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G T Lueder

Publications and source records attributed to G T Lueder.

41 records · Page 3Linked to original sources
PubMedDate not supplied

Spectrum of pediatric dacryocystitis: medical and surgical management of 54 cases.

BACKGROUND: Dacryocystitis in infants and older children is a serious complication of congenital or acquired nasolacrimal duct obstruction. To define the modes of presentation and treatment strategies of this disorder better, we reviewed the clinical courses of 54 children treated for dacryocystitis at St Louis Children's Hospital. METHODS: Clinical, neuroradiologic, and laboratory data were collated for all cases of dacryocystitis treated from 1990 to 1995. Average follow up of the children in this consecutive series was 1.75 years (range, 4 months to 5 years). RESULTS: Of the 54 patients, 36 (67%) had chronic low-grade dacryocystitis, which was treated with nasolacrimal duct probing on an outpatient basis. The remaining 18 patients (33%) had acute dacryocystitis, which was treated with a combined medical/surgical strategy. Medical treatment consisted of hospital admission for administration of intravenous antibiotics followed by inpatient surgery, which varied according to the age of the patient and the clinical history: 1) Acute dacryocystitis in neonates was treated surgically by nasolacrimal duct probing and nasal endoscopy for excision of intranasal duct cyst; 2) Acute dacryocystitis with periorbital cellulitis was treated surgically by nasolacrimal duct probing; 3) Acute dacryocystitis due to facial trauma was treated surgically by dacryocystorhinostomy and stent placement; and 4) Acute dacryocystitis complicated by orbital abscess was treated by inferior orbitotomy for orbital abscess drainage, simultaneous nasolacrimal duct probing, and stent placement. CONCLUSION: Dacryocystitis in the pediatric population may present in either chronic or acute forms. An effective and safe treatment for acute dacryocystitis is hospital admission, both for administering intravenous antibiotics and monitoring to rule out orbital cellulitis or abscess formation. Intravenous antibiotic therapy is followed within a day or two by surgery tailored to the clinical history. In the majority of both chronic and acute cases, nasolacrimal duct probing appears to be an effective treatment strategy.

Abscess↗
PubMedDate not supplied

Tucking the inferior oblique muscle into Tenon's capsule following myectomy.

PURPOSE: Myectomy of the inferior oblique muscle is a common procedure used to correct overaction of this muscle. Previous descriptions of the surgery have not discussed how the surgeon should handle the proximal muscle stump following myectomy. This study examined the effectiveness of inferior oblique muscle myectomy with tucking of the muscle into Tenon's capsule for treatment of inferior oblique muscle overaction. METHODS: The procedure was studied prospectively in 22 patients who underwent 32 inferior oblique muscle myectomies. In 18 patients, the intraoperative behavior of the inferior oblique muscle was recorded. Complete ocular motility examinations were performed before and after surgery. Success was defined as the elimination of inferior oblique muscle overaction and the elimination of hypertropia secondary to persistent ipsilateral inferior oblique muscle overaction in primary gaze. RESULTS: The surgery corrected inferior oblique muscle overaction in 94% of eyes. Hypertropia secondary to persistent ipsilateral inferior oblique muscle overaction was eliminated in 92% of patients. There was no correlation between outcome and the intraoperative behavior of the inferior oblique muscle. CONCLUSION: Tucking of the inferior oblique muscle stump into Tenon's capsule is recommended following inferior oblique myectomy. This procedure is safe and effective for correcting inferior oblique muscle overaction.

Connective Tissue↗