Biomedical subjects

R D Divine

Publications and source records attributed to R D Divine.

5 recordsLinked to original sources

PubMed1983

Bilateral congenital lacrimal sac mucoceles with nasal extension and drainage.

A newborn infant with bilateral mucoceles of the lacrimal sacs also had submucosal masses along the floor of the nose beneath the inferior turbinates communicating with the mucoceles. Drainage of the mucoceles was performed by needle aspiration and wide marsupialization of the nasal masses into the nose under direct visualization. To our knowledge, this is the first time that intranasal extension of mucoceles has been reported, and the first time that lacrimal sac mucoceles have been successfully treated via direct nasal drainage. We advocate careful nasal evaluation in cases of congenital lacrimal sac mucoceles to determine whether intranasal extension is common and whether intranasal drainage can be curative.

Drainage↗

PubMed1983

Nitrous oxide cryotherapy for intraepithelial epithelioma of the conjunctiva.

Nine patients were treated with the nitrous oxide eyelid cryoprobe for large or recurrent intraepithelial epithelioma of the conjunctiva or cornea. Nitrous oxide cryotherapy is more convenient for ocular cryosurgery than liquid nitrogen therapy and seems to be as effective for intraepithelial epithelioma. Surgical debulking of the lesion is recommended before cryosurgery. An obvious advantage of cryosurgery over surgical modalities for intraepithelial epithelioma is that large areas of tumor as well as surrounding tissues can be treated. This procedure results in a higher cure rate and avoids grafting and symblepharon formation. The complications of light cryosurgery seem to be minor even when the cornea is treated. Heavy cryosurgery may result in severe iritis, posterior synechiae, and corneal scarring. A biopsy-proved diagnosis of intraepithelial epithelioma can be misleading and does not rule out the presence of underlying malignant disease.

Aged↗

PubMed1982

Metastatic carcinoid unresponsive to radiation therapy presenting as a lacrimal fossa mass.

A case of metastatic carcinoid tumor presenting as a lacrimal fossa mass is described. This appears to be only the fourth case report of metastatic carcinoid to the orbit and the first to include ultrasound evaluation. the tumor mass did not regress despite radiation therapy as documented on serial ultrasound examinations. Therapeutic implications of this finding are discussed. Metastatic carcinoid tumors are reviewed.

Aged↗

PubMed1982

Metastatic small cell carcinoma masquerading as orbital myositis.

A case of discrete metastases to an extraocular muscle from a silent small cell carcinoma is described. Clinically, diagnostically, and pathologically this masqueraded as orbital myositis. It was not until a full thickness muscle biopsy was obtained that the diagnosis was realized. The need for deep biopsy is stressed. Discrete metastases to an extraocular muscle without other orbital soft tissue involvement is rarely reported. This is the first reported case from a small cell primary tumor. Metastatic orbital disease is discussed.

Adenocarcinoma↗

PubMed1982

Techniques in eyelid wound closure.

While one of the most basic techniques in eyelid surgery is the repair of an eyelid defect that involves the margin, many eyelid defects are still poorly repaired; and much confusion still exists in this area. Based upon sound anatomic and surgical principles, we suggest several modifications of classically described techniques: (1) The greyline suture is replaced by a tarsal suture through the meibomian gland orifices to provide a stronger closure and better alignment. (2) All tension of closure is supported by the deep tarsal sutures rather than by the margin sutures to avoid notch formation or unsightly scars. (3) A two-layered closure where orbicularis and tarsus is closed in a single layer is technically easier and gives results comparable to the classically taught three-layered closure. Conjunctival sutures in the tarsal portion of the eyelid are unnecessary and frequently cause corneal irritation. (4) When lid resection is performed, a pentagonal excision rather than a "V" or wedge resection should be used to minimize tension on the margin when closed. We present in an illustrated step-by-step fashion our preferred technique which gives consistently good results.

Basal Cell Carcinoma↗