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Biomedical subjects

N Shorr

Publications and source records attributed to N Shorr.

72 records · Page 4Linked to original sources
PubMed1986

Cavernous hemangioma of the lacrimal fossa.

A 56-year-old woman presented with proptosis of the left eye for over 1 year. The clinical presentation and computerized tomographic scan findings were consistent with a benign mixed lacrimal gland tumor. An extensive excision of the tumor was planned through a lateral orbitotomy with bone flap. After construction of the bone flap, the clinical appearance of the tumor was not consistent with a benign mixed lacrimal gland tumor. Frozen section pathology was interpreted as cavernous hemangioma. A simple excision of the tumor with preservation of the lacrimal gland was performed. It is emphasized that benign mixed lacrimal gland tumors require extensive excision to prevent recurrence. However, other tumors may have a similar clinical presentation, as in this case, and the surgeon must consider this possibility prior to performing radical surgery.

Blepharoptosis↗
PubMed1986

Central retinal artery occlusion associated with periocular corticosteroid injection for juvenile hemangioma.

Intralesional corticosteroid injections are an accepted treatment for periocular juvenile hemangiomas. This treatment is felt to be relatively free of complications. We report, however, a case of central retinal artery occlusion associated with steroid injection for a periocular juvenile hemangioma in a four-year-old child. It is presumed that the force of injection or digital massage caused retrograde arterial flow, moving steroid suspension particles into the central retinal artery where vascular occlusion occurred. As a result of this case, our treatment regimen has been modified. We now use 0.1 cc steroid alloquats injected slowly through a 30-gauge needle and avoid firm digital pressure on the lesion.

Adrenal Cortex Hormones↗
PubMed1986

Orbital extension of uveal melanoma.

Extrascleral extension of an intraocular melanoma rarely presents as an orbital mass. Three such cases are reported. Two were in orbits with blind eyes. All three underwent exenteration and postoperative radiation. Two of three subsequently died of metastatic disease. The possibility of tumor dissemination by the operative exenteration is explored. The importance of routine tumor surveillance in blind eyes is emphasized.

Aged↗
PubMed1985

Surgical treatment of punctal-canalicular fibrosis from 5-fluorouracil therapy.

5-Fluorouracil (5-FU) has been reported to cause punctal-canalicular fibrosis with resultant severe epiphora. It is reported that the epiphora will often resolve when treatment ceases or is decreased. However, this report describes a case of punctal-canalicular fibrosis so severe that bilateral conjunctivodacryocystorhinostomies were necessary. This has not been previously reported to the best of the authors' knowledge. It is recommended that ophthalmic consultation be obtained for patients in whom long-term 5-FU therapy is anticipated or who develop tearing while on therapy.

Aged↗
PubMed1985

The use of botulinum toxin in blepharospasm.

Twenty-two patients, 17 with benign essential blepharospasm and five with hemifacial spasm, received botulinum toxin by subcutaneous injections in the eyelids and eyebrows. All 22 patients received a standard treatment of 12.5 units of botulinum toxin per side at each injection session. The orbicularis oculi muscle showed pronounced weakness after injection and the spasms decreased. Spasms often recurred despite persistent orbicularis oculi muscle weakness. Side effects were minimal. All patients received some relief, which generally lasted six to 12 weeks.

Blepharospasm↗
PubMed1985

"Madame Butterfly" procedure: combined cheek and lateral canthal suspension procedure for post-blepharoplasty, "round eye," and lower eyelid retraction.

The most common complication of lower eyelid blepharoplasty is eyelid retraction ("scleral show") of the lateral one-third of the lower eyelid, with associated rounding and inferior displacement of the lateral canthus. A procedure in which the middle lamellar cicatrix is lysed, the lateral canthus reconstructed, and the cheek elevated to provide additional vertical anterior lamellar skin is described. Skin grafting is often aesthetically poor in the lower eyelid and is unacceptable in the upper eyelid. This new procedure may be used to elevate the lower eyelid rather than lower the upper eyelid in cases of post-blepharoplasty lagophthalmos with exposure keratopathy. Thus, the procedure offers cosmetic and functional repair, without the use of skin grafts, for the patient who would normally need upper and lower eyelid skin grafting.

Eyelids↗
PubMed1983

Use of temporal fascia and muscle as an autograft.

A wide variety of materials have been used for reconstruction around the eyelids and orbit, including alloplastic materials, such as polyfilament surgical suture (Supramid), silicone, and Teflon, that have a tendency toward early infection or late extrusion. Preserved homografts, such as sclera or fascia lata, are unlikely to extrude but have variable absorption rates. Autografts have proved over the years to be the best, most reliable, and least reactive material for reconstruction. Our use of temporal fascia and muscule grafts has been quite successful.

Adult↗
PubMed1983

Modified lacrimal system intubation.

A modified technique for silicone intubation of the lacrimal system is presented to eliminate the two major postoperative problems of punctal erosion and loop retraction.

Humans↗
PubMed1982

Complications at mucous membrane donor sites.

Full-thickness mucous membrane is an acceptable autogenous graft to replace the deficient conjunctiva resulting from intrinsic disease, surgical resection for carcinoma, or reconstruction of contracted sockets. The mouth provides an excellent source of mucous membrane graft material with few donor site complications. However, we encountered four cases of donor site complications after full-thickness mucous membrane grafting. All cases involved submucosal scarring with contracture. Because the inner aspect of the mouth is a multicontoured surface, the submucosal scarring resulted in web formation and limitation of movement of the mandible or lip. In two cases, we resected submucosal fibrotic scar tissue and designed a standard or multiple Z-plasty to release mucosal tension. This allowed a return to normal oral function.

Adult↗
PubMed1982

Ocular motility problems after orbital decompression for dysthyroid ophthalmopathy.

Ocular motility problems of 50 consecutive patients following orbital decompression for dysthyroid (Graves') ophthalmopathy were analyzed retrospectively. No significant relationship to the development of postoperative diplopia was seen in the amount of retrodisplacement of the globe, the anatomical approach for orbital decompression, or the indication for decompression. Several clinical observations were made. Patients whose indication for orbital decompression was a vision-threatening ophthalmopathy were more likely (although not statistically significantly) to develop postoperative strabismus. Patients who developed changes in preoperative strabismus were more likely to develop increased esotropia and/or restrictive hypertropia. Of 32 patients who were orthotropic in the primary position before operation, 11 developed postoperative strabismus in the primary position. Only five patients had normal versions and ductions before operation. All five of these patients had normal versions and ductions after operation.

Adult↗
PubMed1980

Leukemic iris infiltration.

A 7-year-old boy with acute lymphocytic leukemia developed iris infiltration, blood-streaked hypopyon, and high intraocular pressure. A diagnostic anterior chamber paracentesis was performed, which provided a cytologic diagnosis. The aspirate was studied by both the millipore filter technique with Papanicolaou stain and a dried smear using the Wright's stain. Wright's stain provided more distinct cellular details. Irradiation of the anterior segment resulted in clearing of leukemic iris infiltration, hypopyon, and glaucoma.

Adrenal Cortex Hormones↗
PubMed1980

Tarsal buckling after sutureless Fasanella-Servat procedures.

A patient who underwent bilateral, sutureless Fasanella-Servat procedures experienced wound dehiscence that resulted in a distorted eyelid contour which rquired substantial wound and eyelid revision. Other methods of handling the problem of suture abrasion exist that may prevent tarsal buckling after a Fasanella-Servat procedure.

Blepharoptosis↗
PubMed1977

Anterior tarsectomy reoperation for upper eyelid blepharoptosis or contour abnormalities.

In five cases, a simplified anterior tarsal resection corrected complicated upper eyelid blepharoptosis and contour abnormalities. One case of residual blepharoptosis after levator muscle resection was corrected by resecting an amount of tarsus equal to the desired amount of correction. Two cases of upper eyelid blepharoptosis resulting from overcorrected levator muscle recession were corrected in the same manner. In one case of residual segmental blepharoptosis of the upper eyelid causing a contour abnormality, we resected a segment of tarsus corresponding to the amount of blepharoptosis in the affected segment of the eyelid. In one patient who developed a contour abnormality after a Fasanella procedure with segmental blepharoptosis nasally and overcorrection temporally, a segment of tarsus resected nasally and inserted temporally created an even contour. Anterior tarsal resection is a simple method of revising the upper eyelid level of contour in situations where the upper eyelid anatomy has been distorted by previous surgery.

Adult↗