摘要:

Anatomic dissections on human cadaver heads were performed to determine the anatomy of the terminal nerves in the upper eyelid. Vertically oriented nerves, which are commonly identified in a preseptal location in the upper eyelid, were determined to be sensory nerves, most commonly originating from the supraorbital nerve (VI). Facial nerve (VII) dissections were also performed, with specific attention paid to the temporal branch. The facial nerve innervates the orbicularis muscle on its deep surface, both at the most temporal aspect of the muscle as well as along the supraorbital rim. No motor fibers could be traced into the upper eyelid and no anastomosis was noted between the temporal branch of the facial nerve (VII) and the supraorbital nerve (VI).

ISSN:0740-9303    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Tessier's classification of facial clefts has been quite adequate (1, 2). This cleft occurs as an isolated anomaly or as a coloboma associated with Treacher Collins syndrome, Goldenhar's syndrome, or hemifacial microsomia (3). We present a procedure developed to reconstruct the lateral canthus.

ISSN:0740-9303    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Enophthalmos, a clinical feature of the anophthalmic orbit, often produces a considerable cosmetic deformity. Management of this condition includes surgical volume augmentation with orbital implants. Several types of materials with different shapes have been used with variable success rates. Between 1984 and 1990, we treated 84 anophthalmic patients with room temperature vulcanized (RTV) subperiosteal silicone implants. Adequate volume augmentation and correction of the apparent enophthalmos was achieved in 75 patients. Extended patient follow-up, analysis of data and results, histopathologic assessment of implant capsules, and management of complications have provided a unique opportunity to study the efficacy of the surgery. We present our experience in the management of this condition.

ISSN:0740-9303    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0740-9303    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Two patients with extruded implants postevisceration were assessed and managed with room temperature vulcanized (RTV) silicone implants placed in the retroscleral-intraconal space. The technique described is an alternative and simple surgical method that provides utilization of the remaining sclera, anterior support for the implant, and adequate volume replacement. The postoperative follow-up is relatively short, and clinical and radiologic (CT scan) investigations support the efficacy of the procedure. To the best of our knowledge, such a surgical alternative has not been reported.

ISSN:0740-9303    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Congenital synkinetic movement of the upper eyelid is rare. In this case report, we present a 4-year-old patient with a left upper eyelid ptosis that improved on abduction and became worse on adduction. The patient also had congenital esotropia and superior rectus palsy. Strabismus surgery was performed, and excellent surgical results were achieved. A 17-mm left levator aponeurectomy and myectomy was later performed with satisfactory results. Pathology studies of the levator muscle and aponeurosis showed no evidence of inflammation, degeneration, or atrophy. Electron microscopy showed no skeletal muscle abnormality. We postulate that this congenital synkinetic movement reflects an incomplete nerve cell dying process that occurs during the embryonic phase of development.

ISSN:0740-9303    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Three patients who had orbital decompression for compressive optic neuropathy secondary to Graves' Ophthalmopathy are presented. Despite initial improvement in their visual acuity, all of the patients experienced subsequent relapse due to progressive enlargement of the extraocular muscles, resulting in recurrent compressive optic neuropathy. Management consisted of reoperation, systemic prednisone, and retrobulbar radiation. Enlargement of the extraocular muscles is felt to be caused by continuation of the autoimmune process and/or expansion of the extraocular muscles after slitting of the periorbita and bony removal of the orbital walls.

ISSN:0740-9303    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A well-circumscribed, pseudoencapsulated benign-appearing lesion in the retrobulbar orbit of a 50-year-old man was found to be a metastatic renal cell carcinoma. The patient had a nephrectomy for renal cell carcinoma 15 years before, and had developed four other isolated metastases over the preceding 8 years. He had a further distant metastasis 1 year later, but is living and well 4 years after excision of the orbital tumor. Metastatic renal cell carcinoma of the orbit may have very benign characteristics, both clinically and radiographically, and can often be managed effectively by local excision with prolonged survival.

ISSN:0740-9303    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A 70-year-old woman was referred to our clinic for evaluation and treatment of a recurring case of adenoid cystic carcinoma of the lacrimal gland. She had been diagnosed with this tumor three years earlier, and a local resection was attempted on two occasions. We encountered this patient on the third recurrence of the tumor, and a thorough work-up revealed extensive local involvement but no metastases. A total exenteration of the right orbit was then performed with aggressive resection of local extension followed by irradiation. Thirteen years later, our patient presented with metastases throughout her scalp. She died shortly thereafter, having survived a total of 16.5 years after the time of her initial treatment and 13 years after exenteration with bony removal of the orbit and irradiation. A review of the literature reveals that this patient had one of the longest reported survival times in the literature from the time of initial treatment. Also noteworthy is the 13 years this patient survived after aggressive surgical resection combined with radiotherapy following two previous incomplete resections.

ISSN:0740-9303    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A 77-year-old man had fleshy papillomatous lesions on his eyelid margins, which initially were accompanied by lesions on his lips and tongue and plaques on his scrotum, areolae, neck, axillae, and hands. He had had adenocarcinoma of the sigmoid colon and stomach. Based on the clinical findings and histopathologic evaluation of the eyelids (showing papillomatous changes with hyperkeratosis and mild acanthosis), the diagnosis of acanthosis nigricans was made. Acanthosis nigricans may be benign or malignant; in this patient it was malignant. The malignant form is usually of gastrointestinal origin, and in adults may be a marker for an occult malignancy.

ISSN:0740-9303    

出版商:OVID    

年代:1994

数据来源: OVID