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PubMed2005

The value of computed tomographic scanning in the diagnosis and management of orbital fractures associated with head trauma: a prospective, consecutive study at a level I trauma center.

BACKGROUND: Orbital fractures associated with head trauma are not always easy to diagnose. The real incidence of such fractures is unknown. The aim of this study was to evaluate the usefulness of routine primary computed tomographic (CT) scanning for diagnosis of orbital fractures in head trauma patients. METHODS: Over a 3-year period, 600 consecutive patients admitted with head trauma were examined clinically; these patients then underwent cranial helical CT scanning, irrespective of severity of head injuries and presence or absence of fracture-related symptoms. RESULTS: Orbital fractures were diagnosed on CT scan in 118 cases (19.7%). All patients with symptoms directly related to an orbital fracture had radiologically diagnosed fractures, compared with 58.3% of patients with isolated blepharohematoma and 3.8% of asymptomatic patients. CONCLUSION: CT scan of the orbits is indicated for any head trauma patient who presents either one or more symptoms directly related to an orbital fracture or just isolated blepharohematoma. CT scan of the orbits is not indicated in asymptomatic head trauma patients. Inclusion of the orbits in the scanning is recommendable only if a CT scan is already being obtained for a head injury. Clinical follow-up is important to detect any late-appearing symptoms. Accurate clinical examination still plays a crucial role in the diagnosis of orbital fractures.

Adolescent↗
PubMed2005

Orbital decompression in Graves' orbitopathy: efficacy and safety.

BACKGROUND: Vision-threatening compressive optic neuropathy occurs in a minority of patients with Graves' orbitopathy. Surgical orbital decompression, systemic glucocorticoids and orbital irradiation are treatment options. Orbital decompression is being performed on an increasing number of patients for other indications such as corneal exposure and disfiguring proptosis. AIMS: To examine the outcomes of surgical orbital decompression for Graves' orbitopathy by one surgeon. METHODS: An analysis of a retrospective case series of 88 consecutive patients (151 orbits) who underwent orbital decompression for Graves' orbitopathy between April 1991 and November 2002. RESULTS: The indication for surgery was compressive optic neuropathy for 57 orbits; 94 orbits had an indication other than optic neuropathy. Of those with optic neuropathy, 94% had improvement or maintenance of visual acuity and 93% had improvement in colour vision after decompression. The overall mean reduction in proptosis was 4.7 mm. Of all patients, 30% had new or worsened diplopia postdecompression. Patients with optic neuropathy were more likely to develop new or worsened diplopia than those without optic neuropathy. CONCLUSIONS: Orbital decompression is a safe procedure and effective in improving vision in compressive optic neuropathy. It is effective in reducing proptosis, therefore improving exposure keratopathy and cosmesis. However, new or worsened diplopia is a significant postoperative complication, and subsequent strabismus surgery might be required. This is an important consideration, especially for patients undergoing surgery for non-optic neuropathy indications.

Adult↗
PubMedDate not supplied

Interspecies variation in orbital bone structure of psittaciform birds (with emphasis on Psittacidae).

OBJECTIVE: This text presents an anatomical study of the normal bony orbital structure of a sample of different bird species belonging to the order Psittaciformes. PROCEDURES: The bony anatomy of Psittaciformes' skulls was examined and described using cadavers of birds that were presented already dead to the Federal University of Paraná, Brazil or had been euthanized for humane reasons. Dissections of the orbital cavity were performed under 2-4 x magnification, and descriptions of the orbital bones were made from observations of macerated skulls that had been boiled and cleaned. The present paper discusses the main features of the bony orbit of psittaciform birds, describing known anatomical information but also bringing new information, mainly concerning species differences that might help not only veterinary anatomists but also zoologists, clinicians, researchers, and students of veterinary ophthalmology to better comprehend this order of birds. RESULTS AND CONCLUSIONS: Variations in the anatomic conformation of the bony elements of the orbit were observed in different species of Psittaciformes. Based on these differences, Psittaciformes were classified into two different groups. The first group of Psittaciformes shows an enclosed (complete) bony orbit formed by the junction of the orbital with the postorbital processes, creating a suborbital arch. The second group of Psittaciformes essentially lacked a suborbital arch, presenting an open (incomplete) bony orbit, typical of most modern birds. In the latter group, orbital and postorbital processes are present.

Animals↗
PubMed1993

Effect of eye position within the orbit on electrically elicited saccadic eye movements: a comparison of the macaque monkey's frontal and supplementary eye fields.

1. We quantitatively compared the effects of eye position within the orbit on saccadic eye movements electrically elicited from two oculomotor areas of the macaque monkey's frontal lobe cortex: the frontal eye field (FEF) and the supplementary eye field (SEF). 2. The effect of eye position on electrically elicited saccades was studied by delivering 70-ms trains of intracortical microstimulation while the monkeys fixated a spot of light. Tests of different fixation points located across a rectangular array were randomly intermixed. Complete experiments were carried out on 38 sites in three FEFs of two monkeys and 59 sites from three SEFs of the same two monkeys. Stimulation currents for the array experiments were usually 10-20 microA above the site threshold; the average current used was 36 microA for FEF and 49 microA for SEF. 3. The magnitude of effect of the initial eye position on the elicited saccade's dimensions was quantified at each site by computing the linear regression of saccadic eye movement displacement on the eye position within the orbit when stimulation was applied. This computation was done separately for the horizontal and vertical axes. We call the resulting pair of regression coefficients "orbital perturbation indexes." Indexes of 0.0 represent elicited saccades that do not change their trajectory with different initial eye positions (constant-vector saccades), whereas indexes of -1.0 represent elicited saccades that end at the same orbital position regardless of initial eye position (goal-directed saccades). 4. The effect of eye position varied across sites. In both FEF and SEF, the orbital perturbation indexes were distributed between approximately 0.0 and -0.5, with the horizontal and vertical indexes highly correlated across sites. 5. The average orbital perturbation indexes were small for both eye fields and were not significantly different. The mean horizontal indexes were -0.13 and -0.16 for SEF and FEF, respectively. The mean vertical indexes were -0.16 and -0.13. Neither SEF versus FEF difference was statistically significant. 6. In both SEF and FEF, sites yielding larger-amplitude saccades generally had larger orbital effects than sites yielding smaller saccades. This relationship accounted for the majority of the variability of the orbital perturbation indexes across sites in both SEF and FEF. 7. These results indicate that SEF and FEF are not distinguished from each other by the orbital dependence of their electrically elicited saccades. Thus they do not confirm the previously hypothesized dichotomy that FEF codes constant-vector saccades and SEF codes goal-directed saccades.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMedDate not supplied

Normal range of exophthalmos values on orbit computerized tomography in Koreans.

The value of parameters in Hertel's exophthalmometry was measured by using orbit computerized tomography (CT) in this study. We selected images that revealed the center of the lens, the largest eyeball contour and the optic canal on the axial view of orbit CT. Parameters of exophthalmometry on orbit CT were the distance between the lateral orbital rims of both eyes (A), the shortest distance from the corneal center to line A (B), the B/A ratio, the distance between the lateral orbital rim and the medial orbital rim (C), the length of the line passing through the lens center from the apex to line C (D) and the D/C ratio. To compare the center position of the eye, we measure the axial length (E) and the longest distance between the corneal apex and the posterior pole (F) which is parallel to line B. We also calculated B-F/2 and Hertel-F/2 in order to know if there is a difference between measurements of orbit CT and of Hertel's exophthalmometer. Subjects were classified into group 1 (aged 8-13 years old) and group 2 (aged 20 years old more). Sixteen subjects were enrolled in group 1 (32 eyes). In group 2, 100 subjects were male (200 eyes) and 35 were female (70 eyes). In group 1, the mean value was 89.94 mm for A, 13.49 mm for B, 35.13 mm for C, 10.64 mm for D, 24.40 mm for E, 24.20 mm for F, 0.15 for the B/A ratio and 0.30 for the D/C ratio. In group 2, the mean value was 100.93 mm for A, 15.03 mm for B, 38.78 mm for C, 12.03 mm for D, 24.62 mm for E, 24.33 mm for F, 0.15 for the B/A ratio and 0.31 for the D/C ratio. There was a statistically significant difference between the two groups for parameters A, B, C and D (p = 0.001), but no significant difference for the B/A (p = 0.239) and D/C ratios (p = 0.803). In the males and females of group 2, there was a statistically significant difference for the B/A ratio (p = 0.028). We suggest that the value of the D/C ratio (0.30-0.31) could be used as the index of protrusion. The normal values of exophthalmometry parameters measured by orbit CT could also be helpful to evaluate the exact protrusion in orbital diseases.

Adolescent↗
PubMed1982

Eye and orbital size in the young and adult. Some postnatal experimental and clinical relationships.

The orbital volume in Dutch rabbits ranged from 3.6 ml at 98 days to 5.8 ml at 540 days of age. By 180 days of age the orbital volume had reached about its maximum of 5 ml and was 25% larger than at 100 days of age. The mean orbital volume was less at 540 than at 450 days of age. At 15 days of age the eye volume was about 20% of adult size, at 100 days of age about two thirds, at 180 days of age about 85% of adult size which was reached at about 300 days of age. The mean bulb volume was less at 540 than at 450 days of age. After evisceration, enucleation, or exenteration, in young rabbits there was a decelerated increase of orbital volume and a direct relationship between the lack of intraorbital mass and the subsequent lack of development of the orbit. The addition of a constant-sized implant in the young rabbit, after evisceration or enucleation of the eye, did not enhance orbital growth. In adult rabbits enucleation of the eye did not subsequently alter the orbital volume. In young rabbits an increase of the eye volume after multiple intrabulbar injections of silicone resulted in increase in orbital volume. The same procedure in adult rabbits increased neither the eye nor the orbital volume. Some clinical correlations are made.

Adolescent↗
PubMed2003

Venous anatomy of the orbit.

PURPOSE: To define the normal and variant venous anatomy in the human orbit. METHODS: Orbital dissections, focusing on the venous system, were performed on 17 formalin-preserved human cadavers (34 orbits) and two fresh orbits. Dissections were carefully documented photographically. Results were compared with those in previous reports on the venous anatomy of the orbit. RESULTS: The superior ophthalmic vein (SOV) is the most consistent vein within the superior orbit. The inferior ophthalmic vein (IOV) demonstrated more variation, but important variations were noted in both. Smaller veins demonstrated the largest variability. Several formerly published observations on the venous anatomy of the orbit could not be confirmed in this study. A previously unreported variation in the SOV was found in 9 of 36 orbits, with the SOV having a duplicated segment, which is likely to be a variant medial ophthalmic vein. CONCLUSIONS: The venous anatomy of the orbit demonstrates considerable variability. Some of these variations may have implications in surgical management and natural history of ophthalmic conditions, such as carotid-cavernous sinus fistula (CCSF).

Aged↗
PubMed1995

Prostaglandin E2 alters human orbital fibroblast shape through a mechanism involving the generation of cyclic adenosine monophosphate.

Orbital fibroblasts from patients with Graves' ophthalmopathy, when treated with prostaglandin E2 (PGE2), become stellate and develop prominent cellular processes. In this paper, we describe results of studies designed to characterize the action of PGE2 on orbital fibroblast shape changes in vitro. Orbital and dermal fibroblasts were incubated with PGE2, one of several prostanoid analogues, 8-br-cAMP or forskolin and were then visualized by phase-contrast microscopy. Other studies involved seeding cells in special chambers equipped with electrodes for cell sensing using electric cell-substrate impedance sensing (ECIS) to detect changes in shape. PGE2 (10(-7) mol/L) elicited a rapid and dramatic alteration in the shape of orbital fibroblasts but not those derived from the skin. Cells became stellate and developed prominent cytoplasmic processes that extended out from the central area containing the cell nucleus. The effects were stereoselective in that a number of structurally related compounds, including Sulprostone, PGI2, PGF2 alpha, thromboxane A2, thromboxane B2, and 11 deoxy,16,16 dimethyl PGE2 failed to elicit a similar shape change. Butaprost (10(-5) mol/L), a specific EP2 agonist, elicited a similar shape-change as that observed with PGE2. 16,16-dimethyl PGE2, a nonselective agonist, could mimic the action of PGE2. The effect of PGE2 was apparent at 10(-8) mol/L, maximal at a concentration of 10(-7) mol/L and took 4-8 hr to evolve completely. Cycloheximide (10 micrograms/mL) and actinomycin D (1 micrograms/mL) failed to block the shape change. The morphologic change could be reproduced by addition of 8-br-cAMP (3 mmol/L) and by forskolin (5 mumol/L). Moreover, PGE2 and Butaprost treatment elicited in orbital cultures a massive increase in endogenous cAMP production while analogues not affecting cell shape failed to influence cyclic nucleotide generation. Three strains of orbital fibroblasts from patients with Graves' ophthalmopathy and three from normal orbits were tested and all responded to PGE2 (10(-7) mol/L). Four strains of dermal fibroblasts failed to respond to PGE2. The changes in orbital fibroblast morphology were accompanied by a marked decrease in monolayer impedance as assessed by electric cell-substrate impedance sensing. The earliest effects were apparent within 30 min using this sensitive technique. The widely recognized roles of PGE2 and related compounds in the mediation of the inflammatory response make our current findings in orbital fibroblasts of potential importance to the pathogenesis of Graves' ophthalmopathy.

Cells, Cultured↗
PubMed2006

Detection of thyroid peroxidase mRNA and protein in orbital tissue.

OBJECTIVE: We have previously reported that the absence of thyroid peroxidase antibodies (TPOAb) in Graves' disease (GD) was associated with an increased risk of Graves' ophthalmopathy (GO). This observation raised the possibility that TPOAb could act as a protective factor. However, the presence of thyroid peroxidase (TPO) in the orbit has not been previously reported. The aim of this study was to confirm or exclude the presence of orbital TPO. METHODS AND DESIGN: Relative TPO mRNA expression from GO (n=6) and normal (n=5) orbital fat tissue was determined using real-time PCR technique. Orbital fat in the normal group from blepharoplasty represents extraconal (anterior) fat. mRNA expression in fibroblasts grown from these tissues before and after adipocyte differentiation was also documented. Finally, Western blotting was carried out to verify translation of TPO mRNA transcripts. RESULTS AND DISCUSSION: TPO transcripts were detected in the orbital fat tissue obtained from normal and GO subjects using the real-time PCR technique. TPO expression was increased in GO compared to normal (N) tissues. However, TPO expression in cultured fibroblasts was similar in both groups and adipogenesis did not appear to alter TPO expression. Protein was detected by Western blot analysis using the TPO MAB 47 (mAb 47). The predicted 110-kDa band was detected in orbital fat as well as in orbital fibroblasts. Our results suggest the presence of TPO in GO and N orbital tissues. We hypothesise that immune responses directed against orbital TPO might play a role in modulating the clinical expression of GO.

Adipocytes↗
PubMed2005

[Orbital granulocytic sarcoma: case report].

Orbital granulocytic sarcoma is a localized tumor consisting of malignant cells of myeloid origin. This tumor may present in association with acute myelogenous leukemia. Granulocytic sarcoma may be found in a variety of locations throughout the body including the orbit and typically affects children and young adults. There is a slight male predominance in these cases. This is an uncommon case report of a 33-year-old Latin-American woman who was admitted to the Hospital for rapidly progressive orbital proptosis. There was no systemic manifestation of leukemia. The occurrence of orbital granulocytic sarcoma before the development of systemic leukemia in children and young adults is not uncommon and these cases frequently develop hematological evidence within 2 months after initial orbital disease. In this case report, there was no systemic manifestation of leukemia in the last 30 months, even in the presence of orbital tumors. Granulocytic sarcoma is most frequently confused with malignant lymphoma, rhabdomyosarcoma and neuroblastoma. The differential diagnosis of these cases can be challenging, particularly when there is no evidence of systemic leukemia, when imaging features are not sufficiently specific to distinguish granulocytic neoplasms from other tumors. To establish the diagnosis often a biopsy is required. The treatment in such cases (orbital granulocytic sarcoma) is not standardized. Orbital granulocytic sarcoma may be suspected in cases of orbital tumors even in the absence of systemic manifestations of leukemia at any age.

Acute Disease↗
PubMed1996

Orbital plain films as a prerequisite for MR imaging: is a known history of injury a sufficient screening criterion?

OBJECTIVE: Before undergoing MR imaging at our institution, all patients with potential occupational, recreational, or educational exposure or known accidental exposure to kinetic metal fragments have orbital radiographs to evaluate for the continued presence of intraorbital metallic foreign bodies. The purpose of this study was to evaluate the potential safety of a protocol that would call for obtaining plain films of the orbit before MR imaging only for patients with a definite history of a known metallic foreign body in the eye or orbit. MATERIALS AND METHODS: A total of 2626 patients underwent plain radiography of the orbit to exclude metallic foreign bodies before MR imaging between March 1991 and January 1995. These patients were identified by a billing code number. Reports from these studies, all interpreted by board-certified radiologists, were reviewed. When a metallic foreign body was detected, we reviewed the patient's response during the initial interview when asked about a history of orbital injury or surgery. RESULTS: Of 2626 patients undergoing orbital radiographic studies, 17 (0.65%) had radiographic evidence of intraorbital metallic foreign bodies. Sixteen of these patients gave a history of known injury or had knowledge of probable orbital metallic fragments. The remaining patient, a welder screened because of occupational history, had a 3 x 1 mm metallic foreign body in his left orbit without a history of injury. CONCLUSION: Screening plain films of the orbit are necessary when a patient has a history of a known intraocular or periorbital foreign body or when a patient has a history of occupational exposure to potential metallic ocular injury, as do welders, grinders, and metalworkers.

Adult↗
PubMedDate not supplied

[Problems in diagnosis and extraction of foreign bodies from the orbit associated with pain].

The aim of this study was to present the troubles and significance of a proper diagnosis of a foreign body which caused a double perforation of the eyeball and was retained in the orbit. Another reason for this case report was the intensive pain associated with the existing foreign body in the orbit. A male, 54 years old, had a perforating wound of the eyeball caused by a metal foreign body, which stayed in the orbit close to the scleral wall. X-ray and echographic examinations of the orbit were not conclusive regarding the question whether this foreign body was situated within or outside the eyeball. Only CT imaging showed that foreign body produced a double perforation of the eyeball and was externally close to the sclera. Foreign body was extracted by transconjunctival anterior orbitotomy through the inferior fornix, using the electromagnetic probe. Since the first day of injury and up to the eighth day, the patient had intensive deep orbital pain, which was alleviated only partially by analgetics. It could not be explained by secondary glaucoma because IOP was normal or by an inflammatory process, or in any other way. Only the extraction of foreign body from the orbit led to the complete relief of pain. We believe that the pain was caused by compression of foreign body to some of scleral sensory nerves. X-ray and echographic examinations of the orbit are not always a reliable proof in the proper evaluation whether foreign body is within or outside the eyeball in the orbit. Precise diagnosis can be made only by CT imaging. The pain in the orbit may be caused by compression of foreign body to sensory nerves.

Eye Foreign Bodies↗
PubMedDate not supplied

MR imaging of orbital inflammatory pseudotumors with extraorbital extension.

OBJECTIVE: To demonstrate a variety of MR imaging findings of orbital inflammatory pseudotumors with extraorbital extension. MATERIALS AND METHODS: We retrospectively reviewed the MR features of five patients, who were diagnosed clinically and radiologically as having an orbital inflammatory pseudotumor with extraorbital extension. RESULTS: The types of orbital pseudotumors were a mass in the orbital apex (n = 3), diffuse form (n = 2), and myositis (n = 1). The extraorbital extension of the orbital pseudotumor passed through the superior orbital fissure in all cases, through the inferior orbital fissure in two cases, and through the optic canal in one case. The orbital lesions extended into the following areas: the cavernous sinus (n = 4), the middle cranial fossa (n = 4), Meckel's cave (n = 2), the petrous apex (n = 2), the clivus (n = 2), the pterygopalatine fossa and infratemporal fossa (n = 2), the foramen rotundum (n = 1), the paranasal sinus (n = 1), and the infraorbital foramen (n = 1). On MR imaging, the lesions appeared as an isosignal intensity with gray matter on the T1-weighted images, as a low signal intensity on the T2-weighted images and showed a marked enhancement on the post-gadoliniumdiethylene triamine pentaacetic acid (post-Gd-DTPA) T1-sequences. The symptoms of all of the patients improved when they were given high doses of steroids. Three of the five patients experienced a recurrence. CONCLUSION: MR imaging is useful for demonstrating the presence of a variety of extraorbital extensions of orbital inflammatory pseudotumors.

Adult↗
PubMed1975

[Causes and consequences of orbital injuries].

For 20 years we have treated 219 patients from orbit trauma. According to the nature of injuries we had 57 cases with orbit fracture, 118 with the injury of intraorbital sof tissues, 37 with strange body in the orbit, and 7 cases in which orbital fistula had developed. Orbital fractures were most frequently caused by traffic accidents, until mutaual scuffles were the most frequent cause of injuries of the soft tissues of the orbit. As far as the localization of fractures is concerned, the worst disorder of sight and deformities in the orbital area were discovered in the lesion of the orbital roof and in multiple fractures of the orbital region.

Adolescent↗
PubMed2003

Orbital scintigraphy with the somatostatin receptor tracer 99mTc-P829 in patients with Graves' disease.

UNLABELLED: Receptors for somatostatin (SST) (SSTR) are expressed on various tumor cells as well as on activated lymphocytes. Previous data have shown that (99m)Tc-P829 binds with high affinity to many different types of tumor cells as well as to leukocytes via the human hSSTR2, hSSTR3, and hSSTR5 target receptors. Consequently, (99m)Tc-P829 was successfully introduced as a peptide tracer for tumor imaging. In this study, we evaluated the orbital uptake of (99m)Tc-P829 in patients with active and inactive thyroid-associated orbitopathy (TAO), accompanied by lymphocyte infiltration in the acute stage and by muscle fibrosis in the chronic stage of the disease. METHODS: To evaluate its clinical usefulness in Graves' disease, (99m)Tc-P829 scintigraphy (approximately equal to 740 MBq) was performed in 44 patients with TAO (median duration, 19 mo; range, 1-360 mo). The clinical activity of the orbital disease was graded by the NOSPECS (no signs or symptoms; only signs, no symptoms; signs only; proptosis; eye muscle involvement; corneal involvement; sight visual acuity reduction) classification of the American Thyroid Association, the clinical activity score (CAS), and the superonasal index (SNI). SPECT (360 degrees ) and planar studies were completed within 3 h after injection. Orbital (O) regions of interest (ROIs) were compared with temporoparietal and occipital (OCC) ROIs. Orbital uptake ratios in Graves' disease were compared with data obtained from lung cancer patients with no eye disease (n = 22). RESULTS: Overall, (99m)Tc-P829 biokinetics were the same in Graves' disease patients as in lung cancer patients, showing a rapid blood clearance and visualization of the facial bones within minutes of injection. In all control patients, the orbit appeared as a "cold area," whereas visual orbital accumulation of (99m)Tc-P829 was found in patients with active TAO (O/OCC ratios: 1.26 +/- 0.04 vs. 1.69 +/- 0.04; P < 0.01, respectively). Patients with active eye disease (n = 25) presented with an increased orbital uptake of (99m)Tc-P829 compared with patients with inactive disease (n = 19; O/OCC ratio: 1.12 +/- 0.05; P < 0.01). A statistically significant correlation was found between CAS and the orbital uptake (O/OCC ratio) values (r = 0.90), whereas no correlation could be documented regarding the NOSPECS classification as well as the SNI. CONCLUSION: In TAO, (99m)Tc-P829 yields high orbital binding with good clinical correlation. The better image quality due to the high energy of technetium, the lower radiation dose for patients and personnel, and the short acquisition protocol favor SSTR scintigraphy with (99m)Tc-P829 over (111)In-labeled compounds. The in-house availability of the radiotracer and cost-effectiveness are further advantages.

Cornea↗
PubMed2004

[Ocular and orbital complications of paranasal sinusitis].

PURPOSE: The task of the research was epidemiological and clinical analyses of those patients. MATERIAL AND METHODS: In the period of 1976-200 147 patients with complications of perinasal sinusitis were treated. As numerous classifications of paranasal sinusitis complications exist, the analysis of the material was based on the modified classification proposed by the authors. The frequency of the complications was presented in 5-years periods. RESULTS: There were 133 patients treated due to ocular and orbital complications. In our material there were 79 patients (59.4%) up to 15 years of age and 54 patients (40.6%) older than 15 years. We noted 47 females (35.3%) and 86 males (64.7%). In evaluated 5-years periods the number of patients treated balanced between 17 and 37. In our material dominated orbital periostitis (palpebral edema)--103 cases (77.4%). Subperiosteal abscessus of the orbit was noted in 21 cases (15.8%), inflammation of the orbital tissue--in 5 cases (3.8%), orbital abscessus in 2 cases (1.5%), other rare complications--in 2 cases (1.5%). CONCLUSIONS: Generally the number of patients with ocular and orbital complications of paranasal sinusitis was changing in 5-years periods, but we did not notice any permanent tendency for increase or decrease. In the last 5 years we noted the increase in the number of complications, which was connected with the increase of the number of patients treated for orbital periostitis. In 2 patients we found rare orbital and ocular complications, that were not included in existing classifications. These were: orbital subperiosteal haematoma and episcleritis.

Abscess↗
PubMed2006

[Volumetric measurement of human orbit by means of computed tomographic analysis based on CT scanning digital data].

OBJECTIVE: To establish and elucidate a feasible method by CT-scanning-based computed tomographic analysis for the volumetric measurement of orbit. METHODS: In this study, 19 dry intact dried skulls were used. CT digital data with continuous 0.625 mm transaxial sections was available for each and was inputted a professional tomographic analysis software in DICOM format. Subsequent to the orbital borderline lined on each of continuous axial images, software automatically generated three-dimensional orbital image and gave a value of orbital volume. In mean while, handicraft measurement of orbital volume was carried out for each and obtained another group of orbital volume value. Statistical analysis was made to test possible difference between two measurements. RESULTS: It was demonstrated that volumetric measurement by means of computed tomographic software had a accuracy of the 1.38%. Right and left orbital volumes were found to have a mean difference of 0.3 ml (0-1.4 ml). CONCLUSIONS: CT data-based computed tomographic analysis is a reliable method to measure orbital volume, which could be potentially used to determine the alternation of orbital volume after fracture.

Female↗
PubMed1990

[Orbital wall fracture from the ophthalmologic viewpoint].

The fracture of the orbital wall is characterized by a typical ophthalmological symptomatology, which is repeated more or less completely with each patient. Beside the optic nerve lesion, which is rare, the motility disturbance of the globe is the severest consequence of an orbital wall fracture. It is the ophthalmologist's task to correctly interpret the motility disturbance caused by an orbital wall fracture and to distinguish it from ocular motility disturbances of other origin. Thus he has decisive influence on the indication of an operation. After a short presentation of how an orbital wall fracture comes into being and its connection with a restricted motility of the globe, the diagnostic steps are described. Two questions important for the daily practice are discussed with the help of 161 case histories: 1. the connection between the development of the motility disturbance and the interval between the day of the accident and the day of the operation; 2. the influence of the type of the fracture on the kind and the extent of the motility disturbance and the time required for its complete recovery. It has been observed that the factor time, that is the fastest possible operative revision, does not, as assumed before, play the most important role for the normalisation of the globe's motility. Even late reconstructions of orbital wall fractures achieve good functional results. Only a fracture of the zygomatic bone healed in dislocation cannot be brought back to its proper anatomical position after a period of 4 to 5 weeks. Functionally it is, however, of minor importance. But there is an obvious connection between the type of the fracture and the extent as well as the regression of the motility disturbance of the globe. With isolated fractures of the zygomatic bone there are practically no motility restrictions, with combined fractures of the orbital entrance and the orbital floor there can but there need not be a motility disturbance. Severe motility disturbances are almost always caused by isolated blow out-fractures, especially with the trap-door mechanism and with fractures of the medial orbital wall. Even after an exact anatomical operative reconstruction motility disturbances in connection with medial orbital wall fractures remain for months, whereas they disappear 5 weeks after the operation at the latest with the other types of fractures.(ABSTRACT TRUNCATED AT 400 WORDS)

Child↗