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Biomedical subjects

Dale R Meyer

Publications and source records attributed to Dale R Meyer.

At least 19 recordsLinked to original sources
PubMed2006

Pediatric ophthalmic computed tomographic scanning and associated cancer risk.

PURPOSE: To review pediatric neuroimaging studies of the head and orbit and the radiation-induced cancer risk associated with computed tomography in light of recent attention to pediatric radioimaging by the US Food and Drug Administration, the National Cancer Institute, pediatricians, and radiologists. DESIGN: Perspective. METHODS: Literature review. SETTING: Institutional. PATIENT POPULATION: Pediatric ophthalmic patients requiring neuroimaging studies. INTERVENTION/PROCEDURE: Review of the current literature. MAIN OUTCOME MEASURES: After review of the current literature and discussion of the related issues, recommendations are made for pediatric neuroimaging studies of the head and orbit. RESULTS: Computed tomography (CT) of the head and orbit may be performed in children with the appropriate indications as long as the radiation exposure is minimized. CONCLUSIONS: Information obtained from CT scans of the head and orbit may determine or affect management in the pediatric ophthalmic population. Because of the concern of cancer induced by radiation exposure in children, neuroimaging modalities without radiation exposure, such as magnetic resonance imaging or ultrasound, may be considered. However, when CT is indicated, it is reasonable and acceptable to perform CT of the head and orbit while minimizing the radiation exposure, thereby adhering to the "ALARA" (as low as reasonably achievable) policy recommended by the US Food and Drug Administration. Further studies of the actual radiation dose delivered during pediatric CT of the head and orbit and the true incidence of radiation-induced cancers after scans are warranted.

Child↗
PubMed2006

Acquired nasolacrimal duct obstruction.

Acquired nasolacrimal duct obstruction is a common problem. Although tearing is the usual complaint, the clinical presentation can range from a patient having no symptoms to one with a life-threatening infection. Despite many studies providing useful clues, the exact pathophysiology of the obstructive process is incompletely understood. The clinician must be able to accurately make the diagnosis, which is often a clinical one, because many treatments with excellent success are available.

Humans↗
PubMed2005

Cosmetic oculofacial applications of botulinum toxin: a report by the American Academy of Ophthalmology.

OBJECTIVE: To determine the safety and effectiveness of botulinum toxin for cosmetic oculofacial use. METHODS: Literature searches for relevant citations were conducted in October 2003 for the years 1965 to 2003. The panel reviewed and rated the articles for study design, methods, and results. RESULTS: Randomized double-masked controlled studies showed statistically significant improvement in glabellar, frontal, and lateral canthal rhytids (wrinkles) when injected with botulinum toxin. Standardized documentation using photographs and masked grading by the patient and physician support the efficacy of botulinum toxin for treatment of dynamic rhytids in the glabellar region, forehead, and lateral canthal area. Complications and adverse effects associated with treatment are infrequent and short lived. CONCLUSIONS: Botulinum toxin is safe in the short term and effective in the temporary treatment of glabellar, frontal, and lateral canthal rhytids. Potential functional complications should be discussed with patients who are seeking cosmetic rejuvenation of the periocular and facial region. Further research is needed to determine the ideal effective dose for particular anatomic areas, ideal concentration, applicable doses across the different serotypes of botulinum toxin, duration of effect, changes in efficacy (if any) over extended periods of treatment, and long-term safety.

Academies and Institutes↗
PubMed2005

Nevus lipomatosus (pedunculated lipofibroma) of the eyelid.

Nevus lipomatosus is a rare connective tissue nevus characterized by mature adipose tissue within the dermis. An 11-year-old boy presented with an eyelid papule that had been observed expectantly since birth and had exhibited gradual and progressive enlargement. Excisional biopsy revealed a polypoid mass formed of mature adipocytes within the dermis and subconjunctival mucosa consistent with nevus lipomatosus. This is the first case of nevus lipomatous to our knowledge to be reported on the eyelid. Nevus lipomatous or pedunculated lipofibroma can arise on the eyelid and should be considered in the differential diagnosis of eyelid tumors.

Biopsy↗
PubMed2005

Unusual complex choristoma of the lateral canthus.

This report details the gross and histopathologic findings of an unusual complex choristoma at the lateral canthus. Although this lesion displays elements of hair follicle nevus, bulbar dermoid, epibulbar osseous choristoma, and accessory tragus, it does not fit neatly in any of these categories. We propose that this lesion is the result of faulty migration of pluripotential cells during embryogenesis.

Adipose Tissue↗
PubMed2005

Enucleation with primary implant insertion for treatment of recalcitrant endophthalmitis and panophthalmitis.

PURPOSE: A prevalent conception exists that a two-stage operation (i.e., primary enucleation or evisceration with delayed secondary orbital implant insertion) is necessary when enucleation is required for recalcitrant endophthalmitis or panophthalmitis. The purpose of this study was to assess the utility of single-stage enucleation and primary reconstruction in this setting. METHODS: In a retrospective interventional case series, 22 consecutive patients with advanced endophthalmitis or panophthalmitis refractory to prior medical treatment underwent enucleation and primary implant placement by a single surgeon between 1991 and 2001. Eleven patients received hydroxyapatite implants; 11 patients received silicone implants. All patients were treated during surgery with intravenous antibiotics. All patients were evaluated for persistent local or systemic infection, implant exposure, extrusion, and successful fitting of their prostheses. RESULTS: No cases of persistent orbital cellulitis or meningitis occurred in any of the patients. Two patients with silicone orbital implants had extrusions; one was successfully managed with a secondary dermis-fat graft, and another patient who refused additional treatment was allowed to heal by secondary intention after the implant was removed. None of the patients with hydroxyapatite orbital implants had complications. All patients (20/20) who elected to undergo prosthetic fitting were successfully fit with prostheses. One patient elected not to pursue prosthetic fitting. One patient died of unrelated causes before a prosthesis could be fit. There were no objective findings to preclude successful fitting in either case. CONCLUSIONS: This study suggests that enucleation with primary orbital reconstruction and implant insertion for recalcitrant, fulminant ocular infection is an acceptable and advantageous treatment strategy. The risks and expenses associated with two separate surgeries are decreased, hospitalization time is potentially reduced, and subsequent rehabilitation can be initiated in a more timely fashion.

Adult↗
PubMed2005

Eyelid abscess as a presenting sign of occult sinusitis.

PURPOSE: To describe 5 patients who presented with eyelid abscesses whose subsequent workup revealed occult sinusitis. METHODS: We reviewed the medical records of 5 patients who presented with eyelid abscess. Common presenting signs and symptoms were identified. Successful diagnosis and treatment was accomplished in each case. RESULTS: All patients were in good general health and did not appear to be systemically ill. Eyelid swelling was the chief presenting complaint of each patient. None of the patients complained of fevers or chills. Each patient had an upper eyelid abscess. Symptoms suggestive of sinusitis included purulent nasal discharge and headache. With appropriate radiologic studies, extensive occult sinusitis was identified in each case. Two patients demonstrated a small defect in the bone between the infected frontal sinus and the eyelid. All patients received intravenous antibiotics followed by oral antibiotics, incision and drainage of the abscess, and, after ENT consultation, functional endoscopic sinus surgery. All patients improved after treatment, and none had permanent visual loss. CONCLUSIONS: Clinical suspicion of sinusitis may be aroused with a thorough history and examination. Radiographic evaluation and prompt treatment of both the eyelid abscess and the sinusitis can result in good outcomes for such patients.

Abscess↗
PubMed2004

Eyelid metrics.

Explore the source record for details and available documents.

Abbreviations as Topic↗
PubMed2004

Massive periorbital emphysema associated with laparoscopic nephrectomy.

A 63-year-old man presented with marked swelling and inability to open the left eye immediately after laparoscopic nephrectomy for a left renal mass. A diagnosis of periorbital emphysema was made, and within 3 days, the emphysema spontaneously improved. This case demonstrates that periorbital emphysema, a rare condition, can be a benign complication of laparoscopic nephrectomy.

Emphysema↗
PubMed2003

Sclerosing lipogranuloma of the orbit after periocular steroid injection.

PURPOSE: To report the clinical and histopathologic findings of a large sclerosing lipogranuloma of the orbit arising after a sub-Tenon's corticosteroid injection. DESIGN: Interventional case report and review of the literature. METHODS: A complete ocular and systemic evaluation was performed on a 81-year-old patient, who developed a large orbital mass subsequent to a periocular corticosteroid injection producing proptosis, ptosis, and ocular motility impairment. The lesion was biopsied and submitted for histopathologic analysis. MAIN OUTCOME MEASURES: Orbital, computed tomography, and histopathologic findings. RESULTS: Histopathologic examination revealed lipogranulomatous inflammation. Specifically, this type of reaction was consistent with a diagnosis of sclerosing lipogranuloma. CONCLUSIONS: It is extremely rare to find a large granulomatous orbital lesion arising subsequent to a periocular corticosteroid injection. Only one case has been reported in the English-language literature to date. It is important to include this type of lesion in the differential diagnosis of an orbital mass seen after the injection of periocular corticosteroids.

Aged↗