ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose:To investigate a possible relationship between evisceration and sympathetic ophthalmia.Methods:Data from Mt. Sinai Medical Center and University Hospitals of Cleveland were collected and histopathologic specimens were reviewed for 51 of 90 patients who underwent evisceration between 1980 and 1996 and who returned for follow-up examinations. Additionally, a survey was sent to members of the American Society of Ophthalmic Plastic and Reconstructive Surgery, the Uveitis Society, and the Eastern Ophthalmic Pathology Society to determine the number of enucleations and eviscerations performed and the documented incidence of sympathetic ophthalmia after evisceration.Results:No clinical or histopathologic evidence of sympathetic ophthalmia after evisceration was found among patients treated at the two medical centers. The collective surveys showed a strong preference for enucleation over evisceration, but did not document evidence of sympathetic ophthalmia after evisceration.Conclusions:Evisceration is an effective and safe procedure with a low risk for sympathetic ophthalmia.

ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose:The authors describe a surgical incision and technique for lateral orbitotomy that is intended to minimize visible scarring and deformity.Methods:This is a noncomparative, interventional, retrospective case series. Other surgical approaches for lateral orbitotomy are briefly reviewed. The authors' technique includes incision placement within the natural upper eyelid crease, with minimal extension in a relaxed skin tension line; dissection to the superior and lateral orbital rims in the submuscular plane; and wide dissection within the subperiosteal space. Criteria are described for inclusion of a bone flap in the technique.Results:The eyelid crease incision has been used for exposure of the superolateral diagonal half of the orbit in approximately 600 cases. A variety of pathologic conditions affecting the orbital bones or the subperiosteal, extraconal, or intraconal spaces have been treated. Surgical exposure has been adequate to achieve the goals of surgery in individual cases, and the cosmetic results have been preferable to those the authors achieved using other surgical incisions.Conclusions:The eyelid crease incision for lateral orbitotomy allows dissection in relatively avascular planes, involves minimal transection of orbicularis muscle and lymphatic channels, and results in negligible postoperative scarring. Depending on the size and location of the lesion and the goal of surgery, the eyelid crease incision may be used without a bone flap. However, when a bone flap is needed, the incision does not restrict its size.

ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose:The usefulness of a single intraoperative application of mitomycin C was investigated in repeat dacryocystorhinostomy for membranous failure.Methods:Mitomycin C (0.3 mg/ml for 3 minutes) was topically applied to the fistula site in eight patients undergoing repeat dacryocystorhinostomy for membranous failure.Results:All patients remain asymptomatic and anatomic patency confirmed by probe and irrigation with a mean follow-up period of 14.6 months (range, 6–26 months). No postoperative complications associated with the use of mitomycin C were observed.Conclusions:In patients who do not maintain a patent fistula after dacryocystorhinostomy because of membranous occlusion of the rhinostomy site, the adjunctive use of mitomycin C may increase the success rate of repeat dacryocystorhinostomy.

ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose:To identify possible abnormalities in regional cerebral glucose metabolism in patients with benign essential blepharospasm or Meige syndrome using positron emission tomography.Methods:Ten patients with benign essential blepharospasm and one patient with Meige syndrome were examined using positron emission tomography with deoxyglucose labeled with fluorine 18. The severity of muscle spasm at the time of positron emission tomography was recorded in each patient. In five patients, positron tomography was performed on two occasions (once before and again 1 to 2 weeks after botulinum injection) to look for reproducibility of the findings on positron emission tomography also to see if there was any correlation between the severity of symptoms and positron emission tomography findings.Results:The mean reference ratio for fluorodeoxyglucose F 18 metabolism was significantly elevated in the striatum compared with the frontal, temporal, or parietal regions. Glucose metabolism was also elevated in the thalami. There was no correlation between the severity of blepharospasm and the degree of hyperactivity in the striatum. In the patients who underwent positron emission tomography scanning on two occasions, there was no significant difference between the two studies in any of the regions analyzed.Conclusions:The authors' findings support the hypothesis that benign essential blepharospasm and Meige syndrome may be associated with overactivity of the striatum and the thalamus. Positron emission tomography may prove to be a useful research tool and a possible adjunct diagnostic technique for benign essential blepharospasm and Meige syndrome.

ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose:Sino-orbital fungal infections are serious complications of diabetes and immunosuppression. Standard treatments include surgical debridement of the involved tissues with possible orbital exenteration, intravenous antifungal therapy, and improvement of the host's immunocompetence and metabolic state, when possible. The role of conservative orbital debridement combined with local amphotericin B irrigations in the treatment of these patients was evaluated.Methods:The records of seven consecutive patients with sino-orbital fungal infections, who were treated with limited surgical debridement and local and systemic amphotericin B therapy, were reviewed. The underlying disorders of these patients included acute lymphoblastic leukemia, immunosuppression after renal transplantation, diabetes mellitus, and acquired immunodeficiency syndrome. The fungal species identified includedRhizopus, Mucor, andAspergillus.Results:Follow-up ranged from 4 months to 4 years. All patients retained their preoperative visual acuities. Only one patient ultimately underwent an orbital exenteration for progressive orbital fungal infection. The remaining patients had either complete or incomplete (without further progression) resolution of their fungal infection. Two of the seven patients died of unrelated causes, and no patient died of uncontrolled fungal spread.Conclusions:Conservative orbital debridement with local amphotericin B irrigations is an effective adjunct in the control of sino-orbital fungal infections, especially in patients with reversible immunosuppression and good preoperative visual acuities.

ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose:To identify growth retardation in the orbits of children who have undergone enucleation and orbital implantation.Methods:Children who underwent unilateral enucleation for retinoblastoma were examined. Any patient who had received external beam radiation or chemotherapy was excluded. Follow-up time was 5.5 to 10 years (mean, 8.33 years). Several linear measurements were made on the enucleated orbit and the fellow orbit. These measurements were compared using the paired Studentttest and multivariate analysis of variance.Results:There was no statistically significant difference in any of the measured orbital dimensions between the enucleated and fellow orbits.Conclusions:Enucleation in children, when combined with a large orbital implant, does not cause orbital growth retardation.

ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose:This study of volume replacement in anophthalmic sockets compares the volume replaced by the implant and prosthesis with the volume removed from the socket and evaluates A-scan ultrasonography as a tool to predict an ideal implant size before enucleation.Methods:In this retrospective study of 59 anophthalmic patients, the volume replaced by the implant and the prosthesis was compared with the volume of the enucleated eye. The volume removed was estimated by calculating the volume of the fellow eye using A-scan ultrasonography. Enophthalmos and superior sulcus deformity were measured and correlated with the percent volume replacement in the anophthalmic sockets.Results:Greater enophthalmos and superior sulcus deformity were found in patients with less than 100% volume replacement compared with those with 100% or more volume replacement. The axial length determined by A-scan ultrasonography of the fellow eye suggested that a larger implant size should have been placed in 76.3% of those patients with less than 100% volume replacement. Sixty-three percent of adult patients could have received an implant more than 22 mm in diameter to fill 80% of the volume removed at enucleation.Conclusions:A-scan ultrasonography of the fellow eye provides a useful tool for predicting the implant size before surgery for optimal volume replacement.

ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose:To describe the clinical features of patients with unusual orbital foreign bodies.Methods:The clinical histories, preoperative photographs, imaging studies, and surgical pathologic findings of five patients with unusual orbital foreign bodies are presented. Additionally, published reports pertaining to similar cases were reviewed.Results:The five patients treated by the authors had good outcomes.Conclusions:An orbital foreign body may be overlooked because a small penetrating wound may be accompanied by minimal or no signs of inflammation early in the clinical course. A careful history and physical examination, imaging studies, and a strong suspicion are helpful for establishing the diagnosis of an orbital foreign body.

ISSN:0740-9303    

出版商:OVID    

年代:1999

数据来源: OVID