摘要:

SummaryTumors metastatic to the orbit frequently originate from certain primary tumors such as breast, lung, prostate, and melanoma. The site-specific nature of orbital metastases, as well as that of other metastatic lesions, cannot be the result of random seeding. We present evidence from a review of the literature demonstrating that tumor cells express adhesion molecules of the integrin family, and that these receptors play a pivotal role in the development of a metastatic colony. We investigated orbital metastatic lesions from prostate carcinoma, malignant melanoma, and lobular breast carcinoma to determine the level of integrin expression by immunohistochemistry. Several integrin subunits (α2, α4, β3) were found to have increased expression in the metastasis when compared to normal prostate tissue and normal melanocytes. The increased expression of these integrins may be responsible for the tendency of these tumors to metastasize to the orbit, as well as for the tendency of prostate tumors to metastasize to bone. The results from the staining of the breast metastasis were inconclusive.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryMalignant peripheral sheath tumor (malignant PNS tumor) is a rare, aggressive, and lethal orbital neoplasm that usually arises from sensory branches of the trigeminal nerve in adults. Malignant PNS tumor spreads along nerves to involve the brain, and most patients die within 5 years of clinical diagnosis. The clinical history and examination, imaging studies, surgical procedures, and pathologic specimens of a 23-year-old man with rapid, posttraumatic onset of left orbital proptosis and pain are reported. Biopsy specimens of the tumor were compared with specimens from the same orbit obtained 18 years previously. Histopathology of the left orbital tumor compared with that of an incomplete excision of a tumor 18 years previously in the same orbit revealed both to be malignant PNS tumor. The patient is alive without recurrence 8 months after orbital exenteration and 18 years after initial tumor presentation. This is the youngest age of occurrence and the longest documented survival of a patient with orbital malignant PNS tumor.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryHydroxyapatite orbital implants undergo early ingrowth of fibro-vascular tissue after enucleation. This animal study determined whether control and osteogenin-impregnated hydroxyapatite orbital implants vary in their osteogenic response at 6 and 52 weeks. Rabbits underwent enucleation with implantation of control or osteogenin-impregnated hydroxyapatite spheres. Light microscopy determined fibrovascular ingrowth, and histomorphometry quantitated the amount of bone produced. Osteogenin implants vascularized at a faster rate and contained bony foci by 6 weeks that became confluent at 1 year. Spontaneous osteogenesis was not seen in control animals at 6 weeks. After 1 year they contained bone, although less than in the osteogenin implants. Mixed cell inflammation was observed at the hydroxyapatite-tissue interface in both groups. No inflammation was noted at the interface of hydroxyapatite and bone. These are the first controlled observations that bone-specific differentiation occurs in the pores of spherical hydroxyapatite implants within the soft tissues of the socket. This vascularized process can be enhanced with osteogenin to occur earlier and more uniformly in the implants at one year.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryHydroxyapatite orbital implants are recognized for their excellent results in anophthalmos. Few complications are reported in the literature. We implanted hydroxyapatite spheres in two patients with acquired anophthalmos and denervated or nonfunctional levator palpebrae superioris and superior rectus muscles. In both patients, the implant rotated anteriorly, obliterating the superior fornix and causing proptosis. Prosthetic fitting was impeded, necessitating surgical revision in both patients. A hydroxyapatite implant may rotate and migrate anteriorly in the presence of a nonfunctional superior rectus muscle, distorting the conjunctival fornices and causing proptosis. This complication calls into question whether muscle-attached orbital implants should be used in patients with significant rectus muscle weakness.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryOrbital implant infection is a rare cause of anophthalmic socket pain. Because of the potential danger of infection spreading to nearby structures, it is of paramount importance to diagnose the condition as soon as possible. Scintigraphy is a method for diagnosis of graft infections by radioisotopic imaging of inflammatory sites. We report on a patient with socket pain 3 months after implantation of an acrylic implant. The socket appearance was normal and there were no signs of infection other than culture-positive socket exudation. Three consecutive computed tomography scans revealed no abnormalities.99mTc leukocyte scintigraphy revealed white blood cell accumulation at the implantation site. The implant was removed and cultured. This producedStaphylococcus epidermidisandR. equii.A parenteral antibiotic treatment was instituted with subsequent improvement of symptoms. Four months later, after negative scintigraphy, a hydroxyapatite implant was inserted, demonstrating full vascularization on a bone scan after 2 months. Two months later, the patient developed the previous symptoms, with all of the former findings, including positive scintigraphy. The implant was removed, revealing a microabscess on the anterior aspect, producingS. epidermidison culture. We conclude that scintigraphy using99mTc-labeled leukocytes is a useful technique in diagnosing low-grade orbital infection.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryOur purpose was to determine the efficacy of botulinum A toxin (BOTOX) in promoting wound immobilization and preventing wound dehiscence in patients at risk of wound-healing complications following eyelid reconstruction. In 11 patients at risk of postoperative wound complications, we injected BOTOX into the periocular musculature in addition to standard suture tarsorrhaphy. Each patient experienced excellent wound immobilization and wound healing. There were no complications. Adjuvant use of BOTOX, in conjunction with suture tarsorrhaphy, immobilizes the eyelids and promotes wound healing in patients at risk of wound complications following eyelid reconstruction.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryThe dermoid cyst is one of the most common space-occupying orbital lesions, but there has been no large series that details the clinical, pathologic, and therapeutic aspects of this condition. Furthermore, despite the various presentations and types of dermoid cysts, there is no clinically applicable classification of these lesions. We performed a retrospective histopathologic study of 197 consecutive orbital and periorbital dermoid cysts excised at Wills Eye Hospital during a 32-year period, correlated the histopathologic findings with the recorded clinical and radiographic observations, and devised a clinically applicable classification of orbital dermoid cysts. The mean age at excision was 17 years (range, 5 months to 85 years), and the most frequent clinical finding was a painless subcutaneous mass, present in 89% of cases. In 72% of patients, the mass was located in the superotemporal orbital region and produced no abnormalities of vision or intraocular pressure. Computed tomography and magnetic resonance imaging, performed mainly in the more recent cases, disclosed a characteristic round to ovoid cystic lesion with a well-defined lining. Histopathologically, 165 of the cysts (84%) were lined by keratinizing, stratified squamous epithelium. Ten (5%) were lined by nonkeratinizing epithelium resembling conjunctival epithelium. Hair shafts were present in the wall or lumen of the cyst in 195 (99%) of specimens, sebaceous glands in 148 (75%), and sweat glands in 39 (20%); inflammation was present in 75 cases (38%). Based on these personal observations and a review of the literature, a classification of orbital dermoid cysts is proposed that we believe will provide guidance for the ophthalmologist in the management of these lesions.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryCementifying fibromas are rare fibro-osseous tumors that arise from the periodontal ligament. These tumors are usually small, asymptomatic lesions noted on routine dental radiography, but they can develop into aggressive, expansile masses. The authors report the case of a 12-year-old boy with a tumor involving the maxillary, ethmoid, and frontal sinuses that extended to the right orbit, causing proptosis and disfigurement of the right side of his face. Removal of the tumor with facial reconstruction resulted in significant improvement of vision, despite long-standing disc edema and tension on the optic nerve. On histopathologic examination the lesion was found to be a cementifying fibroma.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryFailed dacryocystorhinostomy caused by the presence of residual lacrimal sac has been termed the “lacrimal sump syndrome.” Epiphora occurs when tears collect in this residual pouch and lacrimal drainage is delayed. Irrigation into the nose may seem normal. This condition can be easily diagnosed with nasal endoscopy and has a characteristic radiologic appearance. Six patients with failed dacryocystorhinostomy caused by lacrimal sump syndrome were successfully treated with an endoscopic contact Nd: YAG laser technique. Endoscopic dacryocystorhinostomy using the contact Nd:YAG laser is an effective method for treating patients who have persistent epiphora or dacryocystitis after failed dacryocystorhinostomy.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

SummaryWe examined a child with congenital ptosis. She underwent a bilateral silicone rod frontalis sling operation. One of the slings became infected and necessitated removal. We noticed no recurrence of her ptosis after sling removal. Removal of a frontalis sling does not invariably lead to recurrence of ptosis. We hypothesize that a scar tract formed in the plane of tissue from which the sling was removed. This band of scar tissue can act as a frontalis sling to elevate the eyelid.

ISSN:0740-9303    

出版商:OVID    

年代:1997

数据来源: OVID