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At least 451 records · Page 25Linked to original sources

PubMed2002

Normal changes in orbital volume during childhood.

OBJECT: The aim of this study was to construct a model of changes in orbital volume that occur throughout childhood from the age of 1 month to 15 years, which could be used for comparative studies of disease states affecting orbital growth. METHODS: Using the procedure of segmentation on magnetic resonance images obtained in 67 healthy children, orbital volume was measured and plotted against age. During the first few months of life left orbital volume is on average 15 cm3 in male and 13 cm3 in female infants; these volumes increase to 26 cm3 and 24 cm3, respectively, by the time the child reaches 15 years of age. During the first few months of life right orbital volume is on average 16 cm3 in male and 13 cm3 in female infants; these volumes increase to 27 cm3 and 25 cm3, respectively, by the time the child is 15 years old. This represents an overall increase in orbital volume by a factor of 1.7 in boys and 1.8 in girls. By the time the child has reached 5 years of age, the orbital volume for both right and left sides has reached on average 77% of the volume seen at 15 years in both sexes. The differences between the two sides are not statistically significant for either sex. The change in orbital volume that is associated with age in general displays a linear pattern. Throughout childhood, orbital volumes are larger in boys than in girls, but share a similar growth pattern. The difference between the two sexes tends toward statistical significance during the first 5 years of life (left orbit p = 0.1, right orbit p = 0.04). CONCLUSIONS: During early childhood, orbital volume increases in a linear fashion, achieving a significant proportion of its final growth by the time the child is 5 years old.

Adolescent↗

PubMed2005

Why the hydration energy of Au+ is larger for the second water molecule than the first one: skewed orbitals overlap.

Using molecular-orbital analysis, we have elucidated the quantum-chemical origin of the intriguing phenomena in sequential hydration energies of the gold cation, which is known to be the most conspicuous among all transition metals. The hydration energy of Au+ with the second water molecule is found to be much larger than that with the first water molecule. Owing to the large relativistic effect of gold (i.e., significant lowering of the 6s orbital energy and significant raising of the 5d orbital energy), the highest occupied molecular orbital of the hydrated gold cation has a large portion of the 6s orbital. As the electron density of the 6s orbital populates in a large outer spherical shell far off the gold nucleus, the p orbitals (or sp hybridized lone-pair orbitals) of the water molecules are able to overlap with the outer part of the 6s orbital in the dihydrated gold cation, resulting in the unusual skewed overlap of p-6s-p orbitals (not the atom-to-atom bond overlap). No previous molecular-orbital analysis has reported this peculiar skewed orbitals overlap. Since this skewed orbitals overlap is saturated with two water molecules, this property is responsible for the low coordination number of the gold ion.

Journal Article↗

PubMed2000

Ultrasonography evaluation of retrobulbar hematoma in bovine orbits

As the proptotic eye is pushed anteriorly against the canthis, pressure within the eye increases until there is inadequate perfusion of the eye due to the pressure effects. computed tomography (CT) scan of the orbit is the most common method of diagnosing a retrobulbar hematoma. In the trauma/emergency department setting, where the wait for a CT scan may present significant delay, bedside ultrasonography may aid in the rapid diagnosis and treatment of a retrobulbar hematoma. OBJECTIVE: To establish concordance between orbital CT scan and a bedside sonographic orbital evaluation of a retrobulbar hematoma. METHODS: Eighteen of 22 bovine orbits were injected with a 10-mL mixture of calcium-treated banked blood and contrast into the retro-orbital space thereby effecting a retrobulbar hematoma. Each orbit was studied with CT and evaluated by a neuroradiologist. Four orbits were left intact as controls. Each orbit underwent an ultrasonographic evaluation. The ultrasonographer was first allowed to study an orbit with a documented hematoma and a control. Thereafter, he was blinded to the orbits containing hematoma, did not physically examine each orbit, and completed each exam in a darkened room. The CT results were correlated with the ultrasound findings. RESULTS: 15 of 18 orbits (83%) were correctly identified as containing hematoma by ultrasound. All four intact orbits were correctly identified as being free of hematoma (kappa 0.6). CONCLUSIONS: Bedside ultrasonography may aid in the rapid diagnosis of a retrobulbar hematoma.

Journal Article↗

PubMedDate not supplied

Orbital blowout fractures: experimental evidence for the pure hydraulic theory.

BACKGROUND: The mechanism of injury and the underlying biomechanics of orbital blowout fractures remain controversial. The "hydraulic" theory proposes that a generalized increased orbital content pressure results in direct compression and fracturing of the thin orbital bone. OBJECTIVE: To examine the pure hydraulic mechanism of injury by eliminating the factor of globe-to-wall contact and its possible contribution to fracture thresholds and patterns. MATERIALS AND METHODS: Five fresh human cadaver specimens were used for the study. In each cadaver head, 1 orbit was prepared to mimic the normal physiologic condition by increasing the hypotony of the cadaver globe to normal intraocular pressure (15-20 mm Hg) with intravitreous injection of isotonic sodium chloride solution (saline). The second orbit served as a "hydraulic control," whereby the globe and orbital contents were exenterated and replaced by a saline-filled balloon at physiologic intraocular pressure. A 1-kg pendulum measuring 2.5 cm in diameter was used to strike the cadaver heads. Drop heights ranged from 0.2 m to 1.1 m (1960 mJ to 10 780 mJ energy). Each head was struck twice, once to each orbit. Direct visualization, high-speed videography, and computed tomographic scans were used to determine injury patterns at various heights between the 2 orbits. RESULTS: A fracture threshold was found at a drop height of 0.3 m (2940 mJ). Fracture severity and displacement increased with incremental increases in drop height (energy). Fracture displacement, with herniation of orbital contents, was obtained at heights above 0.5 m (4900 mJ). Isolated orbital floor fractures were obtained at lower heights, with medial wall fractures occurring in conjunction with floor fractures at higher energies (> or =6860 mJ). The globe intact side and balloon (hydraulic control) side showed nearly identical fracture patterns and levels of displacement at each drop height. CONCLUSIONS: This study provides support for the "hydraulic" theory and evidence against the role of direct globe-to-wall contact in the pathogenesis of orbital blowout fractures. In addition, the orbital floor was found to have a lower threshold for fracture than the medial wall. Preliminary threshold values for fracture occurrence and soft tissue displacement were obtained.

Barotrauma↗

PubMed1985

Superolateral orbital exposure and reconstruction.

Based upon experience with 10 cases of surgical excision of orbital tumors, we describe a modification of the supraorbital and lateral approaches to the orbit. This technique gives a wide superior and lateral exposure of the orbital contents for microsurgical removal of orbital tumors. It is particularly applicable to large orbital neoplasms, tumors in the orbital apex, growths with intracranial extension, and medial orbital tumors. Two separate bone flaps are removed: a craniotomy (or cranio-orbital) flap that includes the superior and lateral orbital rim and a smaller, more posterior flap that includes the remainder of the roof and lateral wall of the orbit. After excision of a tumor, the orbital walls can be reconstructed in their entirety or the surgeon can leave out the smaller, posterior flap for orbital decompression. After reconstruction there are no significant anatomic, functional, or cosmetic deficits.

Humans↗

PubMed2004

Navigation-aided reconstruction of medial orbital wall and floor contour in cranio-maxillofacial reconstruction.

The reconstruction of the anterio-posterior inclination of the medial aspect of the orbital floor, despite a wide 360 degrees exposure, including coronal and conjunctival incisions, is a challenging task in severe injuries of the orbit with massive comminution and complete displacement of the medial orbital wall and orbital floor. Out of a total of 20 patients with orbital fractures, five underwent a surgical intervention of repositioning the medial aspect of the orbital floor and especially the transition area between the orbital floor and medial orbital wall, using navigation-aided procedures. Using the mirroring tool of the Stryker-Leibinger STN-system, post-operative CTs indicated an average difference of the globe position of -4.9% between the operated side and the unaffected side, depending on the position of the medial aspect of the orbital floor. Navigation-aided procedures proved to be an essential precondition for achieving precise and predictable results in orbital reconstruction. In such cases, unlike those with an intact medial orbital wall remnant as a surgical target, bone grafts for reconstruction of the orbital floor cannot be implanted as onlay grafts.

Adult↗

PubMed2004

Status of the internal orbit after reduction of zygomaticomaxillary complex fractures.

PURPOSE: We sought to determine the status of the internal orbit before and after reduction of zygomaticomaxillary complex (ZMC) fractures when treated without internal orbital reconstruction. PATIENTS AND METHODS: We conducted a retrospective study of preoperative and postoperative computed tomography (CT) scans in 65 patients with unilateral ZMC fractures who were treated by reduction of the ZMC complex without internal orbital reconstruction. The size and location of the internal orbital defects, orbital soft tissue displacement, and orbital volume were assessed in the preoperative and postoperative CT scans. RESULTS: Reduction in the ZMC fractures was considered ideal in 58 of the 65 patients. Only minor malpositions occurred in the remaining 7 patients. The size of the internal orbital defects increased slightly with ZMC reduction but the internal orbital fractures were realigned, and few had increases in orbital volume or soft tissue sagging into the sinuses. Examination of follow-up CT scans in several patients taken weeks to months later showed that the residual defects became smaller and that none of these patients had an increase in orbital volume or soft tissue sagging. CONCLUSION: The preoperative CT scan can be used to assess the amount of internal orbital disruption for purposes of developing a treatment plan in patients with ZMC fractures. When there is minimal or no soft tissue herniation and minimal disruption of the internal orbit, ZMC reduction is adequate treatment.

Adolescent↗

PubMed2006

Anatomical 3-dimensional pre-bent titanium implant for orbital floor fractures.

PURPOSE: This cadaver study evaluates the use of pre-bent 3-dimensional titanium mesh implants for orbital floor and medial wall reconstruction. DESIGN: Nonrandomized comparative study. PARTICIPANTS: Eight human cadaveric heads (n = 16 orbits). METHODS: Transcutaneous incisions were used to expose both orbital floors in each cadaveric head. Unilateral orbital floor and medial wall fractures were generated in each specimen. The contralateral orbit remained uninjured. The fractures then were repaired with pre-bent titanium mesh fan plates molded from aluminum templates presenting different sizes. The templates were generated from topographical computed tomography (CT) data previously obtained from normal subjects. The accuracy of orbital reconstruction was evaluated with postoperative CT scans. MAIN OUTCOME MEASURES: The mean value of the distances between the implant and the bony orbit was evaluated. RESULTS: The mean distance between all 16 plates and their respective orbital floors/medial walls was 0.81+/-0.74 mm. Mean values were 0.68+/-0.63 mm for the unfractured side and 0.93+/-0.82 mm for the fractured side. No significant differences were found between orbits when evaluated for side of injury, gender, or size of defect. CONCLUSION: Pre-bent 3-dimensional titanium mesh implants provide accurate reconstruction of orbital floor and medial orbital wall fractures. The mean implant error was <1 mm for all orbits studied.

Adult↗

PubMedDate not supplied

What is orbital pseudotumor?

We have reviewed the literature in order to delineate the clinicopathologic definition of orbital pseudotumor, also called idiopathic nonspecific orbital inflammation. The clinical picture of orbital pseudotumor varies widely, with signs of mass effect, inflammation and/or infiltration. On computed tomography, orbital pseudotumor presents as a unilateral focal or diffuse mass. The histopathologic hallmark of orbital pseudotumor is a mixed inflammatory infiltrate with fibrosis of varying degree. Contrary to an old belief, orbital pseudotumor is not related to orbital reactive lymphoid hyperplasia (pseudolymphoma) and is not a lymphoid tumor. Atypical histopathologic findings of orbital pseudotumor include dominant sclerosis, granulomatous inflammation, vasculitis, and tissue eosinophilia. In the absence of systemic fibroinflammatory, granulomatous, and vasculitic disease, these atypical histopathologic patterns can be considered to represent subclasses of orbital pseudotumors rather then distinct entities. Clinical and prognostic characteristics of both histopathologically classical and atypical orbital pseudotumors appear to be heterogeneous. The etiology of orbital pseudotumor is unknown, but infection, autoimmune disorder, and aberrant wound healing have all been put forward as possibilities. In conclusion, orbital pseudotumor is one distinct disease albeit with many clinical and histopathologic guises.

Humans↗

PubMed2001

Australasian orbital and adnexal Wegener's granulomatosis.

OBJECTIVE: To report a retrospective case series of 29 Australian and New Zealand patients with orbital and adnexal Wegener's granulomatosis (WG). DESIGN: Retrospective case series. PARTICIPANTS: Twenty-nine cases of orbital and adnexal WG were identified. METHODS: A number of oculoplastic surgeons and other clinicians in Australia and New Zealand was asked about their experience with orbital and adnexal WG. Clinical data regarding these cases were conveyed by means of a questionnaire. Cases of ophthalmic WG without features of orbital or adnexal disease were excluded. MAIN OUTCOME MEASURES: Data obtained from the questionnaire includes age, gender, limited or generalized disease, antineutrophil cytoplasmic antibody (ANCA) status, symptoms and signs: nasolacrimal obstruction, sinusitis, fistula/orbital bone erosion, orbital mass/proptosis, extraocular muscle/diplopia, visual acuity reduction caused by optic nerve compression, orbital pain, lid edema/erythema, biopsy status, and treatment status. RESULTS: Twenty-nine patients with orbital and adnexal WG were identified and described. Symptoms included awareness of an orbital mass, epiphora, orbital pain and diplopia. Signs included an orbital mass or proptosis (69%), nasolacrimal duct obstruction (52%), limited ocular rotations (52%), lid erythema and edema (31%), bony destruction (21%), and reduced visual acuity (17%). Two patients had a persistent nasolacrimocanthal fistula. Cytoplasmic pattern antineutrophil cytoplasmic antibodies (c-ANCA) were present in 52% of patients, and in 9 of 10 patients with generalized disease. However, c-ANCA was positive in only 32% (6 of 19) of patients with limited WG. Perinuclear pattern antineutrophil cytoplasmic antibodies (p-ANCA) was positive in 10% of cases. CONCLUSIONS: To diagnose and treat ophthalmic WG effectively, the clinician must be aware of its protean orbital and adnexal manifestations. WG may occur with or without systemic involvement, and c-ANCA was negative in approximately half our cases. Our cases also demonstrated two orbital fistulae, an observation previously believed to be rare.

Adolescent↗

PubMed2002

Orbital tumors in the older adult population.

PURPOSE: To determine the types and frequency of orbital tumors in the older adult population. DESIGN: Retrospective consecutive case series. PARTICIPANTS: Two hundred consecutive patients aged 60 years or older with an orbital tumor managed at a tertiary referral center. MAIN OUTCOME MEASURES: The relative incidence and management of orbital tumors in patients aged 60 years or older. RESULTS: Of approximately 950 consecutive patients with orbital space-occupying lesions managed over a 25-year period on the Oncology Service, 200 patients (21%) were 60 years or older at the time of diagnosis. The orbital tumor was unilateral in 183 patients (92%) and bilateral in 17 patients (8%). The most common clinical features at presentation included mass in 51 patients (26%), proptosis in 36 (18%), and pain in 30 (15%). The mean duration of symptoms was 11 months before referral. The orbital tumor was malignant in 125 patients (63%) and benign in 75 (27%). The most common diagnoses were malignant lymphoma in 47 patients (24%), idiopathic orbital inflammation in 19 (10%), and cavernous hemangioma in 15 (8%). The diagnosis was made with clinical findings and imaging studies in 58 patients (29%) and additional histopathologic examination in 142 patients (71%). Of 217 tumors, the main tumor location was in the superior half of the orbit in 106 lesions (49%), in the anterior orbit in 100 (46%), and in the extraconal space in 135 (62%). Imaging studies showed a mass with well-defined margins in 90 tumors (41%) and ill-defined margins in 127 (59%). The tumors were solid in 203 cases (94%), cystic in 6 (3%), and mixed in 8 (3%). Over a mean of 31 months follow-up, 50 (25%) patients had orbital tumor-related systemic involvement (metastasis or lymphoma), and 150 (75%) remained free of systemic involvement. CONCLUSIONS: Orbital tumors in the senior adult population are malignant in 63% of cases. Malignant lymphoma is the most common tumor in this age group, accounting for 24% of cases. Overall, 25% of patients have systemic problems related to the orbital process develop, so systemic evaluation is warranted.

Aged↗

PubMed1998

Bilateral orbital metastases from breast carcinoma. A case of false pseudotumor.

OBJECTIVE: To inform clinicians of a metastatic orbital neoplasm that frequently masquerades as an orbital inflammatory syndrome and to stimulate thought regarding this neoplasm's fundamental pathobiology specific to its orbital involvement. DESIGN: Interventional case report and literature review. PARTICIPANTS: A 47-year-old woman with an acquired, bilateral, diffusely infiltrative orbital process is described. INTERVENTION: The clinical and radiographic features of the patient's orbital process are reported. The review of two prior fine-needle aspiration biopsy specimens failed to reveal a diagnosis. Histopathologic examination of an open surgical biopsy specimen included standard light microscopy of frozen and formaldehyde-fixed, paraffin-embedded tissue. RESULTS: Characteristics light microscopy findings suggested the diagnosis of metastatic lobular carcinoma of the breast. The patient refused all therapeutic intervention and died 9 months after orbitotomy. CONCLUSION: The presentation of breast carcinoma metastatic to the orbit as a bilateral infiltrative process is far more common than appreciated previously. Its rate of bilateral orbital involvement is 20%, whereas this rate for other adult neoplasms is much lower. The authors report an additional case, review the clinical features of previous case reports and series, and discuss aspects of the metastatic process. Breast carcinoma must be included in the differential diagnosis of infiltrative orbital processes encountered in adult female patients. When "orbital pseudotumor" is detected in an adult female patient, a thorough medical history must be obtained and physical examination performed. If a possible primary breast carcinoma is indicated, one must be wary of metastatic disease, and a histologic orbital diagnosis is warranted. The frequency of orbital metastasis and bilateral orbital involvement of this neoplasm reinforces the possibility for organ-specific metastases.

Breast Neoplasms↗

PubMed2000

Secondary orbital melanomas: analysis of 15 cases.

Orbital melanomas comprise a heterogeneous group of pigmented tumours originating from melanocytes of the ophthalmic tissues, or represent distant metastases of cutaneous melanomas to the orbit. They can be classified into primary and secondary orbital melanomas. Whereas primary orbital melanomas are extremely rare, secondary orbital melanomas are seen more often and usually represent massive extrascleral extensions of uveal melanomas. Their diagnosis is difficult and controversy exists both about the treatment policy and regarding the prognosis. In an effort to clarify some of the aspects of the biological behaviour of these intriguing lesions, we retrospectively reviewed all orbital melanomas treated in our departments during the last eight years. The records of 15 patients with massive secondary orbital melanomas treated surgically were reviewed and analysed. Eleven of the patients were female and four were male. The mean age at the time of surgery was 68 years. Presenting features included unilateral orbital mass, often with painless proptosis, conjuctival bleeding, acute glaucoma crisis, decreased visual acuity and intermittent diplopia. The site of origin was the uveal tract in nine cases, the conjunctiva in three, the eyelids in two and the skin of the lower extremity in one patient. All patients were treated surgically with various types of orbital exenteration. Additional treatment included radiotherapy and chemotherapy. Two patients died from intracranial extension of the disease and 10 died from distant metastases. Three patients are alive with no evidence of disease. The longest survival was 33 months and the mean survival was 16.6 months. Early diagnosis and proper management of ocular melanoma prevents orbital extension and prolongs patient survival. Surgical treatment of secondary orbital melanoma with or without adjuvant radiotherapy and/or chemotherapy does not seem to improve patient survival when compared with conservative treatment used in other reports. However, orbital exenteration is effective for local control of the disease.

Aged↗

PubMed1998

Comparison of the effects of enucleation and orbital reconstruction using free-fat grafts, dermis grafts, and porous polyethylene implants in infant rabbits.

Twenty-nine infant rabbits from four litters were randomly assigned to three groups. No surgery was performed on left eyes. All right eyes were enucleated. Group 1, the control group, had no right-socket reconstruction. Group 2 had reconstruction using free-fat and dermis grafts. Group 3 had reconstruction using porous polyethylene implants. On attaining adult size, rabbits were killed, decapitated, and prepared for measurements. Orbital volume measurements were performed twice and orbital entrance areas were determined once. No significant differences were noted between first and second measurements of orbital volumes. Right orbital volumes were significantly smaller than left orbits in all groups except for the second measurement of the polyethylene implant group. Right orbital entrance areas were significantly smaller than left areas in the control and the free-fat and dermis graft groups. Right orbital entrance areas of the polyethylene group were not significantly smaller than the corresponding left orbital entrance areas. The use of free-fat and dermis grafts for orbital reconstruction in anophthalmic infant rabbits did not significantly stimulate orbital bone growth. In one trial, the polyethylene implant group displayed right orbital volumes and orbital entrance areas that were not significantly smaller than controls.

Adipose Tissue↗

PubMed2001

Ophthalmological outcome following orbital resection in anterior and anterolateral skull base surgery.

OBJECT: Partial resection of the orbital bones is not uncommon during the excision of anterior and anterolateral skull base tumors. Controversy exists regarding the need for and extent of the reconstruction necessary following this resection. The authors studied this factor in a series of patients. METHODS: The authors conducted a retrospective review of 56 patients in whom resection of 57 anterior or anterolateral skull base tumors and partial excision of the orbital bone were performed. Adverse ophthalmological outcomes were noted in 16 patients, in nine of whom adverse outcomes were believed to be directly related to resection of the orbital walls. Some degree of orbital reconstruction was performed during 23 of the 57 procedures. An adverse orbit-related outcome was strongly associated with resection of the orbital floor and with resection of two thirds or more of two or more orbital walls but not with the presence of absence or orbital reconstruction. The latter finding, however, is likely a function of selection bias. CONCLUSIONS: In most patients after partial excision of the orbital bones, elaborate reconstruction is not necessary. Isolated medial and lateral orbital wall defects or combined superior and lateral orbital wall defects, especially in cases in which the periorbita is intact, probably do not require primary reconstruction. In cases of orbital floor defects, whether isolated or part of a multiple wall resection, primary reconstruction is recommended.

Craniotomy↗

PubMed1988

Management of orbital trauma and foreign bodies.

Blunt and penetrating trauma to the orbital region can have a devastating effect both functionally and cosmetically for the orbit. Penetrating injuries to the orbit should be suspected whenever there is a history of trauma to the regions of the eyelids. Meticulous inspection of the eyelids and globe should be undertaken, and if there is any suspicion of a foreign body retained within the orbital soft tissues, then a CT scan should be obtained. It is possible that the foreign body is not opaque, and exploration of the soft tissues may be indicated. Blow-out fractures of the orbit should be explored and repaired when the evidence clearly indicates that a blow-out is present. This includes the clinical presence of diplopia, evidence of muscle entrapment with forced duction testing, and CT scan showing orbital wall fracture with explosion of the orbital contents into the paranasal sinuses. If these signs or symptoms are equivocable, then a waiting period of 10 to 14 days is indicated to rule out the presence of a nerve palsy, which should improve. However, a CT scan showing a large blow-out defect of the orbit should be repaired regardless of the clinical signs at the time because of the late sequelae of enophthalmos and hypophthalmos. It is very difficult to secondarily repair an orbit that is contracted owing to loss of volume from an orbital blow-out fracture. Procedures of this sort involve the reintroduction of autogenous fat into the orbital contents and are very difficult technically. Although orbital fractures should not be routinely explored, each should be viewed with its own merit and an aggressive approach developed if there is clinical evidence of a blow-out fracture.

Eye Foreign Bodies↗

PubMed1995

Orbital fractures in children.

OBJECTIVE: To determine if the pattern of orbital fractures may be influenced by the changing craniofacial ratio of the growing child, as the orbit is the boundary between the face and the cranium. DESIGN: Retrospective case series of 40 patients between the ages of 1 year and 16 years with orbital fractures. SETTING: The Albany (NY) Medical Center Hospital, a tertiary level 1 trauma center. OUTCOME MEASURES: The sex, age, site, and mechanism of injury, associated injury, and treatment methods for children admitted to the Albany Medical Center Hospital with orbital fractures between July 1986 and June 1992. RESULTS: Fourteen children had fractures of the orbital roof, 10 children had fractures of the orbital floor, 14 children had mixed fractures, and two children had fractures of the medial wall. The mean age (4.8 +/- 3.3 years) of the 14 patients with roof fractures was significantly less than the mean age (12.0 +/- 4.2 years) of the 26 children with other orbital fractures. Logistic regression demonstrated that the age at which the probability of lower orbital fractures exceeds the probability of orbital roof fractures is 7.1 +/- 1.0 years. Orbital roof fractures had a significantly greater likelihood of associated neurocranial injuries. The need for surgical repair was significantly lower among children with roof fractures as well as among children 7 years of age and younger. CONCLUSIONS: Orbital roof fractures are a type of skull fracture that occur primarily in younger children as a consequence of the proportionally larger cranium and the lack of frontal sinus pneumatization. Lower orbital fractures are a type of facial fracture that occur primarily in older children as a consequence of the increased vulnerability of the face due to growth and the pneumatization of the paranasal sinuses.

Adolescent↗

PubMed2002

Morphometric measurements from various reference points in the orbit of male Caucasians.

The aim of this study was to determine the morphometric variations from various reference points to decrease risks in orbital surgery. Sixty-two orbits obtained from 31 skulls of male adult Caucasians were measured with a millimetric compass. On the medial orbital wall, the midpoint of the anterior lacrimal crest was the reference point; from this point we measured distances of 23.9+/-3.3 mm, 35.6+/-2.3 mm, 41.7+/-3.1 mm and 6.9+/-1.5 mm respectively to the anterior ethmoidal foramen, posterior ethmoidal foramen, midpoint of the medial aspect of the optic canal and posterior lacrimal crest. On the same wall, distances from the plane of the anterior and posterior ethmoidal foramina to the ethmoido-maxillary suture and distance from the posterior ethmoidal foramen to the anterior ethmoidal foramen and midpoint of the medial margin of the optic canal were 14.9+/-2.3 mm, 9.8+/-2.9 mm and 6.8+/-2.2 mm respectively. On the inferior orbital wall, the main reference point was the infraorbital foramen, and from this point to the midpoints of the lateral margin of the fossa for the lacrimal gland, inferior orbital fissure, inferior orbital rim and inferior aspect of the optic canal was 23.8+/-7.2 mm, 31.9+/-3.9 mm, 6.7+/-1.9 mm and 50.3+/-3.2 mm respectively. On the superior orbital wall, the distances from the supraorbital foramen to the midpoints of the superior orbital fissure, fossa for the lacrimal gland and superior aspect of the optic canal were 45.7+/-3.6 mm, 26.0+/-2.5 mm and 45.3+/-3.2 mm respectively. Furthermore, on the same wall, the distance from the posterior ethmoidal foramen to the midpoint of the superior orbital fissure was 14.6+/-2.8 mm. Finally, on the lateral orbital wall the frontozygomatic suture was the reference point. From this point distances to the midpoints of the fossa for the lacrimal gland, superior orbital fissure, lateral aspect of the optic canal and inferior orbital fissure were 17.5+/-2.1 mm, 37.7+/-3.6 mm, 44.9+/-2.5 mm and 33.4+/-3.1 mm respectively.

Adult↗