摘要:

Medial wall fractures are often overlooked during routine radiographie examination and rarely develop complications. We present complications associated with medial wall fracture in six cases. Complications from medial rectus muscle entrapment include restricted and painful abduction, pseudo-sixth-nerve paresis and pseudo-Duane's-retraction syndrome. Massive orbital emphysema, in one case, was responsible for temporary loss of vision prior to definitive treatment. Two patients developed severe enophthalmos secondary to the medial wall fractures. We suggest that orbital exploration is indicated for painful or limited ocular motility, significant diplopia, severe orbital emphysema, or severe enophthalmos. An inferior approach to the medial wall through the lower eyelid provides good exposure and minimal cosmetic deformity. Postoperative complications included transient paresis of the medial rectus muscle, residual motility disturbance, and residual enophthalmos.

ISSN:0740-9303    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Vertical diplopia following orbital trauma has frequently been attributed to entrapment of the inferior rectus muscle. The high incidence of spontaneous recovery and negative forced ductions suggests that a significant percentage of these patients have other causes for their diplopia, such as direct damage to the extraocular muscles or their innervating nerves. In five patients with blunt trauma to the orbit, high-resolution computed tomography (CT) scanning showed evidence of hemorrhage or edema within the inferior rectus or inferior oblique muscle that was paretie on clinical exam. No evidence of entrapment was noted in any of the five patients. The course was variable. Three patients had almost complete recovery, whereas two demonstrated improvement but with residual restriction or paresis. Our findings support direct extraocular muscle (EOM) damage as the primary cause of diplopia in these patients. High-resolution CT scanning helps in selecting such patients in whom orbital intervention is unnecessary. The clinical goals of binocular single vision in primary and reading positions are emphasized.

ISSN:0740-9303    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Radical maxillectomy is the treatment of choice for malignant tumors of the paranasal sinuses and nasopharynx. Unfortunately, adverse side effects include ectropion, diplopia, and nasolacrimal duct obstruction. We describe a new technique for repair of the cicatricial ectropion and vertical retraction of the lower lid.

ISSN:0740-9303    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A modification of a classical Hughes tarsoconjunctival flap for replacement of the posterior layers of a lower lid is described. The difference from the Hughes flap is that the blood supply is maintained through two tubed pedicles of conjunctiva and Muller's muscle, rather than an apron of conjunctiva.

ISSN:0740-9303    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Implantation of a gold weight in the pretarsal space was performed on 17 patients with poor eyelid closure secondary to facial nerve weakness. Successful results were obtained in 14 (82%) of 17 patients. Postmortem histopathology of such a case demonstrated firm fibrous encapsulation of the weight. Although some authors advocate fixation of lid weights to the orbital septum, fixation in the pretarsal space is preferred for the following reasons: (a) “cheesewiring” is less likely to occur, (b) a limited levator recession may be more easily performed, (c) greater mechanical benefits are obtained, and (d) the potential for inferior migration is less.

ISSN:0740-9303    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Opposing eyelid pedicle flaps are used extensively in ophthalmic plastic surgery. Controversy exists over the timing of pedicle severance. Additionally, the functional and morphologic status of eyelid pedicle flaps at the time of severance has not been fully assessed. We attempt to investigate these questions by measuring the functional and morphologic changes that occur in an animal model of an opposing eyelid pedicle flap. These results were correlated with clinical case studies. Experimental results revealed vascularization of the animal model flap at 5 days. Clinical case studies revealed successful flap division by 3 weeks or less. We discuss factors that may delay flap revascularization.

ISSN:0740-9303    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

There are many characteristic features of the Asian eyelid that differ significantly from those of the Occidental. The most noticeable of these are fullness of the upper eyelid and a low or absent upper lid crease. The patient may desire the preservation of these distinctive features during ptosis surgery. The surgical techniques of ptosis repair and the preservation of the typical Asian eyelid features during ptosis repair have not previously been described in the literature. This study describes the histologie differences between the Asian and Occidental upper eyelid, and the application of this anatomic knowledge to surgical techniques of ptosis repair with special emphasis on the preservation of the Asian eyelid features.

ISSN:0740-9303    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Human bites of the upper eyelid are extremely rare. Few reports have been published on the surgical management of such injuries, and they have dealt mainly with those cases in which the avulsed tissue segment is available for reconstructive surgery. This article reports on a case of human bite injury of the upper eyelid with more than 50% full-thickness loss of tissue, in which the missing segment was not available for reconstruction.

ISSN:0740-9303    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A patient with longstanding dysthyroid eye disease developed a broad adhesion between the globe and the upper eyelid following simultaneous surgery to recess the levator palpebrae superioris and lateral reclus muscles. This unusual complication may have developed as a consequence of failure to suture the conjunctiva of the upper fornix to the tarsus and also due to the prolonged static contact between the resulting adjacent raw areas due to postoperative eyelid traction and pressure dressings. Periods of such contact may have been further prolonged by the action of diazepam, which reduces the peak velocity of saccadic eye movements and suppresses rapid eye movement of sleep. Eyelid surgery should be performed as a separate procedure, under local anesthetic after healing of areas bare of conjunctiva from strabismus surgery utilizing the adjustable suture technique.

ISSN:0740-9303    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Cherubism is a rare, fibroosseous lesion of the jaws that may have orbital manifestations of proptosis, lower eyelid retraction, superior globe displacement, and visual loss. Management of the orbital tumors in two cases from the same family is described. The original description of the disorder is reviewed. The inheritance pattern is autosomal dominant. Pathology findings show multinu-cleated giant cells in a vascular fibrous stroma. Teeth are often missing or displaced. Radiographie studies show symmetric cystic lesions in the jaws and sometimes involvement of the orbital floor and lateral orbital wall. Fibrous dysplasia is in the differential diagnosis, but can be distinguished by clinical characteristics. Treatment may involve curettement or recontouring of the bony lesions.

ISSN:0740-9303    

出版商:OVID    

年代:1989

数据来源: OVID