ISSN:0740-9303    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

PurposeTo describe the anatomic and histologic relations of the muscle of Riolan in the eyelid margin.MethodsSerial microscopic sections of the eyelid were prepared, digitally scanned, and then reconstructed with computer software to create a 3-dimensional profile of this muscle group in two planes.ResultsThe muscle of Riolan is a distinct subdivision of striated muscle that is separate from the pretarsal orbicularis muscle. In parasagittal eyelid sections, the muscle appears to be composed of two separate bundles, the pars ciliaris, located anterior to the tarsal plate, and a second smaller bundle, the pars subtarsalis, located posterior to the orifices of the meibomian glands. Coronal sections, however, demonstrate numerous muscle fibers that traverse the tarsus, connecting the two muscle groups that we describe for the first time as the pars fascicularis.ConclusionsThe three muscle subdivisions are therefore physically joined together and appear to act as a single functional entity that should be collectively referred to as the muscle of Riolan.

ISSN:0740-9303    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

PurposeTo study the lymphatic drainage of the cynomolgus monkey through the use of lymphoscintigraphy.MethodsLymphoscintigraphy with 500 &mgr;Ci of99mTechnetium sulfur colloid injected at specific sites around the eyelids was performed with five cynomolgus monkeys in lateral and ventral positions.ResultsLymphoscintigraphy of the monkey eyelid and periocular tissue revealed lymphatic drainage to the parotid lymph nodes from the entire upper eyelid, medial canthus, and lateral lower eyelid and drainage to the submandibular lymph nodes from the medial and central lower eyelid. In addition to draining to the parotid lymph nodes, the central upper eyelid was also seen to drain to the submandibular lymph nodes.ConclusionsLymphoscintigraphy of the cynomolgus monkey eyelids reveals discrete lymphatic drainage pathways for the upper and lower eyelids and a dual pathway for the central upper eyelid. Future studies will help to clarify the lymphatic drainage pathways of human eyelids.

ISSN:0740-9303    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

PurposeStandard methods for the evaluation of human optic nerve perfusion provide limited information. In this pilot study, the authors investigated the feasibility of qualitative perfusion imaging, a recently developed neuroradiologic technique, as a method of assessing human intraorbital optic nerve blood flow.MethodsQualitative perfusion imaging (based on magnetic resonance fast spin-echo sequences) was used to study the optic nerves of 7 healthy volunteers and 5 patients with known optic nerve disease. Data regarding both study subject background and alteration in optic nerve signal intensity were statistically analyzed.ResultsControl group subjects were significantly younger than study group subjects. No significant differences in optic nerve signal patterns were found within the control group. Comparison of patients with optic neuropathy against the normal composite revealed substantial differences in enhancement characteristics.ConclusionsQualitative perfusion imaging of the human optic nerve is feasible and may serve as the basis for more advanced neuroradiologic studies of optic nerve blood flow abnormalities.

ISSN:0740-9303    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

PurposeTo describe the CT findings of distensible orbital venous anomalies.MethodsWe reviewed the records of 17 consecutive patients who met the imaging criteria for orbital venous anomalies. We analyzed the clinical data and the CT scans qualitatively and quantitatively.ResultsDistensible venous anomalies usually occupied both intraconal and extraconal spaces of the orbit (65%). The contour of the mass was ovoid or fusiform in 3 of the orbits (18%) and tubular or lobular in 14 orbits (82%). The optic nerve was encased by the mass in 8 orbits. Changes in the adjacent bone were detected in 9 orbits. The average volume of the venous anomalies was 1.1 mL in the axial scan and 5.7 mL in the coronal scan. The patients who showed clinically evident exophthalmos on the Valsalva maneuver had larger volumes than those who did not.ConclusionsThe orbital structures adjacent to the distensible orbital venous anomalies were vulnerable to intermittent compression. CT scans, including both postcontrast axial and coronal images, were useful in demonstrating the presence of distensible venous anomalies, even in cases with no apparent exophthalmos on the Valsalva maneuver.

ISSN:0740-9303    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

PurposeTo evaluate the utility of a new diagnostic radiologic technique for anatomic evaluation of the lacrimal outflow system in patients with epiphora and to delineate anatomic variations in the lacrimal systems of patients with both patent and obstructed systems.MethodsThis study retrospectively reviewed clinical and radiologic data in a series of 30 patients with epiphora who underwent our radiologic protocol. Imaging included fluoroscopic dacryocystography followed by helical CT dacryocystography after injection of lacrimal system contrast. Axial CT data was three-dimensionally reconstructed and rotated for viewing of images in multiple projections. Mean axial cross-sectional areas of the lacrimal sac and duct were determined.ResultsSixty lacrimal systems in 30 patients were clinically and radiologically evaluated. The average mean cross-sectional area of the lacrimal sac and duct in the setting of complete obstruction was 0.153 cm2and was statistically significantly larger (p=0.0286) when compared with average mean cross-sectional areas in unobstructed (0.045 cm2) and partially obstructed (0.052 cm2) lacrimal systems and were associated with lacrimal system dilation proximal to the level of obstruction. The difference in average mean cross-sectional area between patients with unobstructed and partially obstructed systems was not statistically significant. A number of lacrimal system abnormalities were noted in our series, including obstructions at various levels of the lacrimal outflow system, lacrimal sac masses, sinusitis, sarcoidosis, sinus carcinoma, and failed dacryocystorhinostomy. Twenty-three lacrimal systems were believed to be radiographically normal. Radiologic findings altered surgical treatment in 10 of 30 patients in this series.ConclusionsThis relatively safe and well-tolerated radiologic technique provides detailed imaging of the lacrimal outflow system and surrounding structures. The information obtained from this technique may be helpful in clinical and surgical decision making.

ISSN:0740-9303    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

PurposeWhen attempting to elevate the lower eyelid for any reason, medial elevation is the most difficult to attain. Medial canthal tendon tightening creates mostly horizontal tension and contributes little vertical vector. We present a technique for applying a lifting force to the medial end of the eyelid: medial tarsal suspension.MethodsThe technique to suspend the medial lower eyelid tarsal plate to the superior orbital rim periosteum is described. The procedure, medial tarsal suspension (MTS), was performed on 38 lower lids of 24 patients. Adjunctive procedures, most commonly lateral canthal sling, were performed on 66% of the lids at the time of the initial medial tarsal suspension. The patients ranged in age from 29 years to 84 years. All had medial lower eyelid retraction, with facial nerve palsy, Graves eye disease, involutional lower eyelid retraction, and forms of muscular dystrophy the commonest etiologies.ResultsThirty-one (82%) of the 38 MTS procedures were successful. There was no unifying factor among the seven failed procedures in five lids of five patients. Three of the five patients, including two who were operated on twice, ultimately had a successful MTS. This procedure was not repeated on the other two failed patients. Range of follow-up was 9 months to 5.6 years, with a mean of 3.7 years. The mean elevation of the central lower eyelid was 1.6 mm in the successful cases.ConclusionsMedial tarsal suspension is an effective way to elevate the medial end of the lower eyelid.

ISSN:0740-9303    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

PurposeTo describe a system for reconstruction of large defects of the eyebrow, glabella, forehead, and temple. The system maximizes the use of direct approximation and advancement flaps before resorting to less aesthetic techniques.MethodsThis was a retrospective cohort study drawn from approximately 70 patients with post-Mohs defects of the eyebrow, glabella, forehead, and temple. Surgical intervention involved the graded application of direct approximation, horizontally oriented advancement flaps, rotational flaps, and free skin grafts. The selection of individual and combined techniques was based on defect area and depth, elasticity of adjacent tissues, and relations of the defect to the neighboring eyebrows and hairlines.ResultsReconstructive techniques applied to defects of the eyebrow, glabella, forehead, and temple can be arranged in an incremental scale that provides progressively more tissue but at an escalating aesthetic cost. The usual defect size limits for direct approximation and advancement flaps can be expanded.ConclusionsTo avoid the limitations of large rotational flaps and skin grafts in this region, maximal use of direct approximation and advancement flaps is recommended.

ISSN:0740-9303    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

PurposeA case of bilateral arcus-like corneal degeneration in the medial limbal regions following bilateral bicanalicular silicone intubation is reported.MethodsCase report.ResultsBilateral arcus-like corneal opacifications were observed in the medial limbal regions of a 33-year-old woman 3 months after the bilateral silicone intubation with dacryocystorhinostomy. No clinical signs of infection and direct contact of the silicone tubes with those regions of the corneas were observed. Routine laboratory tests revealed no abnormalities, and serum lipoprotein composition was normal.ConclusionsSilicone tubing appeared to be the precipitating factor of the corneal opacifications that occurred in this patient.

ISSN:0740-9303    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0740-9303    

出版商:OVID    

年代:2002

数据来源: OVID