The first results of a new anatomical method of approach to the human orbit following a clinical enquiry.
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Adult↗
Biomedical subjects
L Koornneef
Publications and source records attributed to L Koornneef.
Dermolipoma: characteristic CT appearance.
Dermolipomas are choristomas usually located at the external canthus. Clinically they can be confused with dermoid cysts. Preoperative diagnosis of a dermolipoma is important because the surgical approach is less aggressive than for dermoid cysts. We describe the clinical aspects of ten patients with a dermolipoma and demonstrate the posterior extension of these lesions by CT.
Adipose Tissue↗
The use of colour slides in the assessment of changes in soft-tissue involvement in Graves' ophthalmopathy.
There is a need for more reliable and validated methods to assess the eye changes in Graves' disease. Such measurements are now available for the assessment of proptosis, eye muscle dysfunction, and optic nerve involvement. However, no validated objective measurement exists for NO SPECS class II signs. The present study compares the use of colour slides with clinical grading for assessing soft-tissue involvement. Forty-three patients were treated with retrobulbar irradiation. Pre-treatment, and 6 months post-treatment the severity of class II signs was graded from 0 to grade c in two ways; 1) Clinically, by two independent, experienced observers, who recorded their scores on the same day; 2) From colour slides, taken at the same visits, which were graded afterwards in one session independently by the same observers. Inter-observer agreement about clinical grading was low (Kappa 0.32), and was not improved by using the slides (Kappa 0.35). However, by using the clinical scores, the observers disagreed on treatment outcome in 21/43 patients (49%), whereas using the slides disagreement occurred in only 6/43 (14%, p < 0.01). It is concluded that the grading of soft-tissue involvement is highly subjective. However, the use of colour slides does provide a more reliable way to assess a treatment effect and should be used in clinical trials.
Eye↗
What is orbital pseudotumor?
We have reviewed the literature in order to delineate the clinicopathologic definition of orbital pseudotumor, also called idiopathic nonspecific orbital inflammation. The clinical picture of orbital pseudotumor varies widely, with signs of mass effect, inflammation and/or infiltration. On computed tomography, orbital pseudotumor presents as a unilateral focal or diffuse mass. The histopathologic hallmark of orbital pseudotumor is a mixed inflammatory infiltrate with fibrosis of varying degree. Contrary to an old belief, orbital pseudotumor is not related to orbital reactive lymphoid hyperplasia (pseudolymphoma) and is not a lymphoid tumor. Atypical histopathologic findings of orbital pseudotumor include dominant sclerosis, granulomatous inflammation, vasculitis, and tissue eosinophilia. In the absence of systemic fibroinflammatory, granulomatous, and vasculitic disease, these atypical histopathologic patterns can be considered to represent subclasses of orbital pseudotumors rather then distinct entities. Clinical and prognostic characteristics of both histopathologically classical and atypical orbital pseudotumors appear to be heterogeneous. The etiology of orbital pseudotumor is unknown, but infection, autoimmune disorder, and aberrant wound healing have all been put forward as possibilities. In conclusion, orbital pseudotumor is one distinct disease albeit with many clinical and histopathologic guises.
Humans↗
Cholesterol granuloma of the frontal bone: CT diagnosis.
Cholesterol granuloma of the frontal bone is a distinct clinical entity. This expanding lesion grows slowly within the diploe of the frontal bone until it extends into the orbit and causes globe displacement. We report the clinical and the CT findings in 11 patients with cholesterol granuloma of the orbit. The CT characteristics of cholesterol granuloma of the frontal bone appear to enable a correct preoperative diagnosis.
Adult↗