele is a benign condition leading commonly to limited eye movement or ocular pain but it could also induce visual acuity impairment by compressing the optic nerve Aim: To discuss, through a case report, different ophthalmologic manifestations of the fronto-ethmoidalmucocele. Reported case: A 46-years-old man with no general history consulted for a bilateral ocular redness and itching. He reported, however, a mild protrusion of his left globe evolving for oneyear. The clinical examination revealed a unilateral proptosis in the left eye with a discrete limitation of theadduction...
June 2017: La Tunisie Médicale
Sandra Zečević Penić, Marijana Lisak, Tomislav Gregurić, Hrvoje Hećimović, Vanja Bašić Kes
This case report presents a patient diagnosed with Tolosa-Hunt syndrome (THS) after an extensive neuro-diagnostic and neuroimaging evaluation. Diagnostic work-up included thorough physical and neurological examination, complete laboratory serum assessments, neuroendocrine and immunohistochemistry analysis, cerebrospinal fluid analysis, neurophysiology assessment, ophthalmologist examination and neuroimaging. Th e most important diagnostic tool in deriving the diagnosis of THS was neuroimaging evaluation that included baseline and follow-up cranial contrast enhanced magnetic resonance imaging (MRI)...
June 2017: Acta Clinica Croatica
Margaret L Pfeiffer, Helen A Merritt, Lucy A Bailey, Karina Richani, Margaret E Phillips
Purpose: To describe a case of orbital apex syndrome as a result of isolated bacterial sinusitis. Observations: A 63-year-old woman presented with an orbital apex syndrome from isolated bacterial sinusitis with rapidly declining visual acuity to no light perception. We compared our case with 6 similar cases of severe vision loss from isolated bacterial sinusitis. In contrast to previously published cases, our patient presented with good vision yet deteriorated to no light perception despite appropriate treatment...
June 2018: American Journal of Ophthalmology Case Reports
Devang Gupta, Monica Gadodia
To quantify the successful outcome in patients following optic nerve decompression in post traumatic unilateral optic neuropathy in form of improvement in visual acuity. A prospective study was carried out over a period of 5 years (January 2011 to June 2016) at civil hospital Ahmedabad. Total 20 patients were selected with optic neuropathy including patients with direct and indirect trauma to unilateral optic nerve, not responding to conservative management, leading to optic neuropathy and subsequent impairment in vision and blindness...
March 2018: Indian Journal of Otolaryngology and Head and Neck Surgery
Edward Margolin, Cindy T Y Lam
BACKGROUND: Diplopia can be the result of benign or life-threatening etiologies. It is imperative for the emergency physician to be proficient at assessing diplopia and recognize when urgent referral or neuroimaging is required. OBJECTIVE: The first part of this review highlights a simple framework to arrive at the appropriate disposition of diplopic patients presenting to the emergency department (ED). The second part of this review provides more detail and further management strategies...
February 6, 2018: Journal of Emergency Medicine
Devin Ruiz, Elie E Rebeiz
INTRODUCTION: Venous malformation is a common tumor of the orbit, presenting with visual impairment and proptosis. These lesions can be excised via an external or transcranial approach, but recent advances in minimally invasive surgery have led to increased popularity of endoscopic approach. PATIENT: The authors report a 62-year-old female presenting with diplopia and proptosis, found to have a 1.7-cm venous malformation of the orbital apex. An endoscopic trans-nasal approach was undertaken for surgical resection...
February 6, 2018: Journal of Craniofacial Surgery
Pradeep Goyal, Steven Lee, Nishant Gupta, Yogesh Kumar, Manisha Mangla, Kusum Hooda, Shuo Li, Rajiv Mangla
Orbital apex disorders include orbital apex syndrome, superior orbital fissure syndrome and cavernous sinus syndrome. These disorders result from various etiologies, including trauma, neoplastic, developmental, infectious, inflammatory as well as vascular causes. In the past, these have been described separately based on anatomical locations of disease process; however, these three disorders share similar causes, diagnostic evaluation and management strategies. The etiology is diverse and management is directed to the causative process...
January 1, 2018: Neuroradiology Journal
Wolf A Lagrèze, Lutz Joachimsen, Nikolai Gross, Christian Taschner, Jochen Rössler
Microcystic lymphatic malformations are difficult to treat surgically, especially when located in the orbital apex. Recently, pharmacologic inhibition of the mTOR pathway by sirolimus was reported as a safe and efficacious treatment option for lymphatic malformations (also known as lymphangiomas). We report the case of a young male patient in which a unilateral, retrobulbar lymphatic malformation regressed to a large extent under treatment with 1 mg sirolimus given orally twice a day over a period of six months...
February 6, 2018: Orbit
Lauren Crawford, Sanjeev Sharma
Orbital apex metastasis from adenoid cystic carcinoma (ACC) is rare. We present a patient with known metastatic ACC presented with a rapidly declining vision with visual acuity oculus dexter (OD) equal to counting fingers at two feet. On imaging, she was found to have a right orbital apex tumor causing compressive optic neuropathy. She received the intensity modulated radiation therapy (IMRT). After completion of the therapy, she had regained essentially a full vision with visual acuity OD of 20/30 without corrective lenses...
November 22, 2017: Curēus
Hamid Borghei-Razavi, Huy Q Truong, David T Fernandes-Cabral, Emrah Celtikci, Joseph D Chabot, S Tonya Stefko, Eric W Wang, Carl H Snyderman, Aaron Cohen-Gadol, Paul A Gardner, Juan C Fernández-Miranda
BACKGROUND: Minimally invasive accesses to the anterior skull base include the endoscopic endonasal approach (EEA) and the supraorbital eyebrow approach. These 2 are often seen as competing approaches, not alternative or combinatory approaches. In this study, we evaluated the anatomic limitations of each approach and the combined approach for accessing the anterior skull base. METHODS: Ten neurovascular injected cadaver heads were used for the study. The supraorbital approach to the anterior skull base was performed on 5 heads, and EEA was done on the other 5 heads...
February 19, 2018: World Neurosurgery
Hai Jin, Shun Gong, Kaiwei Han, Junyu Wang, Liquan Lv, Yan Dong, Danfeng Zhang, Lijun Hou
OBJECTIVES: Both traumatic orbital apex syndrome (OAS) and traumatic superior orbital fissure syndrome (SFOS) are rare conditions after craniofacial injury. Few types of researches investigate the difference in clinical characteristics and outcome between them. We describe clinical features and cranial nerves functional recovery of traumatic OAS or SOFS and to discuss surgical decompression of these patients. PATIENTS AND METHODS: A retrospective study was performed of 15 patients diagnosed with traumatic OAS and 39 patients with traumatic SOFS from July 2010 to July 2017 in our hospital...
December 30, 2017: Clinical Neurology and Neurosurgery
Lance Bodily, Jenny Yu, Dante Sorrentino, Barton Branstetter
Purpose: Orbital apex syndrome due to spread of infectious sinusitis is a serious disease, often with an insidious presentation with few ophthalmic signs and symptoms. Failure to recognize and treat infectious orbital apex syndrome early portends a grave prognosis, including profound, permanent visual loss and potentially death. Herein we describe a representative case and discuss the relevant aspects of prompt diagnosis and treatment. Observations: An unusual case of infectious orbital apex syndrome due to contiguous spread of Streptococcus viridans sphenoethmoiditis in a hospitalized, immunosuppressed patient with acute myelogenous leukemia is presented...
December 2017: American Journal of Ophthalmology Case Reports
Mohab Abozed, Ghanem Alsulaiti, Fatema Almannaei, Ali Raza, Ahmed El Beltagi, Ali Ayyad
A 66 year old Indian gentleman presented with a 3 days history of headache and gradual progressive loss of vision in his eft eye, ophthalmological assessment showed no light perception in his left eye with papilledema and afferent papillary defect. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) were done and showed an expanding lesion in the left anterior clinoid process encroaching upon the left orbital apex and optic nerve with features suggestive of a mucocele. Patient was started on dexamethasone, and urgent craniotomy was undertaken, where marsupialization and resection of left anterior clinoid mucocele was done, and histopathologic examination of the operative specimen was consistent with a mucocele...
June 2017: ENeurologicalSci
Zhenxing Li, Danfeng Zhang, Jigang Chen, Junyu Wang, Liquan Lv, Lijun Hou
Objective: Traumatic orbital apex syndrome (TOAS) is a rare disease characterized by the damage of cranial nerves (CNs) II, III, IV, and VI. The aim of our study was to analyze the functional recovery of CNs in TOAS and discuss the management of these patients. Methods: We retrospectively reviewed 28 patients with TOAS treated in the Department of Neurosurgery, Shanghai Changzheng Hospital from February 2006 to February 2016. Functional recovery of CNs was evaluated based on extraocular muscle movement and visual perception...
2017: BioMed Research International
Luke Halliday, Paul Ikgan Sia, Dinesh Selva, Bobby S Korn
A 64-year-old man presented with a 3-month history of diplopia and left-sided proptosis. Examination was significant for impairment of his left second, third, fourth, fifth, sixth and seventh cranial nerves. Magnetic resonance imaging revealed a left orbital apex and cavernous sinus lesion. However, subtle thickening of his left frontal and supraorbital nerve was not identified until later. A trial of steroids provided minimal effect. Biopsy of the lesion showed a well-differentiated squamous cell carcinoma...
December 14, 2017: Survey of Ophthalmology
Nadia Daldoul, Leila Knani, Faten Gatfaoui, Hechmi Mahjoub
Our study aimed to describe the therapeutic management of moderate and severe dysthyroid orbitopathies and to evaluate the factors associated with optic neuropathy as well as the prognostic factors of poor visual outcome using a statistical analysis. We conducted a retrospective study of 22 patients presenting with moderate to severe dysthyroid orbitopathy in at least one eye and hospitalized in the Department of Ophthalmology at the University Hospital Farhat Hached, Sousse over the period from 1998 to 2015...
2017: Pan African Medical Journal
Dong Li, Haoli Mao, Zheyuan Yu, Liang Xu, Jie Yuan, Min Wei
Orbital hypertelorism is a common congenital craniofacial anomaly in Asians. As Tessier pointed out, the correction of hypertelorism is effectively the correction of the nasal deformity, which is characterized by a broad, flat nose accompanying an increased interorbital distance and a lack of nasal projection. OBJECTIVES: To measure the changes in the orbital and nasal parameters after Tessier box osteotomy and primary aesthetic rhinoplasty, performed concurrently with otogenous costochondral graft...
January 2018: Journal of Cranio-maxillo-facial Surgery
M Shahidatul-Adha, E Zunaina, A T Liza-Sharmini, W H Wan-Hazabbah, I Shatriah, I Mohtar, Y Azhany, H Adil
INTRODUCTION: Ocular tuberculosis (TB) encompasses a broad spectrum of clinical manifestations affecting different structures of the eye. It is caused by Mycobacterium tuberculosis, a great ancient organism that induces various types of diseases and unfavorable outcomes if unrecognized and not well treated. PURPOSE: To report the clinical profile of 34 ocular TB cases observed during 6 years period in Hospital Universiti Sains Malaysia (HUSM). METHOD: A retrospective review of medical records from 34 patients diagnosed with ocular TB in HUSM from January 2011 until December 2016...
December 2017: Annals of Medicine and Surgery
Yasuhiro Takahashi, Yoshiyuki Kitaguchi, Maria Suzanne Sabundayo, Hirohiko Kakizaki
PURPOSE: The inferior oblique muscle branch of the oculomotor nerve is susceptible to injury during orbital fat removal from the inferolateral quadrant of the orbit. Understanding the amount of removable orbital fat volume in this quadrant may be helpful in achieving maximum fat decompression without causing nerve injury. The aim of this study was to calculate the orbital fat volume in the inferolateral quadrant using computed tomographic (CT) images. METHODS: In this retrospective, observational study, contiguous 1-mm coronal CT images were obtained from 53 sides (30 patients)...
October 20, 2017: International Ophthalmology
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