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Biomedical subjects

J V Linberg

Publications and source records attributed to J V Linberg.

52 records · Page 3Linked to original sources
PubMed1988

Recovery after loss of an eye.

Recovery after loss of one eye requires an adjustment to monocular vision and resolution of a significant, serious emotional trauma. The impact on everyday life is not well documented. We surveyed 125 monocular patients by questionnaire regarding their recovery. Eighty-five of 125 respondents reported that loss of one eye had not changed their life in any permanent way. Only seven reported persistent visual problems, whereas 12 described problems in employment and 21 had anxiety or poor self-image. Among 49 adults who had suddenly lost a sighted eye, 50% reported that their adjustment period for driving, work, recreation, home activities, or walking was less than 1 month. Ninety-three percent thought that their adjustment was completed by 1 year. In conclusion, most patients were able to resume everyday activities after a short period of adjustment. Problems with employment and self-image were frequent, but visual problems were unusual.

Adult↗
PubMed1988

Histopathology of nasolacrimal duct obstruction compatible with localized sarcoidosis.

We report a case of nasolacrimal duct obstruction with histopathology compatible with localized sarcoidosis, in a patient with no evidence of systemic disease. Excisional biopsy of the nasolacrimal duct revealed multiple noncaseating granulomas. Previously reported cases of sarcoidosis involving the lacrimal drainage system all had systemic disease, and these case are reviewed. Our case illustrates the potential value of nasolacrimal duct biopsy during dacryocystorhinostomy.

Dacryocystorhinostomy↗
PubMed1987

The anatomy of the lateral canthal tendon.

This report documents the anatomy of the lateral canthus using gross dissection, histologic examination, computed tomography, magnetic resonance imaging, and clinical measurement. Lateral canthal dissections of 16 cadaver orbits demonstrated a well-defined attachment of the tarsal plates to the orbital rim, averaging 10.6 mm in length and 10.2 mm in width at their insertion on Whitnall's tubercle, 1.5 mm behind the orbital rim and 9.7 mm inferior to the frontozygomatic suture. Histologic examination showed a band of dense fibrous tissue attached to the tarsal plates, with intermingled muscle fibers from the pretarsal orbicularis oculi muscle. A small pocket of fat was identified posterior to the orbital septum and anterior to the lateral canthal tendon. Clinical measurements of normal adults revealed 2 mm of lateral movement of the canthal angle during abduction, apparently caused by posterior fibrous attachments to the check ligament of the lateral rectus muscle.

Adult↗
PubMed1987

Orbital compartment syndromes following trauma.

The etiology of traumatic optic neuropathy is uncertain, except when intraocular pressure is elevated and CRAO can be observed. Various mechanisms have been implicated, and the etiology probably varies with individual cases. Prognosis is best when vision is initially intact and subsequently deteriorates, suggesting compression that may be reversible. Some authorities recommend high doses of systemic steroids as initial therapy. Anatomically, the orbit is a relatively closed compartment, and significant pressure may develop following intraorbital hemorrhage, edema, or emphysema. When clinical signs of severe orbital hemorrhage and pressure (proptosis) are associated with an optic neuropathy, the clinician is faced with a difficult decision. Mechanical decompression of the orbit is technically within our ability, and considerable positive experience has been derived from the treatment of compressive optic neuropathy in Grave's disease. Although the efficacy of decompression in trauma is uncertain, the literature provides anecdotal reports of restored vision. With full informed consent regarding these issues, orbital decompression seems appropriate for the rare case in which clinical signs of orbital pressure are impressive.

Compartment Syndromes↗
PubMed1987

Metastatic disease first presenting as eyelid tumors: a report of two cases and review of the literature.

We present two unusual cases in which an eyelid tumor was the first sign of metastatic disease. The first involved a 53-year-old man with pulmonary carcinoma and the second a 71-year-old man with malignant lymphoma. Fifteen similar cases from the literature are reviewed. The most frequent primary lesion is breast carcinoma in women, which appears as a diffuse lesion of one or two eyelids. Metastatic lung carcinoma in men appears as solitary nodules, representing the second-most common type of lesion. The questions of left- or right-side predominance, age and sex of patients, types of tumors, and prognosis are discussed.

Aged↗
PubMed1986

Ptosis following radial keratotomy. Performed using a rigid eyelid speculum.

Seven patients with acquired ptosis and normal levator function following anterior radial keratotomy are presented. Five of these patients then elected to undergo radial keratotomy of the opposite eye, and four had symmetrical lid fissures (mild bilateral ptosis) after bilateral surgery. Ptosis is a well-known complication of cataract extraction, but has not been reported following radial keratotomy. Unlike cataract extraction, radial keratotomy does not require anesthetic injections, bridle sutures, or conjunctival flaps. The rigid Knapp eyelid speculum used in these cases remains as the only apparent cause of eyelid trauma and subsequent ptosis. During radial keratotomy, the speculum was opened widely in order to provide good corneal exposure and avoid contact with the diamond knife. Contraction of the orbicularis oculi muscle against the rigid speculum may have traumatized the lid, resulting in a levator aponeurosis disinsertion and subsequent ptosis.

Adult↗
PubMed1986

Primary acquired nasolacrimal duct obstruction. A clinicopathologic report and biopsy technique.

Primary acquired nasolacrimal duct obstruction (PANDO) of adults is a clinical syndrome of unknown cause, and the histopathology of the nasolacrimal duct has not been substantially studied. A technique of excisional biopsy of the soft tissue contents within the nasolacrimal canal during external dacryocystorhinostomy (DCR) is presented. No complications were associated with the biopsy technique in 14 cases. Two cases of lacrimal obstruction secondary to sarcoidosis and leukemia were discovered in biopsies of patients with the clinical syndrome of PANDO, demonstrating the value of routine biopsy during DCR. Biopsies revealed a spectrum of changes that correlated with duration of symptoms. Early cases revealed active chronic inflammation along the entire length of the narrowed nasolacrimal duct. Intermediate cases revealed focal resolution of the inflammatory process with fibrosis, while late cases showed fibrous obliteration of the entire duct. Although the first event in primary acquired nasolacrimal duct obstruction remains uncertain, clinicopathologic correlation suggests that compression of the duct by inflammatory infiltrates and edema precedes clinical chronic dacryocystitis.

Adult↗
PubMed1986

Control of lacrimal secretion after sphenopalatine ganglion block.

Tear secretion with topical anesthesia ("Basal secretion") was measured in 10 normal subjects using Schirmer's tear strips before and after a sphenopalatine ganglion block. In an additional three normal subjects, tear turnover was determined with an objective fluorophotometer both before and after sphenopalatine ganglion block. The sphenopalatine ganglion block was obtained by the injection of the lidocaine (2%) into the sphenopalatine fossa. Topical anesthesia (proparacaine 0.5%) was used prior to all measurements. Tear secretion with topical ocular anesthesia was reduced substantially by sphenopalatine block, as measured by either Schirmer's strips or objective fluorophotometry. The more exact fluorophotometric method recorded a complete cessation of tear turnover flow following ganglion block. These findings support other reports, suggesting that all tear secretion is under neurologic control and dependent on reflex stimulation.

Adult↗
PubMed1985

Preserved irradiated homologous cartilage implants in canine eyelids.

Preserved irradiated homologous costal cartilage implants were placed in six canine lower lids for a period of 7-12 weeks. The three implants placed under a covering of conjunctiva simulating current clinical technique were well tolerated and demonstrated little change. Exposed implants produced obvious clinical inflammation and two of three exposed grafts disappeared during the 4- to 5-week interval. The single exposed implant that was retained demonstrated partial epithelialization but suffered extensive absorption and remodeling.

Animals↗
PubMed1982

Study of intranasal ostium external dacryocystorhinostomy.

A rigid endoscope was used to directly examine, measure, and photograph the intranasal ostium created by an external dacryocystorhinostomy (DCR). This technique was used to examine 19 patients who underwent 22 standard external DCRs. All patients had clinically successful results, documented by a positive Jone I dye test following surgery. The dimension of the bony opening created at surgery was measured and averaged 11.84 mm in diameter. The average diameter of the healed intranasal ostium was only 1.80 mm. No statistically valid correlation between the size of the bony opening and the final size of the healed intranasal ostium could be established. Thus, a large surgical anastomosis did not necessarily result in a large healed intranasal ostium. Excellent functional results were obtained even when the intranasal ostium was quite small. Other indications for the use of this technique are discussed.

Dacryocystorhinostomy↗
PubMed1982

External dacryocystorhinostomy. A prospective study comparing the size of the operative and healed ostium.

This study compares the size of the operative anastomosis with the size of the healed intranasal ostium resulting from 22 external dacryocystorhinostomies. The area of the healed intranasal ostium was approximately 2% of the area of the surgical anastomosis. No correlation was found between the size of the surgical anastomosis and the size of the healed ostium. In all cases, excellent functional results were obtained, regardless of the size of the healed ostium. This study suggests the size of the surgical anastomosis is not directly related to the success of the procedure, although it must be large enough to technically perform the procedure.

Dacryocystorhinostomy↗
PubMed1982

Orbital emphysema complicated by acute central retinal artery occlusion: case report and treatment.

Orbital emphysema is a well-known clinical entity that has been considered benign and requiring no treatment. A case of marked orbital emphysema with simultaneous central retinal artery occlusion is described. The prompt relief of this occlusion following aspiration of air from the orbit suggests that orbital emphysema is an unreported cause of central retinal artery occlusion.

Emphysema↗
PubMed1981

Transorbital decompression. Indications and results.

In a few patients with Graves' disease, visual loss related to an optic neuropathy develops. Clinical and radiologic evidence suggests that the mechanism of visual loss is optic nerve compression in the orbital apex. Steroids may offer improvement, but often the condition recurs unless high doses are maintained. Orbital decompression provides dramatic visual and cosmetic improvement in most cases. A transorbital approach suitable to the experienced orbital surgeon for decompression of the orbital floor and medial wall has been presented in a companion article. Results of this approach in 12 eyes with visual loss unmanageable by steroid therapy indicate a gratifying improvement in vision. Strabismus is the most frequent complication. Results with follow-up ranging from six to 18 months are encouraging and comparable to the results obtained with other methods of surgical decompression.

Adult↗
PubMed1981

Transorbital approach to decompression in Graves' disease.

Patients with Graves' disease have an increased volume of orbital tissue that sometimes results in serious functional and cosmetic problems. Visual loss may result from optic nerve compression in the orbital apex. Surgical decompression provides space for expansion of orbital tissues and often results in dramatic improvement. A transorbital approach to decompression of the orbit, appropriate for the ophthalmologist with adequate orbital experience, is presented. A lower eyelid incision is used in the manner of exploring a blow-out fracture. The majority of the orbital floor and the entire ethmoidal complex are removed. Removal of bone to the orbital apex is emphasized in cases of optic neuropathy. A comparative study of the indications, results, and complications of this procedure vs other techniques of decompression for Graves' disease is presented in a companion article.

Ethmoid Bone↗
PubMed1980

Preserved irradiated homolgous cartilage for orbital reconstruction.

Human costal cartilage is an excellent implant material for orbital and periorbital reconstruction because of its light weight, strength, homogeneous consistency and the ease with which it can be carved. Its use has been limited by the necessity of a separate surgical procedure to obtain the material. Preserved irradiated homologous cartilage has been shown to have almost all the autogenous cartilage and is concenient to use. Preserved irradiated homologous cartilage transplants do not elicit rejection reactions, resist infection and rarely undergo absorption.

Adolescent↗