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At least 1,513 records · Page 84Linked to original sources
PubMed1989

Sinus histiocytosis with massive lymphadenopathy: bilateral orbital involvement spanning 17 years.

We report a case of sinus histiocytosis with massive lymphadenopathy (SHML) with a right inferior orbital mass. The mass was excised and, on histopathologic examination, was believed to be a "lipogranuloma." Thirteen years later, the patient was seen at our institution for what appeared to be a recurrent orbital mass. Orbital tumors were removed from the right superior and inferior orbit and from the left superior orbit. Histopathologic examination of these tumors at this institution and at the Armed Forces Institute of Pathology showed them to be SHML. The original biopsy tissue obtained in 1969 was reexamined and found also to be SHML. The clinical and histopathologic features of this disease are discussed.

Adult↗
PubMed1987

[Orbital cysts caused by conjunctival inclusion occurring after orbito-oculo-palpebral surgery].

Acquired conjunctival implantation cysts of the orbit after oculo-orbital and palpebral surgery are benign tumors. The term (terminology) implies "mis-placement" of the conjunctival epithelium into the orbit. Till now they have been described after "enucleation surgery". In fact, they can follow "any kind" of oculo-orbital-palpebral surgery, our series shows. We report here seven cases of acquired implantation orbital cysts; we discuss pathogeny, diagnosis, and the different investigations. We insist upon curative and above all preventive treatment.

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

Evaluation of orbital injuries.

Trauma to the orbit is evaluated with a careful history, a thorough physical examination, and specific radiographic studies. Orbital trauma involves a wide range of conditions, including soft tissue adnexal injury, orbital contusion, optic nerve damage, ocular injury, intraorbital foreign bodies, and orbital fractures. This article emphasizes the importance of an accurate history and a comprehensive examination. It highlights relevant questions to ask, discusses the meaning of pertinent complaints, describes steps in the examination, discusses the diagnostic importance of the physical findings, and recommends specific radiographic studies for accurate identification and localization of orbital fractures and intraorbital foreign bodies.

Eye Foreign Bodies↗
PubMed1987

Complications in orbital lesions.

Excellent imagination of anatomy and diagnostic procedures are the basis for the diagnosis and therapy of orbital lesions. They can divided into (1) periorbital, and (2) intraorbital diseases: (1.1) fractures of the orbital floor; (1.2) alterations of the orbital roof; (1.3) endonasal ethmoidal removal; (1.4) operations for orbital decompression; (2.1) arterial lesion with increase of tension after retrobulbar injection, vulneration of the ethmoidal arteries and resection of orbital fat; (2.2) retrobulbar tumors. Examples are demonstrated. The most frequent complications are disturbances of motility, but operative revisions of these should not be done before 6 months have passed. Additional therapeutic recommendations are made.

Child, Preschool↗
PubMed1986

Mechanisms of global support and posttraumatic enophthalmos: I. The anatomy of the ligament sling and its relation to intramuscular cone orbital fat.

The mechanisms of posttraumatic enophthalmos were evaluated to determine the interrelation between fat and ligaments in globe support. Anatomic studies demonstrate that the ligaments form an essential "sling" framework for the globe but are alone insufficient to maintain the globe's full forward position. Removal of extramuscular fat in cadavers and in patients undergoing blepharoplasty did not significantly change globe position. Loss of intramuscular cone fat (atrophy or displacement) in cadavers and patients produced enophthalmos. Fat atrophy is not a prominent feature in most patients with posttraumatic enophthalmos. Some loss of intramuscular cone fat from displacement outside the muscle cone is frequently present. The principal mechanism, however, of posttraumatic enophthalmos involves a displacement and change in the shape of orbital soft tissue. Loss of bone and ligament support permits posterior displacement and a reshaping of orbital soft tissue under the influence of gravity and the remodeling forces of fibrous scar contracture. The shape of the retrobulbar orbital contents changes from a modified cone to a sphere, and the globe sinks backward and downward. Given that the volume of orbital soft tissue is constant following trauma, procedures to restore the shape and position of the orbital soft tissue by mobilization and bone reconstruction will correct or significantly improve enophthalmos.

Adipose Tissue↗
PubMed1981

[Ultrasonography and computed tomography in ophthalmological practice: comparative value during exploration of the eye and orbit (author's transl)].

Ultrasonography is a completely harmless method of examining the eye and the orbit and uses light, inexpensive equipment, within the reach of any ophthalmologist, to provide excellent information concerning the eye and is also well adapted to orbital examination. Cephalic computed tomography, which uses ionizing radiation, is especially efficient in orbital investigations, but this kind of examination is only required in about 10% of cases. It requires expensive, cumbersome equipment and highly specialised staff; frequent use of this method, as well as the injection of contrast products, can be risky. The reader will find 3 tables that summarize briefly the comparative possibilities of ultrasonography and computed tomography in bulbar and orbital investigations and for biometry. A 4th table underlines the suitability of one method or the other in terms of the symptomatology. Consultation of this table could be a time-saver: the ophthalmologist would always begin with the method most likely to give the best information and not waste time doing both. As far as the globe and the orbit are concerned, ultrasonography is normally sufficient. When this method seems problematical or gives insufficient information, the investigation can easily be completed with a computed tomography. Using this method, therefore we can go some way towards limiting the irradiation of the crystalline lens (sometimes unjustified) and towards saving time and money within the Health Service.

Cephalometry↗
PubMed1994

[Magnetic resonance tomography and computerized tomography of Wegener's granulomatosis of the orbits].

Of a total of 121 patients with histological proven Wegener's Granulomatosis, orbital involvement occurred in 12 cases. Eight of them underwent magnetic resonance imaging (MRI) of the head and brain, in 2 cases computed tomography (CT) was additionally performed. With MRI orbital granulomas had a low signal intensity in T1- and T2-weighted spin-echo sequences. After i.v. contrast medium administration an inhomogeneous enhancement was found. Because of the multiple imaging planes and high soft tissue contrast, orbital granulomas were better delineate with regard to the intraorbital muscles and the optic nerve using MRI than with CT. Osseous destruction and sclerosis of the orbital walls were demonstrated more effectively using CT. MRI and CT are thus complementary for diagnosing and staging, of orbital granulomas and periorbital involvement in Wegener's Granulomatosis.

Adult↗
PubMed1994

[Extraction of orbital foreign bodies using a new kind of image processing system].

We present a new localization system in orbital surgery. The procedure is based on the linkage of two methods. A preoperative thin-layer CT scan is taken and the image data are fed into a high-capacity computer which computes a three-dimensional model of the orbit. Intraoperatively, the volume model of the skull is linked to a mechanical arm for position measurement. Surgical instruments can be mounted to this arm. The computer then projects the position of the instrument into the volume model of the orbit, so that the surgeon can follow the movements of his instruments on the monitor. The surgeon has a means of checking position that comes close to constant intraoperative CT monitoring. Thereby the surgeon is able to localize even small foreign bodies without extensive explorations. We present six patients in whom orbital foreign bodies had to be extracted during the past 5 years. A 44-year-old man had an iron foreign body; the external wound was treated surgically elsewhere. Two patients (25 and 22 years old) had glass foreign bodies; in one of them the splinters were not seen using conventional X-ray. Choosing the exact level with the Hounsfield window, the foreign bodies could be demonstrated on the monitor. In three patients with orbital fractures and compression of the optic nerve, dislocated bone splinters were extracted. The localization of those splinters was easy using the imaging system, but would have been rather difficult by other means.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

A case of orbital emphysema as an ocular emergency.

Orbital emphysema is radiologically apparent in 50% of cases of orbital fractures, but it is generally a benign, self-limited condition. However, visual loss may occur if a fracture produces orbital compression via a ball-valve effect, allowing air to enter but not leave the orbit. A case of compressive orbital emphysema complicated by ischemic optic neuropathy is reported. Intraorbital needle aspiration relieved the compression with improvement of visual acuity and normalization of intraocular pressure.

Adult↗
PubMed1993

Comparison of real-time ultrasonography and coronal computed tomography in the diagnosis of orbital fractures.

Real-time ultrasonography (US) was used to evaluate the bony orbit in 19 patients who had sustained orbital trauma. The ability of US to demonstrate clinically significant orbital fractures was compared with that of thin-section coronal computed tomography (CT); the latter method was treated as definitive. US had a sensitivity of 92%, a specificity of 100% and a positive predictive value of 100%. Quantification of the size of fragments by the two methods yielded similar results. Real-time US adequately displayed the anatomic features of the orbit and detected clinically significant fractures. This technique may have a role in post-traumatic imaging of the orbit when coronal CT is not possible.

Female↗
PubMedDate not supplied

[The surgical approach to invasive orbital tumors].

The orbital exenteration is less and less practiced today, because of the reduced pathology which may impose such a radical intervention, but also because it has been transferred, in the lest two decades, to the maxillofacial plastic surgery. The paper presents three orbital exenterations, accomplished in the spinous-cell carcinoma of the inferior eye lid invading in the orbit, basal-cell epithelioma of internal angle recidivated during repeated interventions and conjunctival malignant melanoma invading the orbit. It is shown that orbital exenteration must not to abandoned by the ophthalmologists, which are the first doctors contracted by these patients and the only ones which can decide when the ocular globe may be sacrificed, with a recovery of the region as aesthetic as can be.

Aged↗
PubMed1997

Orbital exenteration and placement of a prosthesis in fish.

OBJECTIVE: To develop a procedure for orbital exenteration and prosthesis placement in fish. DESIGN: Prospective study. ANIMALS: 5 cultured hybrid striped bass (Morone saxatilis x M chrysops) ranging from 30 to 50 cm in length. PROCEDURE: Exenteration was performed, using a dorsal approach in which blunt dissection was performed in the circumorbital sulcus. The orbit was then dried, and simple interrupted sutures were placed, leaving 2 suture loops within the orbit. The orbit was filled with polyvinylsiloxane, and a prosthetic glass eye was seated in the polyvinylsiloxane. RESULTS: All fish retained the prosthesis and had satisfactory cosmetic results at the end of the 8-week study period. CLINICAL IMPLICATIONS: The increase in popularity of pet fish and abundance of valuable aquarium and show fish have led to heightened awareness of piscine ocular disease. Aquarium fish are often euthanatized because of disfiguring ocular problems. The technique described here for surgical exenteration and cosmetic orbital prosthesis placement in fish may extend the captive life of public display fish.

Animals↗
PubMed1996

[Surgery of orbital tumors with the Krönlein-Berke-Reese method in material from the Ophthalmology Clinics in Bałystok].

PURPOSE: To analyse the results of surgical treatment of tumors located in the posterior part of the orbit. MATERIAL AND METHODS: 12 patients (5 women and 7 men, aged 10-70 years) with tumors located in the posterior part of the orbit, operated on in the years 1985-1995 in Ophtalmology Clinic in Bialystok with the use of Krönlein-Berke-Reese lateral orbitotomy method. Tissues of removed tumor were evaluated histopathologically. RESULTS: In 7 cases tumor was removed completely, including 3 cases with simultaneous optic nerve removal. In 3 other cases tumor was removed partially, whereas in 2 cases eventration of the orbit was necessary. Persistent postsurgical defects of the eyeball mobility were not found in any of the patients. In 2 patients with partially removed tumor a constant blepharoptosis was observed, which required further operation. Visual acuity in patients with preserved optic nerve remained unchanged in 6 out of 7 cases. In 1 case-completely removed cavernoma-visual acuity decreased from 5/7 to 5/16. CONCLUSIONS: Lateral orbitotomy enables successful removal of tumors located in the posterior part of the orbit. Moreover, this method is relatively safe, especially in comparison with cranial approach to tumors badly located in the orbit.

Adolescent↗
PubMed1996

Surgical methods and approaches in the treatment of orbital disease.

Many orbital disorders require surgical intervention to establish the diagnossis or to provide the basis for planning the appropriate surgical procedure in these selected cases. The indications for biopsy versus complete surgical excision of orbital lesions are outlined. The nature of the specific techniques, including fine-needle aspiration biopsy, endoscopic biopsy, anterior orbitotomy, lateral orbitotomy, and multidisciplinary combined approaches to the orbit is discussed. Separate sections, with an emphasis on clinical radiographic correlates, are devoted to the commonly encountered surgical disorders, thyroid orbital decompression and acquired anophthalmia (evisceration, enucleation, and exenteration).

Biopsy, Needle↗
PubMedDate not supplied

The precaruncular approach to the medial orbit.

BACKGROUND: Most approaches to the medial orbit and lower provide suboptimal access and leave visible scars. The transcaruncular approach is an improvement over previous procedures, but disadvantages remain: there is no defined surgical plane through the caruncle; the caruncular tissue is highly vascular; and the approach may cause considerable postoperative morbidity. For these reasons, cadavers were studied to develop a surgical approach that would avoid the caruncle. A prospective outcome evaluation was then performed. MATERIALS AND METHODS: Two male and 2 female cadavers were studied to ascertain whether the plane medial or lateral to the caruncle provided optimal access to the medial orbit. Fifteen consecutive procedures were then prospectively evaluated using the medial approach. RESULTS: The "precaruncular" approach medial to the caruncle provided the most direct route to the medial orbit, with a clear, avascular path of dissection and improved exposure. In 15 consecutive procedures, there were no complications. The patients healed rapidly, with minimal postoperative morbidity. CONCLUSIONS: The precaruncular approach was demonstrated on cadavers to be more efficacious than approaches directly through or lateral to the caruncle. This finding was confirmed in a prospective evaluation of 15 procedures, in which no complications occurred. More rapid healing was noted than with prior experience using the transcaruncular route. The precaruncular approach provides a preseptal plane to the medial orbit that can be extended to the orbital floor or roof as needed, and offers a direct connection between the posterior lacrimal crest and the tarsal plate for medial canthopexy.

Adult↗
PubMed2003

Idiopathic orbital inflammation: distribution, clinical features, and treatment outcome.

OBJECTIVE: To evaluate the distribution and clinical as well as treatment outcome characteristics of idiopathic orbital inflammation with the aim of delineating a more systematic approach to diagnosis and treatment. METHODS: A 10-year retrospective review of patients with idiopathic orbital inflammation treated at one institution. RESULTS: Ninety eyes in 65 patients (22 men and 43 women) were studied. Diagnoses were isolated dacryoadenitis (n = 21), isolated myositis (n = 19), concurrent dacryoadenitis and myositis (n = 5), orbital apex syndrome (n = 6), and idiopathic inflammation involving the preseptal region, supraorbital region, sclera, Tenon capsule, orbital fat, or optic nerve (n = 14). The mean age at presentation was 45 years. Pain and periorbital swelling were the most common clinical features and were observed in 45 (69%) and 49 (75%) patients, respectively. Seventeen patients (26%) had bilateral involvement. Biopsy was performed in 19 patients (29%) with atypical presentations or who failed to respond to the initial therapy. Patients were treated with steroids alone (n = 45), steroids and subsequent radiation therapy (n = 8), steroids and nonsteroidal anti-inflammatory agents (n = 6), nonsteroidal anti-inflammatory agents alone in mild cases (n = 2), and, rarely, radiation therapy without steroids (n = 1) or surgical debulking alone (n = 1). Of 65 patients, 41 (63%) represented treatment successes, with complete symptom relief at the time of the last follow-up, and 24 (37%) represented treatment failures, with partial or no relief of symptoms. Treatment failures were often characterized by recurrence of inflammation after a period of quiescence (58%) and unremitting, recalcitrant inflammation (38%); 1 patient ultimately required an exenteration. CONCLUSION: Systemic steroid with a slow taper has been the established first-line treatment for idiopathic orbital inflammation, but refractory cases accounted for a significant portion of treatment failures in our study, reflecting the need for a more systematic approach to the study of this multifaceted disease and for therapeutic alternatives to systemic steroids.

Adolescent↗
PubMed1977

Regression of orbital hemangioma detected by echography.

Two infants had orbital cavernous hemangioma that showed impressive regression documented by ultrasound follow-up. In a 15-week-old infant the hemangioma regressed from a size of 11.49 mm to 5.36 mm in prominence during a six-month period. In a 9-month-old infant the mass regressed from 8.53 mm to 4.6 mm during a six-month period. These cases demonstrate that orbital cavernous hemangioma in infancy occasionally shows impressive regression. Furthermore, they illustrate the value of orbital ultrasonography in defining the natural history of orbital hemangioma. Similar follow-up studies in large numbers of infants with orbital hemangioma are needed to further our understanding of the natural history of this tumor.

Female↗