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[INTUBATION OF THE LACRIMAL DUCTS].
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[The lacrimal film].
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[CARCINOMA OF THE LACRIMAL SAC].
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Clinical and histologic evaluation of the prolapsed third eyelid gland in dogs.
Eighteen prolapses of the gland of the third eyelid in 17 Beagles were randomly allocated to 3 groups, which included nontreated (group 1, n = 6), excised (group 2, n = 4), and surgically repositioned (group 3, n = 8) glands. A schirmer tear test (STT) was performed on affected and normal (control) eyes for 5 consecutive days on weeks 0 (baseline), 2, 4, 6, 8, 10, 12, 16, 18, 20, and 24. All prolapsed third eyelid glands were excised and examined histologically. Ten female and 7 male Beagles were used in the prospective study. Mean age at prolapse was 35.1 weeks (range, 6 to 89 weeks). Control STT data revealed a population mean of 22.2 +/- 2.1 mm/min. Complications developed in 4 of 6 eyes when the gland was allowed to remain in a prolapsed position. Complications for group-1 eyes were significantly (P < 0.005) greater than those for eyes in groups 2 and 3 (0 of 12). Comparison of affected and control eye baseline data revealed decreased STT values for eyes with prolapsed glands (P < 0.01). Mean differences between affected and control eyes were 2.2, 2.0, and 3.4 mm/min for groups 1, 2, and 3, respectively. A significant (P < 0.001) decrease in lacrimation (0.2 to 3.1 mm/min) in group-2 eyes was detected after removal of the gland. Tear production for affected eyes of nontreated dogs fluctuated above and below that of control eyes prior to excision of the prolapsed gland of the third eyelid; however, with time, affected and control eye STT values were not significantly different.(ABSTRACT TRUNCATED AT 250 WORDS)
[Chemical composition of excretions of the lacrimal glands].
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Lacrimal location of sinus histiocytosis (Rosai-Dorfman-Destombes disease).
A 7-year-old West African male patient presented with recurrence of multiple cervical lymphadenopathy. Cervical node biopsy disclosed a sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman-Destombes disease). During follow-up, the patient developed a left orbital mass corresponding to an enlarged lacrimal gland shown by CT. The histologic features of the gland were consistent with the diagnosis, and with steroid treatment, the gland decreased in size. Although rare, the diagnosis of sinus histiocytosis with massive lymphadenopathy has to be considered in cases of lacrimal gland enlargement.
Lacrimal gland myoepithelioma in a rhesus macaque (Macaca mulatta).
An 18-year-old rhesus macaque (Macaca mulatta) developed ptosis of the left upper eyelid due to a mass that had first been observed 10 years previously. The 11 x 7 x 7-mm mass was surgically excised, and the ptosis resolved after 5 days. Histologic examination of the mass revealed two confluent cell populations. Most cells were spindle-shaped and were arranged in loose fascicles. Smaller numbers of cells had squamous differentiation. The spindle-shaped cells expressed smooth muscle actin. Cells with squamous differentiation did not express smooth muscle actin, but did, along with around half of the spindle-shaped cells, express pan-cytokeratin. On the basis of histologic and immunohistochemical findings, the mass was diagnosed as myoepithelioma. The neoplasm most likely originated from the palpebral lobe of the lacrimal gland, although accessory lacrimal gland origin could not be excluded. Recurrence of the neoplasm has not been observed 6 months after surgery.
[A new lacrimal intubation set (author's transl)].
The authors report a new lacrimal intubation set made with two very malleable metal probes and with a silicone tube. The system can be used during the repair of the nasolacrimal duct injuries, during dacryorhinocystostomy, and also for the repair of canaliculus injuries with the little set.
[A new method of lacrymal derivation in the canalicular obstruction (author's transl)].
The authors believe that in their experience the best method of lacrymal derivation in the canalicular obstruction is the Jone's technique. However, the post operatoire complications are numerous in this method and therefore they are looking for a new procedure of lacorhinostomy: - the type of tube is a silicone tube which has the great advantage of not irritating the tissues; - the silicone tube is introduced into the lacrymal duct. After having used this technique for four years the authors are convinced that this is the best method.
[Crying upon eating: the crocodile-tears syndrome].
A male infant who, since birth, had begun to cry as soon as he began to nurse was found to have the crocodile tears syndrome. It is thought that in this condition the lacrimal glands are partially innervated by efferent fibres of the facial nerve (VII). The syndrome may be congenital, but may also be a consequence of an infection or trauma. Treatment is surgical or by the use of botulinum-A toxin.
Management of the lacrimal system during maxillectomy.
BACKGROUND: Oncologic resection of the maxilla requires management of the nasolacrimal sac/duct system (NLS). A variety of techniques may be used: simple transection, transection with transcanalicular stenting, drilling of the entire nasolacrimal bony canal to the inferior meatus with mobilization of an intact NLS, marsupialization of the NLS with or without stenting, and simple transection with routine delayed dacryocystorhinostomy (DCR) for symptomatic epiphora. Rates of prolonged epiphora range from 13 to 63%. OBJECTIVES: We present our approach to NLS management during maxillectomy, and our rates of epiphora. STUDY DESIGN: Review of 212 consecutive patients who underwent transection of the NLS during medial maxillectomy, complete maxillectomy with preservation of orbital contents, suprastructure maxillectomy, or maxillectomy as part of anterior craniofacial resection. Patients with primary NLS tumors were excluded. Prolonged epiphora is defined as persistent if it lasts more than 6 months. METHODS: After exposure of the anterior maxillary wall and inferior and medial orbital rim, a high-speed drill and Kerrison rongeurs are used to remove the anterior wall of the nasolacrimal canal. The NLS is transected 12-15 mm distal to the periorbita and removed from the canal. Two 4-6-mm opposing incisions are made at the distal duct. Two semicircular flaps are everted, folded, and sutured to the proximal sac or periorbita. A transcanalicular stent is not placed. RESULTS: Two-hundred twelve patients underwent the above-mentioned procedure. Four patients (1.9%) developed prolonged epiphora, which required delayed DCR. CONCLUSIONS: Marsupialization of the NLS without stenting provided us with an acceptably low rate of prolonged epiphora.
[Crying upon eating: the crocodile-tears syndrome].
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[Scintigraphy of the lacrimal ducts. Value of the lateral incidence in postoperative period].
Lacrimal scintillography, a simple, non traumatic, and physiological method, has been for a long time an useful exploration in the study excretory pathology. It allows an accurate diagnosis especially in the case of functional stenosis and, due to its ability to indicate the exact seat of obstruction, this technique is able to determine the surgical treatment required. This study underlines the contribution of lacrimal scintillography in the control of surgical anastomosis permeability, because of a modification in the initial technique: the use of scintillography in employing the lateral view rather than the front view, usually used, permits a better visualisation of the new surgically created excretory passage, particularly in the posterior area of nasal fossae.
Immunohistochemical study of pleomorphic adenoma of lacrimal gland.
Immunohistochemical examinations of lacrimal gland specimens were carried out with monoclonal antibodies to S-100 protein and glial fibrillary acidic protein (GFAP) in 3 cases of normal tissue, 2 cases of hypertrophy and 3 cases of pleomorphic adenoma of the lacrimal gland. In specimens of normal lacrimal gland tissue, S-100 protein was identified in myoepithelial cells and ductal epithelia, but GFAP was not identified in any part of the gland. In specimens of lacrimal gland hypertrophy, the findings were identical. In pleomorphic adenoma of the lacrimal gland, asteroid cells in the myxoid and/or chondroid areas were strongly stained by antibodies to both S-100 protein and GFAP. In the solid areas of pleomorphic adenoma specimens, S-100 protein-positive fusiform or round cells and GFAP-positive round cells were observed. It was thought that S-100 protein-positive cells could have originated from myoepithelial cells and that GFAP could be a tumor-associated antigen. These findings agreed with recent immunohistochemical findings in pleomorphic adenoma of the salivary gland. It was speculated that pleomorphic adenoma of the lacrimal gland could cause mesenchymal metaplasia of the myoepithelial cells, as happens in pleomorphic adenoma of the salivary gland.
[Malignant tumors of the lacrimal gland--a report of 27 cases].
We report 27 cases of primary malignant tumors arising from lacrimal gland, including 12 cases with adenoid cystic carcinoma, 9 cases with malignant mixed tumor and 6 cases with other lacrimal gland carcinoma seen in Zhongshan Ophthalmic Center from 1981 to Nov. 1989. These patients with malignant neoplasms accounted for 65.85% of all patients with primary epithelial tumor of lacrimal gland. The clinical presentation, imaging features in X-ray, ultrasonic and CT scan, the diagnosis, differential diagnosis, treatment and prognosis are discussed and analysed.
[Postoperative epiphora].
The authors discuss the management of watering of the eyes occurring after facial or palpebral surgery. The most serious form is watering of the eyes associated with a pericorneal ring, which constitutes an ophthalmological emergency. Watering of a "white" eye suggests an abnormality of the lacrimal ducts. The clinical context and instrumental exploration can localize the obstruction, which is an essential step prior to surgical treatment.
Disappearance of primitive basaloid cells after external irradiation in adenoid cystic carcinoma of the lacrimal gland.
OBJECTIVE: To study the histopathological findings of basaloid adenoid cystic carcinoma after high dose orbital irradiation. MATERIAL AND METHOD: The histopathology study was done in a 38-year-old Thai female patient who had basaloid adenoid cystic carcinoma of the right lacrimal gland confirmed by incisional biopsy. After a 60-Gy external irradiation, the mass decreased in size and finally could not be palpated, but subsequent orbital imaging still showed infiltrative soft tissue mass at the right lacrimal gland with bony defects at posterosuperior and lateral walls without extraorbital extension. Orbital exenteration and lateral orbitectomy was performed. The specimen was submitted for histopathological examination. RESULTS: Microscopic examination revealed periglandular infiltration with chronic inflammation of the palpebral lobe of lacrimal gland. The orbital lobe was extensively replaced with fibrous tissue. There was only a small area of cribiform pattern of the adenoid cystic carcinoma left; no basaloid pattern was seen in the tissue. CONCLUSION: The primitive cells (basaloid pattern) disappear after orbital irradiation for adenoid cystic carcinoma of the lacrimal gland. Replacement with fibrous tissue is seen.