摘要:

We present new information regarding the sympathetic nerve anatomy in the cavernous sinus and retrobulbar orbit of the cynomolgus monkey. Postganglionic sympathetic nerves were identified using an immunoperoxidase technique in which the primary antiserum was directed against tyrosine hydroxylase, the rate-limiting enzyme in norepinephrine synthesis. Our work is unique in adapting this staining method to paraffin-embedded tissue. This technique allows sympathetic nerve fibers to be distinguished from other autonomic, sensory, and motor nerves. A large sympathetic nerve bundle lateral to the internal carotid artery in the cavernous sinus gave off one or more branches that leave the artery to encircle the abducens nerve. Further division occurs within the cavernous sinus, but all sympathetic nerve fibers destined for the orbit entered it through the superior orbital fissure. None pass through the optic canal. In the orbit, sympathetics were associated with the ophthalmic artery and some of its branches and with the sensory root to the ciliary ganglion. After entering the ganglion, the sympathetic fibers were lost to detection in most specimens, but they were again seen in a single short ciliary nerve in one instance. Sympathetic nerve fibers were not detected adjacent to several structures identified in the human anatomy literature, such as the intracranial and intracanalicular segments of the ophthalmic artery, the nasociliary nerve, the long ciliary nerves, the nerve to the inferior oblique muscle, or the lacrimal artery and nerve.

ISSN:0740-9303    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

We studied 44 patients who had dacryocystorhinostomy for primary acquired complete nasolacrimal duct obstruction. The lacrimal sac and nasal mucosa adjacent to the osteotomy were examined histologically. The lacrimal sac had chronic inflammatory changes in 33 of 37 patients with varying degrees of fibrosis in 34 of 37. Focal ulceration of the lacrimal sac epithelium was present in 15 cases. Goblet cells, present in 11 specimens, were not identified in 26 specimens. Moderate or severe chronic inflammation was found in 14 of 44 nasal mucosal specimens and marked fibrosis in 22. The pathology of the lacrimal sac and nasal mucosa is similar to that of the nasolacrimal duct in complete nasolacrimal duct obstruction. The nasal inflammation may have resulted from dacryocystitis or alternatively contributed to the dacryocystitis.

ISSN:0740-9303    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Pseudoretraction of the contralateral upper eyelid has long been recognized as a clinical phenomenon in certain patients with unilateral ptosis. In this prospective study of 30 patients with ptosis, we used two commonly used tests for pseudoretraction, the digital “lift” and “closure” tests. We also describe two new adaptations, the “lift and release” and “closure and release,” which enhance these basic tests. The incidence of pseudoretraction in unilateral ptosis was found to be 66.7% and the test with the highest positive yield was the “closure test” (66.7%). The use of clinical tests for pseudoretraction, including the “release” maneuvers, are recommended as part of routine preoperative assessment of blepharoptosis.

ISSN:0740-9303    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Lower lid retraction is commonly seen in dysthyroid orbitopathy. We have treated 55 lower lids in 38 patients with lower lid retraction by a tarsal transplant from the upper lid to the lower lid. An overall effect of 2-mm improvement 0.7 mm occurred. Eighty-nine percent of the lids achieved the position of the lower lid within 1 mm of the limbus. We think that the upper to lower tarsal transplant offers a technically easy and reasonable solution to moderate lower lid retraction associated with dysthyroid orbitopathy.

ISSN:0740-9303    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Ocular dystopia with inferomedial displacement of the globe is an unusual but well-recognized complication of bony orbital decompression. It is caused by displacement of the muscle cone and orbital connective tissue system into the maxillary and ethmoidal sinuses. We illustrate a surgical variation of bony orbital decompression leaving intact a strut of bone at the maxillary-ethmoid junction. This bony strut reduces inferomedial displacement of the muscle cone and provides a medial supporting “ledge” in cases requiring late orbital reconstruction.

ISSN:0740-9303    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Periosteum is a well-known source of tissue used in eyelid and orbital reconstruction. The periosteum medial to the medial canthal tendon, on the lateral wall and bridge of the nose, is an excellent place from which to mobilize this tissue to use as replacement medial canthal tendon. When the medial canthal tendon is lost following cancer extirpation, reconstruction can be accomplished by elevation and rotation of a nasal periosteal flap. Representative cases are presented to demonstrate the technical aspects of the procedure.

ISSN:0740-9303    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Ectropion following entropion surgery is an uncommon situation that creates an unhappy patient and physician when it occurs. The precipi tating events that lead to this situation may be related to a faulty understanding of the pathophysiology of the entropic process, utilization of an inappropriate technique, overcorrection of entropion repair, bleeding into the operative field with subsequent scarring of the lid, or a combination of the above. Correction of this situation requires restoration of the normal anatomy where possible, release of any scar bands, and often a lid-tightening procedure.

ISSN:0740-9303    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Upper eyelid blepharoplasty as traditionally performed may fail to adequately debulk the eyelids especially in the middle age or older patient. A technique used by the senior author for the past 10 years is described. The en bloc resection of redundant upper eyelid tissue can be readily combined with other procedures.

ISSN:0740-9303    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The goal of trichiasis treatment is to eliminate misdirected cilia that irritate the eyeball. Established methods for removal of the eyelashes include epilation, electrolysis, and cryotherapy. Cryotherapy is currently the most effective method in widespread use, but has as potential posttreatment complications “visual loss, lid notching, corneal ulcer, acceleration of symblepharon formation, xerosis, cellulitis, activation of herpes zoster, skin depigmentation, and severe soft tissue reaction.‘’ (Wood JR, Anderson RL. Complications of cryosurgery.Arch Ophthalmol1981;99:460–3.) The use of an argon laser allows more precise placement and control of the treatment, with better overall results. We reviewed the clinical course of 77 patients with a diagnosis of trichiasis, and 1 with distichiasis. We have found treatment of trichiasis with an argon laser with the patient under local anesthesia to be an effective office procedure.

ISSN:0740-9303    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

We present two cases of anterior extrascleral extension of malignant melanoma in eyes previously blind from other causes. In both cases, the tumor was not detected by the physician but rather by the patient himself (case 1) or his wife (case 2). In one case, the tumor became manifest more than 60 years after the eye became blind from trauma. Although blind eyes may harbor lethal tumors and, therefore, need regular examinations, this simple part of the physical examination frequently remains neglected by ophthalmologists as well as by primary care physicians. We wish to emphasize the potential life-saving importance of regular examinations of blind eyes.

ISSN:0740-9303    

出版商:OVID    

年代:1992

数据来源: OVID