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At least 1,531 records · Page 85Linked to original sources
PubMed1983

Subperiosteal abscess of the orbit.

Seven cases of subperiosteal abscess (SPA) of the orbit are reported. Anatomic relationships shared by the orbits, paranasal sinuses, and facial venous system explain the rapid development of SPA after periorbital infection. Computed tomography and echography allow distinction between SPA and other stages of orbital inflammation that are often indiscriminately grouped under the rubric of orbital cellulitis. These techniques suggest that elevated orbital pressure is the primary, and potentially reversible, mechanism of visual impairment produced by SPA. Difficulty in accurately determining the responsible pathogens, relative isolation of the subperiosteal space with regard to antibiotic penetration, and risk of precipitous visual loss require prompt surgical drainage in most cases.

Abscess↗
PubMed1984

Classification and incidence of space-occupying lesions of the orbit. A survey of 645 biopsies.

Six hundred forty-five consecutive biopsies of orbital lesions performed at a major ophthalmic hospital during a 20-year period were used to develop a comprehensive classification of orbital tumors and pseudotumors, excluding thyroid orbitopathy. Although this series has certain bias, it probably closely parallels the incidence of orbital lesions that would prompt a biopsy in an ophthalmic practice. It is hoped that this review, combined with a familiarity of the signs and symptoms of various orbital lesions, will aid the clinician in the diagnostic evaluation of the patient with an orbital mass.

Biopsy↗
PubMed1985

An individualized approach to orbital decompression in Graves' orbitopathy.

With better understanding of the various techniques available for orbital decompression, the indications for surgical decompression in Graves' orbitopathy are now less rigid. Decompressions may be performed for (1) prolonged orbital congestion and pain, (2) orbital problems resistant to steroid treatment, (3) orbital problems where there have been steroid complications, (4) severe corneal exposure that cannot be treated with lid-lengthening surgery, and (5) the standard indication--Graves' optic neuropathy. Assessment of muscle size by computed tomographic scanning and ultrasound, as well as the measurement of orbital pressure, are important advances in the assessment of these patients. The lateral approach produces less strabismus and allows for exophthalmos reduction, especially if fascia temporalis is incised and if part of that muscle is removed. The inferomedial approach is advisable in patients with severe posterior optic neuropathy caused by apical crowding of the enlarged muscles, particularly the medial rectus. The two approaches may be combined in severe cases.

Female↗
PubMed1988

Orbital surgery. The technique of coronal scalp flap approach to the qateral orbitotomy.

Lateral orbitotomy may be performed using a coronal scalp flap to provide exposure of the lateral orbital wall and rim. A coronal incision is made across the scalp. The scalp flap is developed anteriorly to expose the orbital margin from the superior orbital rim to the zygomatic arch. The temporalis muscle is dissected from its bony attachments and bluntly retracted, providing maximal exposure of the lateral orbital wall. The orbitotomy proceeds as required. The case concludes with a layered closure. In selected patients, the coronal scalp flap provides improved exposure and postoperative aesthetics compared with approaches in which the skin and muscle layer are incised directly over the lateral orbit. Complications are infrequent.

Humans↗
PubMed1989

A search for lymphatic drainage of the monkey orbit.

Colloid solutions of technetium Tc 99m and india ink injected into the retrobulbar space of the cynomolgus monkey outside the extraocular muscle cone were removed from the orbit by the lymphatic vessels of the conjunctiva and eyelids and were then concentrated within the lymph nodes that drained the conjunctival and eyelid areas. Colloid solutions injected into the retrobulbar space inside the extraocular muscle cone did not reach the conjunctiva and did not collect in any lymph nodes over a 24-hour period. Within the orbit, the injected colloids spread along the planes of the connective-tissue septa. No lymphatic vessels were identified within the orbits posterior to the conjunctiva. Small amounts of india ink left the posterior orbit and ultimately entered the contralateral orbit. This posterior pathway did not lead to lymphatic vessels or lymph nodes and therefore does not appear to represent a prelymphatic pathway.

Animals↗
PubMed1995

Inverted papillomas that invade the orbit.

We describe 10 patients with inverted papillomas (IPs), uncommon endophytic epithelial tumors that arose in the nose, paranasal sinuses, and lacrimal sac, that invaded the orbit; review the world literature on IP; and discuss treatment options. Patients ranged in age from 49 to 72 years (mean age, 62 years; median age, 66 years). Six patients were men and four were women. Presenting symptoms and signs included a medial canthal mass (n = 5), epiphora/lacrimal drainage obstruction (n = 3), inability to wear eyeglasses (n = 2), diplopia (n = 1), and painful dentures (n = 1). Histopathologic examination was performed in each patient and revealed all patients to have areas with malignant transformation: six patients with IPs that contained areas of squamous cell carcinoma and four with areas of transitional cell carcinoma in the tumor within the orbit. Eight of the patients with IPs had a recurrence after initial resection. In two patients, the IPs were completely excised and did not recur; yet, follow-up was short. Eight patients required orbital exenteration for local control of disease. Nevertheless, local spread of tumor through bone to brain occurred in three patients with orbital involvement. Indeed, IPs that invade the orbit have a high incidence of malignancy and are locally aggressive tumors. Treatment is difficult, and the recurrence rate is high. Early, wide excision of this aggressive tumor provides the best chance of cure.

Aged↗
PubMed2002

Bilateral orbital complications of pediatric rhinosinusitis.

Orbital complications of pediatric rhinosinusitis are usually unilateral at presentation. We describe 3 children with bilateral orbital cellulitis that occurred as a complication of rhinosinusitis. The children ranged in age from 11 to 14 years, had prolonged hospital stays that ranged from 10 to 19 days, and underwent multiple surgical procedures to drain subperiosteal and intraorbital abscesses. They appeared to have direct spread of disease from the ethmoid sinuses to both orbits, without intracranial spread of infection. Therefore, the presence of bilateral orbital complications of rhinosinusitis does not necessarily imply spread of disease to the cavernous sinus. Children who present with bilateral orbital complications of rhinosinusitis should be treated aggressively from the outset, since they suffer from a more widespread form of the disease.

Adolescent↗
PubMed1988

The temporal approach to impacted lateral orbital wall fractures.

Impact forces centered over the lateral orbital rim may cause fracture dislocations of the frontal process of the zygoma and the orbital plate of the sphenoid bone. These two major components of the lateral orbital wall may be impacted separately or as a unit into the posterior orbit to cause severe injuries to the eyeball or optic nerve. These ophthalmic injuries may be worsened by attempts to manipulate the bony fragments through the standard periorbital incisions. A safer approach is the temporal approach that exposes the entire lateral zygomatico-orbital region through a hemicoronal incision. This allows for manipulation of the lateral wall fragments under direct visualization and without retraction pressure on the globe. This larger operation appears justified in selected cases by the reduced risks to an already compromised eyeball or optic nerve.

Accidents, Traffic↗
PubMed1993

Orbital decompression for preservation of vision in Graves' ophthalmopathy.

Graves' ophthalmopathy (thyroid eye disease) can result in progressive visual loss. The University of Washington (Seattle) experience in orbital decompression was reviewed for the years 1983 through 1990 to determine overall safety and outcome. Twenty patients underwent transantral decompression of 36 orbits for either steroid therapy failure, steroid therapy intolerance, or recurrence of optic neuropathy with tapering of the steroid therapy. Decompression successfully improved visual function in 33 of the orbits (92%) and a second decompression procedure was successful in another two (5%) of the orbits (6%). There were no major complications or cases of decreased visual function. Diplopia, present preoperatively in 17 patients (85%), was improved in eight patients (47%) and unchanged in nine patients (53%). However, of the three patients without preoperative diplopia (15%), one had development of new-onset diplopia postoperatively. Transantral decompression of the orbit offers a safe and effective therapeutic modality for vision-threatening Graves' ophthalmopathy.

Adrenal Cortex Hormones↗
PubMed1985

Clinicopathologic and immunologic characteristics of non-Hodgkin's lymphomas presenting in the orbit. A report of eight cases.

Of 325 consecutive cases of non-Hodgkin's malignant lymphomas, 8 patients (2.4%) showed orbital presentation. The clinicopathologic and immunologic analysis of the eight patients revealed characteristic biologic features. Despite the apparently isolated orbital presentation, all cases had subclinical systemic disease. Seven of the eight cases exhibited lymphoplasmacytic/cytoid features, with concurrent type II cryoglobulinemia in five of them. In addition, during their clinical course, five patients showed single or multiple subcutaneous nodules with the same histologic and immunologic pattern as the orbital tumor. This study demonstrates that most orbital lymphomas share particular clinicopathologic and immunologic features, suggesting an origin from a B-cell subset with preferential homing to orbital tissues and subcutis.

Aged↗
PubMed1994

Mesenchymal chondrosarcoma of the orbit. Report of three new cases and review of the literature.

BACKGROUND: Extraskeletal mesenchymal chondrosarcoma is a rare tumor characterized by undifferentiated mesenchymal cells with islands of mature hyaline cartilage. Considering all sites, long-term survival is approximately 30%. Only seven cases of orbital mesenchymal chondrosarcoma have been reported. METHODS: The records of three cases of orbital mesenchymal chondrosarcoma treated at the Columbia-Presbyterian Medical Center, and the seven previously reported cases of this tumor were reviewed to determine clinical characteristics and appropriate therapy. RESULTS: Nine of the 10 patients were female; age of onset ranged from 10 to 35 years. Of eight patients with at least 2 years of observation, five survived 5 or more years after resection, or after resection plus adjuvant therapy. Two patients died of metastatic disease 2 and 5 years, respectively, after the initial treatment, and one died of pneumonia 6 months after surgery. Review of the histology of the three cases treated at Columbia-Presbyterian Medical Center did not identify distinct histologic types that might guide therapy. Presenting symptoms were typical of symptoms of an orbital mass: proptosis, pain, diplopia, change in visual acuity, ptosis, and tearing. CONCLUSION: The small number of reported cases of mesenchymal chondrosarcoma of the orbit prevents definitive conclusions, but it appears that resection is adequate therapy in some cases. Extraskeletal mesenchymal chondrosarcoma of the orbit may have a better prognosis than tumors in other sites.

Adolescent↗
PubMed1994

The role of chemotherapy in orbital involvement of retinoblastoma. The experience of a single institution with 33 patients.

BACKGROUND: Orbital involvement is a rare occurrence in retinoblastoma but still carries a bad prognosis. The aim of this study was to define more clearly the role of chemotherapy in this advanced disease. METHODS: Between 1977 and 1991, 33 patients were treated at the Services de Pédiatrie at Institut Curie (Paris, France) for orbital involvement of retinoblastoma, which was isolated in 20 patients and associated with metastases in 13 patients (outside the central nervous system [CNS], 6; within the CNS, 7). Treatment included chemotherapy for 33 patients, irradiation of the orbit for 23 patients, and intrathecal chemotherapy and/or CNS irradiation in selected patients. RESULTS: The plateau phase of the survival curve was reached at 15 months, with a survival of 34% plus or minus 8%. The disease free interval was longer when patients had no CNS disease (P < 0.05). Twenty of the 21 recurrences (95%) occurred within 1 year after diagnosis of orbital involvement. CONCLUSIONS: Intensive chemotherapy using cyclophosphamide, platinum compounds, epipodophyllotoxins, doxorubicin, and vincristine was effective in orbital involvement of retinoblastoma even with associated extra-CNS metastases. However, associated CNS disease still carries a bad prognosis, and long term follow-up is necessary to evaluate the risk of a second tumor.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2002

Bony orbital anatomy of the koala (Phascolarctos cinereus).

This is the first documented study of the anatomical details of the normal koala orbit. Baseline data are established which are necessary for understanding and treating ocular disease in the koala (Phascolarctos cinereus). The bony anatomy of the orbit of the koala was examined and described from animals that presented dead or had been euthanized for humane reasons. Dissections of the orbital cavity were performed under magnification, and descriptions of the orbital bones were from macerated skulls that had been boiled and cleaned. In general, the orbital bones of the koala, and their respective foramina, are consistent with those of other carnivorous polyprotodont and herbivorous diprotodont marsupials.

Animals↗
PubMedDate not supplied

Reversible visual loss due to impacted lateral orbital wall fractures.

Impaction of the sharp medial edge of the orbital plate of the greater sphenoid wing into the orbital apex is a unique type of lateral orbital wall fracture that can produce a potentially reversible optic neuropathy. Two patients in whom the lateral or temporal approach to the orbit was used to reduce this type of fracture will be presented. In both patients, improvement in vision appeared to be related to removal of a bone fragment compressing the optic nerve in the orbital apex.

Adult↗
PubMedDate not supplied

Closure of large orbital-maxillary defects with free latissimus dorsi myocutaneous flaps.

The treatment of advanced cancer of the maxillary sinus often requires extensive ablation and orbital exenteration that results in large full-thickness defects of the upper cheek and orbital regions. Reconstruction of such defects with local flaps is usually difficult because of the need for a large flap. Several regional flaps such as the deltopectoral flap, the temporal flap, and the shoulder flap may be used, but these techniques frequently require surgery in stages and result in severe deformity of the donor site. The island pedicled, pectoralis major myocutaneous flap may be rotated up to the orbital region; however, the uncertain blood supply to the skin in the distal area of the pectoralis may cause unexpected marginal necrosis of the flap. Reconstruction of large orbital-maxillary defects can readily be accomplished in one stage using microsurgical free transfer of latissimus dorsi myocutaneous flaps. The thoracodorsal artery and vein that form the nutrient pedicle of the flap approaches 2 mm in external diameter and up to 10 cm in length, allowing greater versatility in head and neck reconstruction. The muscle may be used to fill the orbital and maxillary cavities and will accept a skin graft on its deep surface. The donor defect is closed primarily and the resulting scar is well concealed beneath the arm. If necessary, extremely large flaps may be transferred by harvesting the entire latissimus dorsi muscle and the overlying skin based on the thoracodorsal system.

Abdominal Muscles↗
PubMed2003

Typical genomic imbalances in primary MALT lymphoma of the orbit.

Primary orbital non-Hodgkin lymphoma is a mucosa-associated lymphoid tissue (MALT)-type extranodal marginal zone lymphoma. Little information is available on its genome as conventional cytogenetics is limited by scarce biopsy material, while fluorescence in situ hybridization (FISH) explores only selected regions. Comparative genomic hybridization (CGH) performs full genomic analysis and is applicable to different sources of DNA, such as fresh and frozen cells, as well as paraffin-embedded tissues. In this study, CGH was used to analyse primary MALT lymphoma of the orbit. Aneuploidy was identified in six of the ten cases studied. Gains (19) were more frequent than losses (5). The most frequent duplications involved chromosome 3 (common region at 3q24-qter), as expected in marginal zone lymphoma, and chromosome 6 (common region at 6p21.1-21.3), which is typical of an orbital location. Other chromosome gains were found at 1p, 7, 8q, 9q, 12, 13, 17, 18, 19, 22, and X. Losses were located at 1q, 6q, 9q, 11q, and 13q. Two cases showed isolated duplications of chromosome 6p or 9q. Isolated imbalances were found only in tumours affecting the conjunctiva. Complex aneuploidies were observed in lymphoma of the retro-orbital tissue. In summary, CGH in orbital MALT lymphoma provided new insights into typical genomic imbalances and underlying pathogenetic mechanisms.

Aged↗
PubMed1993

Common histopathological changes in aged human orbital arteries.

The physiology of the orbital arteries supplying the eye is currently under intensive investigation. However, while the anatomical distribution of these vessels in humans is well known, their normal histology and age-related or other pathologic alterations have hardly been studied. We obtained at autopsy 10 orbits from persons aged > or = 74 years, and two orbits from a person aged 47 years. Specimens were taken from 20 locations along the orbital arteries, from the internal carotid to the globe, and studied by light microscopy. We observed the following arteriosclerotic changes, in order of decreasing frequency: intimal hyperplasia, medial atrophy, atherosclerotic fibrous plaques, and calcifications of the internal elastic lamina. As a rule, the intensity of the changes decreased from proximal to distal. This study shows that aged human orbital arteries are readily subject to degenerative changes that may play an important role in ophthalmic vascular disease.

Aged↗
PubMed1987

Aesthetic considerations in the reconstruction of the anophthalmic orbit.

Twenty-four patients with severe anophthalmic orbit syndrome were treated with a combination of techniques utilizing autogenous tissue. Autogenous corticocancellous bone grafts were used in the orbit as a volume filler. The temporalis muscle and a fasciae flap with a pericranial flap were used as a curtain to cover the bone grafts and to give a softening effect. The prosthesis used was a regular eye shell. With this method it can be smaller, thinner, and lighter to produce less deformation of the lower lid, particularly when used for a long period of time. In children who have this deformity compounded by small orbits after oncologic treatment, three-wall orbital enlargement is done to achieve a larger orbit, so as to match the normal unaffected socket and produce symmetry.

Adolescent↗