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https://www.readbyqxmd.com/read/29349049/the-reliability-of-the-transconjunctival-approach-for-orbital-exposure-measurement-of-positional-changes-in-the-lower-eyelid
#1
Sung Ho Yoon, Jin Hoon Lee
Background: Lower eyelid incisions are widely used for the orbital approach in periorbital trauma and aesthetic surgery. In general, the subciliary approach is known to cause disposition of the lower eyelid by scarring the anterior lamella in some cases. On the other hand, many surgeons believe that a transconjunctival approach usually does not result in such complications and is a reliable method. We measured positional changes in the lower eyelid in blowout fracture repair since entropion is one of the most serious complications of the transconjunctival orbital approach...
December 2017: Archives of Craniofacial Surgery
https://www.readbyqxmd.com/read/29348987/rhino-orbital-cerebral-mucormycosis-a-fatal-complication-of-uncontrolled-diabetes-mellitus
#2
Purva Bavikar, Varshil Mehta
Mucormycosis is a progressively invasive disease, with a fatal outcome, on late presentation. A 38-year-old female presented with diabetic ketoacidosis with right eye ptosis and a frozen globe without any signs of inflammation, externally. She underwent transnasal endoscopic debridement of paranasal sinuses and exenteration of the right eye. The histopathology specimen revealed the growth of mucormycosis. She was treated with intravenous (IV) amphotericin B, IV insulin, and extensive debridement surgery, but had an unfavorable outcome due to rapid mucor invasion to the brain...
November 13, 2017: Curēus
https://www.readbyqxmd.com/read/29348274/sinogenic-intracranial-complications-is-adalimumab-a-culprit
#3
Mikkel Seremet Kofoed, Niels Fisker, Anne Estmann Christensen, Anette Drøhse Kjeldsen
We present two 11-year-old girls with chronic recurrent multifocal osteomyelitis, treated with adalimumab. Both developed severe intracranial complications to sinusitis. Patient 1 had been treated with adalimumab for 15 months when she developed acute sinusitis complicated by an orbital abscess, forehead swelling, a subdural empyema and osteomyelitis of the frontal bone. She was treated with a rhinosurgical and neurosurgical approach with intravenous antibiotics.Patient 2 had been in adalimumab treatment for 10 weeks...
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29344487/enlarging-pigmented-eyelid-mass-associated-with-remote-pencil-trauma
#4
Paul O Phelps, J Andrew Carlson, Dale R Meyer
The authors present a case of a gradually enlarging pigmented mass of the upper eyelid and anterior orbit that was discovered to be the graphite tip of a pencil surrounded by macrophages bearing graphite and fibrous tissue. A 25-year-old woman with no medical history presented with a gradually enlarging pigmented lesion of her left upper eyelid. She denied any history of previous skin cancer, trauma, or previous surgery. A biopsy was performed. This revealed an encapsulated grayish, pigmented mass within the medial portion of the left upper eyelid and anterior orbit...
November 2017: Ocular Oncology and Pathology
https://www.readbyqxmd.com/read/29342439/review-of-ophthalmology-medical-professional-liability-claims-in-the-united-states-from-2006-through-2015
#5
Atalie C Thompson, P Divya Parikh, Eleonora M Lad
PURPOSE: To describe characteristics of closed medical professional liability (MPL) claims against ophthalmologists in the United States. DESIGN: Retrospective analysis of MPL claims from 2006-2015. Data were obtained from the Physician Insurers Association of America (PIAA) Data Sharing Project (DSP). Comparison was made between ophthalmology and all healthcare specialties for physician demographics, prevalence and costs associated with closed claims, and resolution of claims...
January 13, 2018: Ophthalmology
https://www.readbyqxmd.com/read/29339322/endoscopic-endonasal-craniofacial-surgery-for-recurrent-skull-base-meningiomas-involving-the-pterygopalatine-fossa-the-infratemporal-fossa-the-orbit-and-the-paranasal-sinus
#6
Masahiro Shin, Masaaki Shojima, Kenji Kondo, Hirotaka Hasegawa, Shunya Hanakita, Akihiro Ito, Taichi Kin, Nobuhito Saito
OBJECT: Skull base meningiomas carry a non-negligible risk of recurrence. In particular, those arising from the sphenoid wings or middle cranial fossa penetrate into extracranial regions, uncommonly showing massive expansion into the craniofacial regions on recurrence. The role of endoscopic endonasal surgery for those intractable lesions remains unclear. METHODS: We performed endoscopic endonasal craniofacial surgery for 8 recurrent meningiomas invading into the pterygopalatine fossa, infratemporal fossa, nasopharynx, paranasal sinus, or orbit, comprising 2 meningothelial and 1 fibrous meningiomas (WHO grade I), 3 atypical and 1 clear cell meningiomas (grade II), and 1 anaplastic meningioma (grade III)...
January 12, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29338280/variable-skeletal-anatomical-features-of-acromegaly-in-the-skull-and-craniocervical-junction
#7
Maria Piagkou, Othon Manolakos, Theodore Troupis, Nikolaos Lazaridis, Konstantinos Laios, Alexandros Samolis, Konstantinos Natsis
OBJECTIVE: This study adds important information regarding the morphological alterations caused by growth hormone hypersecretion in the skull and craniocervical junction (CCJ). A variably asymmetric skull due to acromegaly coexists with expansion of the paranasal sinuses and multiple Wormian bones. CASE REPORT: A pathologically asymmetric dry skull of a European male, aged 38 years at death, with cranial vault and skull base thickening is described. The extensive paranasal sinus pneumatization caused a generalized thinning of the bony walls...
November 2017: Acta Medica Academica
https://www.readbyqxmd.com/read/29337012/expanding-the-limits-of-endoscopic-intraorbital-tumor-resection-using-3-dimensional-reconstruction
#8
Luciano Lobato Gregorio, Nicolas Y Busaba, Marcel M Miyake, Suzanne K Freitag, Benjamin S Bleier
INTRODUCTION: Endoscopic orbital surgery is a nascent field and new tools are required to assist with surgical planning and to ascertain the limits of the tumor resectability. OBJECTIVE: We purpose to utilize three-dimensional radiographic reconstruction to define the theoretical lateral limit of endoscopic resectability of primary orbital tumors and to apply these boundary conditions to surgical cases. METHODS: A three-dimensional orbital model was rendered in 4 representative patients presenting with primary orbital tumors using OsiriX open source imaging software...
December 26, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/29336295/transnasal-endoscopic-resection-of-pediatric-orbital-cyst-how-i-do-it
#9
Jingying Ma, Zhenxiao Huang, Bing Zhou
BACKGROUND: An orbital cystic lesion is a common orbital disease and has classically been approached via external incision. The introduction of endoscopic surgery has revolutionized the management of sinus and skull base disorders. Similarly, endoscopic techniques have been increasingly used to access intraorbital lesions with excellent outcomes, especially in pediatric patients. OBJECTIVE: We described, in detail, the surgical technique of the endoscopic approach to treat a pediatric orbital cyst...
January 1, 2018: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29335798/3d-morphological-change-of-skull-base-and-fronto-temporal-soft-tissue-in-the-patients-with-unicoronal-craniosynostosis-after-fronto-orbital-advancement
#10
Bin Yang, Jian Ni, Binghang Li
PURPOSE: This study aims to comprehensively evaluate the deformation of the skull base and fronto-temporal soft tissue in the patients with anterior plagiocephaly over 1 year of age by three-dimensional (3D) imaging after fronto-orbital advancement (FOA). METHODS: We quantitatively analyzed the surgical results and outcome of FOA performed in 10 patients with anterior plagiocephaly. The measurements of the skull base and fronto-temporal soft tissue were performed based on 3D computed tomography (CT) scan...
January 15, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29334542/medial-buttressing-in-orbital-blowout-fractures
#11
Sathyadeepak Ramesh, Christine Bokman, Hamzah Mustak, Christopher Lo, Robert Goldberg, Daniel Rootman
PURPOSE: To study whether ethmoidectomy predisposes the orbit to medial wall fracture with lesser trauma. METHODS: An interventional cadaver study of 5 heads (10 orbits); the left or right orbit was randomized to undergo endoscopic complete ethmoidectomy with the fellow orbit as control. Fractures were induced with direct globe trauma, and heads underwent CT scanning. Energy to induce fracture, peak orbital pressure at time of fracture, fracture pattern, and volume of herniated tissue were measured and analyzed...
January 12, 2018: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29329172/clinical-features-and-outcomes-of-post-traumatic-silent-sinus-syndrome
#12
Edward J Wladis, Robert C Kersten, M Reza Vagefi, Carlos Pinheiro-Neto, Roman Shinder, H Jane Kim
PURPOSE: To identify demographic features and clinical outcomes associated with post-traumatic silent sinus syndrome. METHODS: A retrospective review was carried out at 3 academic medical centers to identify all cases of post-traumatic silent sinus syndrome. Clinical features and management strategies were recorded. Postoperative outcomes were assessed, and statistical analyses were performed via a dedicated computerized software package. RESULTS: Twenty cases were identified (14 men and 6 women, mean age = 44...
January 10, 2018: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29325886/comparison-analysis-of-orbital-shape-and-volume-in-unilateral-fractured-orbits
#13
Johanna Nilsson, Johan Nysjö, Anders-Petter Carlsson, Andreas Thor
Facial fractures often result in changes of the orbital volume. These changes can be measured in three-dimensional (3D) computed tomography (CT) scans for preoperative planning and postoperative evaluation. The aim of this study was to analyze the orbital volume and shape before and after surgical treatment of unilateral orbital fractures using semi-automatic image segmentation and registration techniques. The orbital volume in 21 patients was assessed by a semi-automatic model-based segmentation method. The fractured orbit was compared relative to the contralateral orbit...
December 21, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29325384/-diagnosis-and-treatment-of-strabismus-caused-by-nasal-endoscopic-surgery
#14
L K Ai, X Wu, J N Wang, J Li, Y Wu, J Zhou, W X Song, R L Guo
Objective: Strabismus with diplopia is the main orbital complication of functional endoscopic sinus surgery (FESS). This study was to analyze clinical findings, treatment and outcomes of such cases. Methods: Retrospective case series. Twenty-three cases were divided into 3 groups based on the disease severity: group A, partial transection of the medial rectus muscle, group B, complete transection of the medical rectus, group C, transection of the medial rectus combined with the other orbital injuries. Complete ophthalmology examinations, including eye alignment, eye motility, force duction test, force generation test, general eye exam, and medical imaging (orbital CT or MRI), were performed for each case...
December 11, 2017: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/29319595/pythium-keratitis-leading-to-fatal-cavernous-sinus-thrombophlebitis
#15
Anubha Rathi, Arunaloke Chakrabarti, Tushar Agarwal, Neelam Pushker, Mukesh Patil, Hemant Kamble, Jeewan S Titiyal, Rishi Mohan, Seema Kashyap, Sanjay Sharma, Seema Sen, Gita Satpathy, Namrata Sharma
PURPOSE: To report a case of Pythium insidiosum keratitis leading to fatal cavernous sinus thrombophlebitis. METHODS: Case report. RESULTS: A 70-year-old man presented with excruciating pain, redness, and diminution of vision in his left eye for 2 weeks after washing his hair with tap water. A total corneal ulcer with surrounding infiltrates and associated corneal thinning was present. Corneal scraping revealed the presence of Gram-positive cocci...
January 9, 2018: Cornea
https://www.readbyqxmd.com/read/29319400/deep-lateral-wall-orbital-decompression-following-strabismus-surgery-in-patients-with-type-ii-ophthalmic-graves-disease
#16
Michael P Ellis, Emily C Broxterman, Alan R Hromas, Thomas J Whittaker, Jason A Sokol
PURPOSE: Surgical management of ophthalmic Graves' disease traditionally involves, in order, orbital decompression, followed by strabismus surgery and eyelid surgery. Nunery et al. previously described two distinct sub-types of patients with ophthalmic Graves' disease; Type I patients exhibit no restrictive myopathy (no diplopia) as opposed to Type II patients who do exhibit restrictive myopathy (diplopia) and are far more likely to develop new-onset worsening diplopia following medial wall and floor decompression...
January 10, 2018: Orbit
https://www.readbyqxmd.com/read/29319378/nonhealing-orbital-floor-fracture-in-a-pediatric-patient-a-unique-presentation-of-pseudo-silent-sinus-syndrome
#17
Siwei Zhou, Katherine Duncan, S Tonya Stefko
Silent sinus syndrome was first described as spontaneous enophthalmos and hypoglobus associated with subclinical maxillary sinusitis without prior trauma or surgery. This clinical entity has later been described after trauma in which damage to the ostiomeatal complex leads to atelectasis of the maxillary sinus. We report a case of a 14-year-old boy who presented 4 years after sustaining a non-operative orbital floor fracture with enophthalmos and transient diplopia. Computed tomography (CT) demonstrated enlargement in size of the original orbital floor fracture and bilateral maxillary sinus disease...
January 10, 2018: Orbit
https://www.readbyqxmd.com/read/29317363/spheno-orbital-meningiomas-surgery-multicenter-management-study-for-complex-extensive-tumors
#18
Louis-Marie Terrier, Florian Bernard, Henri-Dominique Fournier, Xavier Morandi, Stéphane Velut, Pierre-Louis Hénaux, Aymeric Amelot, Patrick François
BACKGROUND: Spheno-orbital meningiomas (SOMs) are complex tumors involving the sphenoid wing, the orbit, and sometimes the cavernous sinus with bone hyperostosis and sheet-like dural involvement. Optimal removal, proptosis cure and visual preservation remain a challenge. OBJECTIVE: To study the management of surgically treated SOMs METHODS: The clinical records of 130 consecutive patients undergoing surgery for SOMs were retrospectively collected in a database during a 20-year period to analyze symptoms, surgical technique, clinical outcome, and follow-up...
January 6, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29317144/comparison-of-clinicoradiological-findings-between-patients-with-recovering-diplopia-and-those-with-residual-diplopia-after-surgery-for-pure-orbital-blowout-fracture
#19
Hye Na Jung, Sang-Il Suh, Hyung-Jin Kim, Inseon Ryoo
PURPOSE: Diplopia is a common symptom of blowout fracture (BOF), and can persist after proper surgical management. We compared clinicoradiological findings between patients with recovering diplopia and those with residual diplopia after surgery for orbital BOF. MATERIALS AND METHODS: We retrospectively evaluated the CT images of 170 patients with orbital BOF and preoperative diplopia. We reviewed the following factors: sex, age, mechanism of injury, presence of diplopia before surgery, presence of enophthalmos before surgery, presence of an ocular motility abnormality before surgery, time interval between the trauma and surgery, fracture type, fracture size, volume of herniated orbital soft tissue, ratio of the volume of herniated orbital soft tissue to fracture size, number of points of contact between the extraocular muscle (EOM) and bony edge, EOM swelling, EOM swelling ratio, EOM displacement, EOM circling, EOM tenting, and EOM entrapment...
December 15, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29310408/case-report-repairing-orbital-skin-defects-using-composite-flaps-after-giant-eyelid-derived-tumor-excision-and-orbital-exenteration
#20
Bin Fan, Jian-Ju Liu, Bei-Fen Wang, Ying-Jian Sun, Guang-Yu Li
RATIONALE: Though giant malignant tumors arising in the eyelid are rare, they often require extensive surgery for removal along with orbital exenteration. Because of this, repairing orbital defects is an important factor in the surgical strategy. PATIENT CONCERNS: Case 1 was a 78-year-old nomad man who presented in the Department of Ophthalmology with a giant tumor in his right eyelid, which had developed over three years. Clinical examination revealed a huge pigmented, nonhealing ulcerated lesion, approximately 52×44×40 mm in size...
December 2017: Medicine (Baltimore)
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