摘要:

The presence of orbital lymphatics in the primate model is demonstrated using light and electron microscopic enzyme histochemistry. In addition, strictly morphological definitions of lymphatics, such as discontinuous basal lamina, thin and irregular walls, anchoring filaments, and attenuated endothelial cell cytoplasm, were applied. This study confirmed the presence of conjunctival lymphatics reported by others. It also clearly demonstrated the presence of orbital arachnoid and lacrimal gland lymphatics that have not been previously described. A few areas of the extraocular muscles and connective tissue at the orbital apex also showed evidence of the presence of lymphatic vessels. Additional work is needed to define the nature and extent of orbital lymphatics as well as their connection to the extraorbital lymphatic system.

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Twenty-five cases of mucoepidermoid carcinoma of the lacrimal gland are compiled, the largest series reported to date. Five of these have not been previously reported. Additional follow-up is presented for seven cases previously reported in the literature, and 13 other cases from the literature are reviewed. This study suggests that histologic grading of the tumor into low- (grades 1 and 2) and high-grade (grade 3) tumors is most predictive of prognosis and can be used to formulate a therapeutic plan. Of the 16 patients with a known histologic grade for their tumors, 8 had low-grade tumors and 7 of these patients survived after extirpation with or without radiotherapy. On the other hand, only 1 of the 8 patients with high-grade tumors for which extended follow-up was available has remained tumor free. The authors suggest that low-grade tumors can be treated with complete extirpation with or without adjuvant radiation and that these tumors generally have a good prognosis. Grade 3 tumors, on the other hand, may be treated aggressively with exenteration and excision of bone, if needed, as well as adjuvant radiation. But these tumors, despite this treatment, carry a poor prognosis.

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Histochemical effects of botulinum B toxin were studied on fibers from longissimus dorsi muscle in Albino rabbits and compared to effects produced by botulinum A toxin. Acetylcholinesterase staining, muscle fiber size analysis, and ATPase staining indicated botulinum B toxin produced a denervation gradient and field similar to that produced by botulinum A toxin. At 5 weeks postinjection with botulinum B toxin, analysis showed muscle fiber size variability, and diffuse acetylcholinesterase fiber staining comparable to botulinum A toxin at the injection site. Muscle sections taken at 4.0 cm for analysis showed statistically significant decreased fiber size variability and contraction of acetylcholinesterase staining pattern for both immuno-types. In addition, the denervation reflected by histochemical staining and fiber size analysis appeared transient and lasted for approximately 3 months for both immunotypes. These findings suggest botulinum B toxin produces pharmacologic effects on innervation of striated muscle similar to botulinum A toxin. Because immunologic tolerance has been demonstrated after therapeutic botulinum A toxin injections, further clinical studies need to be conducted with other immunotypes of toxin with no cross-reactivity to type A.

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Over the past 5 years, Vicryl mesh (polyglactin-910) implants were used successfully to reconstruct the orbital floor in 28 patients with significant preoperative diplopia due to orbital floor fractures. The layered mesh is available in 26.5 χ 24 cm sheets, each of which is folded onto itself into 24 layers and packaged; 24 layers are approximately 4 mm thick. Appropriately sized implants varying in thickness from 6 to 56 layers were used to cover and fill the orbital floor defect. Absorbable Vicryl mesh is well-tolerated by orbital tissues; since it is soft and pliable, it is unlikely to compress orbital structures such as the optic nerve, lacrimal sac, or extraocular muscles. A second surgical site necessary for autogenous implants is avoided. The Vicryl mesh implant is technically easy to insert and does not require fixation in the orbit. Because Vicryl mesh is absorbable, the risks associated with permanent alloplastic implants are reduced. Similarly, there is no potential spread of communicable disease with homologous tissue implants. Follow-up ranged from 1 month to 2 years (median, 13 months). None of the patients had late complications. The only complication was transient, low-grade eyelid inflammation in four patients.

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Patients with unilateral congenital ptosis often adopt chin elevation to maintain fusion. This compensatory head posturing has been considered a sign of fusion, thus indicating a low risk for amblyopia. To evaluate this sign, we reviewed the charts of 11 preverbal children with unilateral congenital ptosis who had straight eyes and appropriate compensatory head posturing to maintain binocular vision. Four additional patients with unilateral ptosis and no compensatory head posturing were tested for comparison. All patients had undergone an examination and had been tested by pattern Visual Evoked Potential (VEP) under chloral hydrate sedation. Five of the 11 patients with compensatory head posturing were found to be amblyopic, three moderately so and two severely affected. The four patients without compensatory head posturing were amblyopic. It is our hypothesis that compensatory head posturing allows peripheral fusion even when significant amblyopia is present. Additionally, the clinical sign of a compensatory head turn to maintain binocular vision does not rule out the presence of significant amblyopia.

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The successful long-term management of epiphora caused by punctal stenosis presents a difficult problem for the ophthalmologist. The purpose of this paper is to describe a successful procedure that respects lacrimal excretory anatomy and provides excellent results in the management of epiphora. Twenty-three patients (32 eyes) with punctal stenosis underwent excision of the stenotic puncta followed by microscopic externalization of the vertical canaliculus. At 6 months and 1 year, only one patient complained of tearing; at 2 years, three eyes experienced tearing and were successfully dilated; no eyes experienced tearing at 4 years. Only one patient experienced a dry eye, which was managed with topical lubricants. Microscopic punc-toplasty thus provides excellent long-term management of epiphora from punctal stenosis with minimal disruption of anatomy.

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The use of the epiglottis as a composite graft in eyelid reconstruction is presented. Anatomy, histology, and physiology of the epiglottis are discussed. Two cases in which the epiglottis was used in reconstruction of lower eyelid deformities are reported.

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A noncosmetic blepharoplasty with levator tuck was planned to repair a congenital ptosis presumed to be caused by levator maldevelopment. During surgery a mass was found in the lid, revealing the ptosis to be mechanical in nature. Biopsy and subsequent pathological exam revealed this to be a plexiform neurofibroma in a reportedly undiagnosed patient.

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

A modified gold weight has been developed for use in paretic upper eyelids following seventh nerve damage. The modified weight is implanted in the pretarsal space. The weight was developed to enhance lid blinking, minimize extrusion, provide better cosmesis, and to provide a good upper lid blinking mechanism.

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0740-9303    

出版商:OVID    

年代:1993

数据来源: OVID