摘要:

Seven patients with significant frontal trauma involving the supraorbital region associated with orbital roof “blow-in” fractures were admitted to the Maryland Institute for Emergency Medical Services Systems (MIEMSS) at the University of Maryland Medical System over a 16-month period. High-resolution computed tomography (HRCT) with three-dimensional reconstructions demonstrated a downward displacement of the orbital roof in the absence of any orbital rim discontinuity. Associated findings included contussive and hemorrhagic injury to the ipsilateral frontal and parietal lobes, proptosis, ptosis, chemosis, orbital hematoma, and optic nerve contusion. The only long-term ocular pathology in this group of patients was mild to severe optic atrophy. It is recommended that all patients with frontal bone trauma have thin-cut computed tomographic evaluation of the orbit.

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Following orbital exenteration, there is a spectrum of immediate and delayed options for orbital reconstruction. Goals of reconstruction after exenteration include detection of recurrent disease, restoration of boundaries between the orbit and surrounding structures, and optimal aesthetics. Local solutions to problems of the exenterated orbit, such as healing by granulation or application of split-thickness skin grafts, are advantageous for detecting recurrent disease. Regional solutions, involving transfer of periorbital tissue into the orbit, may mask recurrent disease and create adjacent deformity; however, these solutions can be used to restore orbital boundaries and shallow the orbital cavity. Distant solutions, such as skin-muscle flaps and free tissue grafts, allow for facial reconstruction in patients with extensive orbital and periorbital defects.

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Sixty-one lid-loading procedures, performed by the author, were evaluated prospectively, Simple, gold weight implantation, combined with lower lid retractor recession, placement of fascia lata, and lateral tarsal strip tightening is effective for promoting voluntary closure and correction of lower lid paralytic ectropion. Placement of a heavier gold weight, in combination with mullerectomy, is a reliable new approach for mimicking involuntary blink without ptosis.

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The anatomy of the orbital septum and associated eyelid connective tissues was examined using cadaver dissection, histologie sections, surgical observations, and special radiologie imaging. The embryologie development of the eyelid connective tissues was also reviewed. Examination revealed a distinct layer of fibroadipose tissue in the eyelid and eyebrow posterior to the orbicularis and frontalis muscles, and anterior to the orbital septum. Fibrous septa within the submuscular fibroadipose tissue become contiguous with more compact lamellae of the orbital septum posteriorly imparting a multilayered quality to the orbital septum. Fat within the fibroadipose layer anterior to the orbital septum may be mistaken for the preaponeurotic fat pad by the unwary surgeon and may lead to surgical error. The orbital septum and the levator aponeurosis were found to join 2 to 5 mm above the superior tarsal border (average, 3.4 mm). Recommendations for ptosis surgery based on these anatomic principles are given.

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

A modified Müller's muscle-conjunctival resection procedure was performed to correct minimal to mild blepharoptosis with good levator function. A semilinear formula was used to excise specific amounts of Müller's muscle for different amounts of blepharoptosis. This formula was modified by less than adequate responses with the phenylephrine test. The phenylephrine test was also used to unmask contralateral ptosis so that bilateral surgery or less resection on the primarily ptotic eye could be planned. This modified technique and formula provides an approach to better quantitate minimal to mild ptosis surgery and yield more predictable results.

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Combined procedures that address multiple etiologic factors in involutional entropion are not new, but ophthalmic surgeons have been slow to accept this surgical approach. Traditional procedures that correct only one or two of the etiologic factors have a high incidence of recurrent entropion. The purpose of this article is to encourage the use of a combined procedure in the treatment of all cases of primary and recurrent entropion to minimize recurrences. Between 1983 and 1989, 127 consecutive eyelids with involutional entropion in 97 patients were operated by the senior author (R.P.C.) using the procedure described in this paper. Of these eyelids, 39% (49) had previous surgery and 22% (28) had more than one previous procedure. Although occasional minor postoperative problems occurred, they were readily managed, and there have been no known recurrences of entropion with an average follow-up of 33 months.

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Many techniques have been described for performing successful dacryocystorhinostomies (DCRs). The patency of the passageway from the internal common punctum through the osteotomy site into the nasal cavity is usually the limiting factor in the success of the DCR. We present a modification using a “coffee can lid” stent to keep the osteotomy site open when there is no free space between the osteotomy and the nasal septum (medial wall of the nose).

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The cytopathology of a lipogranuloma of external origin is reported in the eyelid of a 32-year-old man excised 1 year following regional exposure to an explosion of hydraulic oil under high pressure. The foreign lipids were still present in chronic lipogranulomas with intercellular lipidfilled cysts surrounded by macrophages and giant cells containing intracellular lipid-filled vacuoles. These indicate efforts in storage and very slow digestion. Secondary fibrosis in the region of the lipogranuloma was an important associated process. In view of the widespread technical use of hydraulic oily fluids under high pressure, it is recommended that these fluids be biodegradable.

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Cyanoacrylate skin adhesions of the lateral lower eyelid reinforced with surgical tape were created in three patients in order to temporarily correct epiphora due to lid laxity, eyelid malposition, punctal malposition or punctum-eyelid apposition. The cyanoacrylate adhesions resulted in relief of epiphora or aided in establishing the cause of epiphora, and allowed the patient to “sample” the anticipated benefits of corrective lid surgery. Trial eyelid repositioning may be useful in cases where there is only mild or equivocal punctal malposition or lid laxity and the surgeon wishes to predict the effect of corrective lid surgery.

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The present paper presents three cases of transient internal ophthalmoplegia during blepharoplasty. All cases were characterized by a dilated pupil that was unreactive to light or an accommodative stimulus. There were no cases of visual loss or permanent pupillary abnormalities. We attribute the temporary pupillary mydriasis and accommodative insufficiency to anesthesia of the short ciliary nerves or ciliary ganglion from local anesthetic diffusing into the orbit at the time of injection. To the best of our knowledge this is a complication of eyelid surgery that has not been previously described.

ISSN:0740-9303    

出版商:OVID    

年代:1991

数据来源: OVID