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Biomedical subjects

L Koornneef

Publications and source records attributed to L Koornneef.

At least 91 records · Page 5Linked to original sources
PubMed1987

The role of direct multiplanar high resolution CT in the assessment and management of orbital trauma.

Basic anatomic research has resulted in the discovery of an intricate intraorbital connective tissue system involved in normal eye movements, and in combination with the development of the direct triplane high-resolution CT technique, this research has dramatically improved the treatment of orbital trauma. On the basis of clinical and CT evaluation, four causes of motility impairment after orbital trauma are now recognized and permit patient-tailored treatment methods.

Accidents, Traffic↗
PubMed1986

Squint surgery in patients with Graves' ophthalmopathy.

The results of extraocular muscle surgery in 22 patients with Graves' ophthalmopathy were evaluated. All patients were classified in NOSPECS class 4. The mean age at the time of squint surgery was 55(10)/12 years; there were 6 males and 16 females. Ten patients had primary extraocular muscle surgery. Twelve patients were first treated with prednisone alone or prednisone and retrobulbar irradiation therapy (1000 RAD) and orbital decompression because of other ocular symptoms. All patients were euthyreotic at the time of operation, and their motility was unchanged for at least 6 months. Altogether 40 muscles were operated; most often recession of the inferior rectus (11 X) and recession of the medial rectus (9 X) were performed. All patients achieved orthophoria and a useful field of binocular single vision postoperatively.

Adult↗
PubMed1986

Patient positioning for direct sagittal CT of the orbit parallel to the optic nerve.

A patient positioning technique for midsagittal brain scanning was modified to allow for direct sagittal computed tomography examinations of the orbit parallel to the optic nerve. High-resolution, artifact-free images are obtained that clearly depict all vital interfaces in sagittal cross sections. This technique is applicable to nearly all patients and does not present the many disadvantages of multiplanar reformating.

Brain↗
PubMed1985

Glued fixation of split-skin graft to the bony orbit following exenteration.

A technique is described to fix a split-skin graft to the bony orbit with a new homologous fibrin adhesive system. This shortens the time between the exenteration and the fitting of an epithesis to the bony orbit as compared with the granulation technique or fitting the graft with a prolonged pressure bandage. The advantages and risks connected to the glue system are discussed.

Aprotinin↗
PubMed1985

Malignant melanoma of the eyelid skin: histopathology and behaviour.

Histological sections from 24 patients with malignant melanoma of the eyelid skin were studied and correlated with clinical follow-up for an average of 8.6 years. There was an average post-treatment follow-up of 7.4 years with a cure rate of 78% in the superficial spreading group. The average follow-up in the nodular melanoma group was 9.4 years with a cure rate of 75%. Nodular melanoma patients with the lesion in the lid margin have a worse prognosis than those with the lesion on the eyelid skin.

Adolescent↗
PubMed1984

Lymphoid proliferations in the orbit: malignant or benign?

Clinical, pathological, and immunological analysis of 20 patients with ocular adnexal lymphoid disease has demonstrated several parameters which are useful for distinguishing malignant from benign lesions. Patients in the fourth or fifth decade of life presenting with an acute history of pain, oedema, epiphora, double vision, and ptosis, with a mass localised in the lacrimal gland area, are more likely to have a pseudolymphoma or a chronic inflammatory lesion than a true non-Hodgkin lymphoma (NHL). It is not possible to obtain a definite diagnosis without surgical intervention, because only three out of nine patients with orbital NHL had evidence of a monoclonal B cell population in peripheral blood on admission to the Orbital Centre. Furthermore it was confirmed that the identification of the various orbital lymphoid infiltrates becomes more distinct when immunological techniques are added to the clinical and histopathological methods of investigation. Multidisciplinary cooperation leads to further improvement of diagnosis and treatment of ocular adnexal lymphoproliferative disease.

Adult↗
PubMed1983

Motility disturbances in Graves' ophthalmopathy.

In a retrospective study of 30 patients with Graves' ophthalmopathy and 25 patients with exophthalmus due to other causes the patterns of ocular motility disturbances and the CT-findings were reviewed. In Graves' ophthalmopathy motility disturbances were found in 83% of the patients, in the control group 26% of the patients showed abnormal ocular motility. Enlarged eye muscles were found in 46% of the patients with Graves' ophthalmopathy and enlargement of the medial rectus muscle was the most consistent finding (42%). A clinical correlation was made between the severity of eye movement restriction and the appearance of the muscle on CT-scan.

Eye Movements↗
PubMed1982

Current concepts on the management of orbital blow-out fractures.

Surgical versus nonsurgical treatment of orbital blow-out fractures has been controversial in the past. In the 1950s it was advocated that all blow-out fractures be treated surgically based on the conception that extraocular muscles were blown out and trapped in the fracture hole, causing double vision and enophthalmos. Gradually, however, a shift to a more conservative approach occurred, probably because of the complications of surgery, the disappointing results in improvement of motility and enophthalmos, and the growing evidence of spontaneous improvement of double vision. This article analyzes the literature chronologically and blends this analysis with the results of a new anatomical approach to the human orbit. New theories on the mechanism of blow-out fractures are postulated. No longer is entrapment of muslces in a blow-out fracture held responsible for the severe motility problems; rather it is viewed as caused by a dysfunction of the entire motility apparatus in the fracture region. Consequently, conventional surgical treatment, repairing the orbital floor only, seems to have lost its theoretical foundation and a conservative approach is advocated until microsurgical techniques become more readily avaliable to treat the sequelae of blow-out fractures at their origin.

Connective Tissue↗
PubMed1979

Orbital septa: anatomy and function.

As a consequence of some puzzling motility disturbances in patients with blow-out fractures, a new anatomic approach to the human orbit was developed. This new approach revealed unknown connective tissue septa inside the orbit. These connective tissue septa were highly organized and formed an accessory locomotor system. This system is involved in pathologic circumstances like blow-out fractures and can account for the motility disturbances in these cases; additionally, it plays an important, yet to be unravelled, role when normal eye movements are performed.

Connective Tissue↗
PubMed1977

New insights in the human orbital connective tissue. Result of a new anatomical approach.

Exenteration and dissection of the collapsed specimen has so far been standard procedure in the anatomic study of the orbital contents. If, as in surgery, the orbit is approached through the palpebral aperture and its connective tissue is kept extended in the framework of the oribital walls, hitherto unrecognized septa of connective tissue are found, containing vessels, nerves, and smooth muscular tissue. No anatomic evidence was found for the existence of a common muscle sheath behind the globe, subdividing the orbit into central and peripheral surgical spaces. The study of serial sections of complete orbits shows a definite structural organization and constant pattern of this connective tissue system. The relations of the eye muscles and the eyeball with these connective tissue structures, the periorbit and the enclosed fat cushions, are of interest with reference to normal motions of the globe.

Connective Tissue↗
PubMed1977

The architecture of the musculo-fibrous apparatus in the human orbit.

Combining the thick serial (60 mu) histological section technique with the 0.5 cm cleared section technique, a definite structural organization in orbital connective tissue and adipose tissue components lying in between, is revealed. Additionally, an interindividual uniformity and bilateral symmetry in the human orbital connective tissue structures was found. Finally, using the reconstruction technique it became clear that each eye muscle has its own connective tissue system in the orbit and that its architecture highly differs dependent on, which orbital area is approached. It is conceivable that in future the spatial architecture of the musculo-fibrous apparatus in the human orbit might prove to be of importance for clinical diagnosis and surgical approach.

Adult↗
PubMed1977

Details of the orbital connective tissue system in the adult.

The study of serial thick (60 mu) histological sections reveals a highly complicated but orderly constructed connective tissue system within the orbit. Between this system adipose tissue compartments are present built up in a comparable orderly fashion. In this intraorbital continuum, to which Tenon's capsule, the so-called check ligaments, the fascial sheaths of the muscles and the periorbital membrane belong, other different areas of characteristic connective tissue septa originating from the fascial sheaths of the eye muscles are recognizable. These different areas are linked to the presence of the different eye muscles and can be regarded as belonging to these eye muscles. That is why, in our opinion, this total of orbital connective tissue, together with the adipose tissue compartments lying in between, must be regarded as an additional mechanism playing an important role when eye movements are performed. The highly regular pattern and intra- and interindividual uniformity within this system will be clarified in the following paper, using models which specially highlight spatial architecture.

Adipose Tissue↗
PubMed1976

The development of the connective tissue in the human orbit.

The development of the mesenchymal structures of the human orbit was studied using 10 mu or 60 mu serial sections of orbits of foetuses of 35 to 320 mm stages (C.R. length; 2-9 months). The ontogenesis of the orbital walls, the eye muscles, the blood vessels and the connective tissue was compared. This comparison revealed that the eye muscles and their fasciae together with the adventitial layers of the larger blood vessels and nerves develop first, closely linked in time to the progress of ossification and growth of most of the orbital bones. Only the (endochondral) ossification of the ethmoid starts much later. The orbital connective tissue septa development commences later, i.e. from the third month onwards, concurrently with the development of special mesenchymal condensations, a particular capillary system and adipose tissue. About five months later the adult configuration is attained.

Connective Tissue↗