Lower eyelid reconstruction.
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Blepharoplasty↗
Biomedical subjects
Roberta E Gausas
Publications and source records attributed to Roberta E Gausas.
Advances in applied anatomy of the eyelid and orbit.
PURPOSE OF REVIEW: The oculofacial surgeon seeking to achieve ideal outcomes and avoid complications in aesthetic, functional and reconstructive surgery must have an understanding of the three-dimensional anatomic features, as well as the dynamic aspects, of the eyelid and orbital region. Knowledge of the orbital and periorbital region may be the last frontier of human anatomy, as new information is still being uncovered every year and each clarification of anatomy leads to a new level of sophistication in the understanding and treatment of orbital and eyelid disease both medically and surgically. RECENT FINDINGS: Recently, a great deal of attention has been focused on better understanding of the vasculature, fatty tissue, fascial attachments, and lymphatic drainage of the orbital and periorbital region. This in turn has provided improved clinical understanding of orbital disease and surgical applications of these findings have been described. SUMMARY: Anatomic knowledge in ophthalmology is not yet complete but constantly evolving. Exciting new insights into treatment of ophthalmologic disease have resulted from the application of an ever greater anatomic understanding of the orbital and periorbital region.
Anatomy, Cross-Sectional↗
Malignant solitary fibrous tumor metastatic to the orbit.
A 61-year-old man with a history of malignant solitary fibrous tumor of the chest had development of unusual sites of metastasis involving the sphenoid wing of the orbit and soft tissues of the cheek. He was found to have a solitary fibrous tumor, an uncommon type of spindle cell neoplasm that most often arises in the pleura, which was metastatic to the orbit. This is the first reported case of malignant solitary fibrous tumor metastatic to the orbit. The clinical and histopathologic findings of metastatic malignant solitary fibrous tumor are described.
Humans↗
A systematic comprehensive approach to management of irreversible facial paralysis.
Irreversible facial palsy (IFP) presents a multitude of problems arising from a paretic periorbital and facial complex, the solutions to which cross the spectrum of multiple specialties. The process of facial rehabilitation can be simplified by subdividing the face into functional units. These units consist of the brow complex, the periorbital complex, the midface complex, and the lower face/oral complex. Although all of these units are interrelated and influence each other, careful study of the deformity and symptoms of each unit yields a coherent approach and customized surgical plan. The following provides a complete evaluation method for the surgeon to review and customize an approach to the individual patient's needs and desires. Facial rehabilitation must be tailored to each individual, addressing both functional as well as aesthetic concerns for each facial unit.
Face↗
Orbital presentation of posttransplantation lymphoproliferative disorder: a small case series.
OBJECTIVE: To describe a small series of patients with orbital presentation of posttransplantation lymphoproliferative disorder (PTLD). DESIGN: Retrospective, interventional case series. PARTICIPANTS: Three patients with orbital presentation of histologically diagnosed PTLD. METHODS: Review of medical records. MAIN OUTCOME MEASURES: Measured parameters included vision, proptosis, and tumor extent. RESULTS: Three cases of orbital PTLD are described. In two of the cases, the tumor initially demonstrated orbital signs and symptoms, whereas in the third case, orbital and systemic signs were synchronous. Two of three patients had disseminated disease discovered at the time of presentation. One adult patient had synchronous presentation of PTLD in the orbit and prostate. One pediatric patient had tumor dissemination to the liver at the time of presentation. The PTLD tumors were classified histologically as diffuse large cell lymphoma of monomorphic or immunoblastic type in all three cases. Treatment included local irradiation, decreased immunosuppression, and antilymphocyte monoclonal antibodies. CONCLUSIONS: Orbital presentation is a rare manifestation of PTLD. However, ophthalmologists must consider this diagnosis carefully in organ transplant recipients with subtle orbital signs and symptoms at presentation. Early detection may alter prognosis. In each case presented, the diagnosis was established via lesion biopsy and subsequent histologic or flow cytometric evaluation, or both.
Antineoplastic Combined Chemotherapy Protocols↗
Metastatic breast cancer to 4 eyelids: a clinicopathologic report.
A 47-year-old woman presented complaining of progressive, painless swelling of all 4 eyelids for 6 weeks. Her medical history was significant for breast cancer 14 months prior. Examination results showed a diffuse, firm thickening of all 4 eyelids with mild erythema of the overlying skin. Orbital computer tomography revealed extensive preseptal infiltration of soft tissue of all 4 eyelids, which enhanced with contrast. Results of a bilateral biopsy of the upper eyelids demonstrated extensive infiltration of the orbicularis muscle. Histologic features were consistent with metastatic breast cancer. Results of both the primary breast cancer biopsy taken 14 months previously and the eyelid biopsies were the same histologic type. Presentation of metastatic breast cancer to the eyelids is rare, but a recurrence must be considered in any patient with a history of breast cancer, despite the length of tumor-free survival. Bilateral involvement should not exclude metastases from diagnostic consideration, but rather, the diagnosis requires a high degree of clinical suspicion and recognition of the various cutaneous forms.
Breast Neoplasms↗