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PubMedDate not supplied

[Early embryonic formation of the human vomeronasal organ].

We studied the origin and development of the vomeronasal system in early human embryos of 10-18 mm crown-rump length under normal and pathological conditions. The formation of the vomeronasal organ from the vomeronasal groove and placode in a 10-mm embryo is described. We propose that the vomeronasal cavity originates in the schizocoel way. We studied the development of the vomeronasal and olfactory nerves. Attention is paid to the development of the nasolacrimal duct and the epithelial plug. The possible use of the vomeronasal system by embryos during the first seven weeks of development is discussed.

Embryonic and Fetal Development↗
PubMedDate not supplied

MR in squamous cell carcinoma of the lacrimal sac.

A case of squamous cell carcinoma arising from the right lacrimal sac is presented. MR T2-weighted images showed a mass of low signal intensity in the right medial canthus extending into the nasolacrimal duct. This led us to postulate a high-grade malignant neoplasm arising in the lacrimal sac.

Biopsy↗
PubMed1995

Ocular absorption, distribution, and systemic absorption of a novel antiglaucoma medication, prostaglandin derivative, in male white rabbits.

A prostaglandin derivative, (5Z,9 alpha,11 alpha,13E)-9,11-dihydroxyprosta- 5,13-dienoic acid sodium salt (S-1033), that lowers intraocular pressure with little adverse effect, may have clinical value in the treatment of glaucoma. After [14C]S-1033 (0.2% solution) was instilled into the eye of a white rabbit, radioactivity and S-1033 appeared in systemic plasma so rapidly (tmax, 5 min) and S-1033 was eliminated very rapidly with half-lives of 2.8 and 11.0 min at alpha- and beta-phases, respectively. The metabolite, M-1, [1R-[1 alpha,2 beta-(1E),3 alpha,5 alpha]]-3,5-dihydroxy-2-(1- octenyl)-cyclopentanepropanoic acid (tetranor-S-1033), appeared in plasma very rapidly (tmax, 5 min), suggesting that a fast metabolism was a major factor in the rapid elimination of S-1033 from plasma. The values for the ratios of the area under the curve of ocular instillation to intravenous administration for radioactivity and S-1033 were 1.01 and 0.52, respectively, indicating that more than half of the S-1033 instilled was transported into the systemic circulation. To clarify the contributing pathway of the massive and rapid systemic absorption of S-1033 after topical dosing, plasma levels of S-1033 were investigated after instillation to rabbits in which the nasolacrimal ducts were occluded. Plasma concentrations of S-1033 were slightly higher than those in intact rabbits, suggesting that conjunctiva would be as important as nasal mucosae for the systemic absorption under the physiological condition. As for the intraocular distribution, the highest levels of radioactivity were found in the cornea, conjunctiva, and anterior sclera.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorption↗
PubMed1994

[Ocular chlamydia infections in Munsterland. A clinical study of 409 patients].

We evaluated demographic data, McCoy cell cultures from conjunctival smears and chlamydia-specific IgG and IgA serum antibody titers in 409 patients (194 men and 212 women) suffering from (kerato)conjunctivitis of presumed bacterial etiology in 1988-1992. Overall, 105 patients were positive in culture and/or serology tests (78 in McCoy cell cultures, 45 in serology tests). In 33 patients (31%) corneal involvement was epithelial (5), subepithelial (13), phlyctenular (7) and/or took the form of pannus vasculosus (12). The incidence and severity of corneal signs correlated with the duration of the (kerato)conjunctivitis. Nasolacrimal duct complications were documented in 16 patients with a duration of illness exceeding 6 months. Some 33% of cases were recorded in May and June, a further 26% from November to January. The age groups primarily affected were: females 20-30 years (25%), males 30-40 years (25%). The highest number of new cases was registered in 1990.

Adolescent↗
PubMed1994

Silastic intubation for Canaliculus communis stenosis.

Silastic intubation was performed for Canaliculus communis obstruction in 32 cases. Two eyes showed additional impatent nasolacrimal duct and were not treated. The silastic intubation was performed by aid of a long, hollow blunt injection needle which allows us to check the patency of the lacrimal system once the stenosis of common canaliculus is perforated. The success rate for isolated silastic intubation was 70%, which is similar to the results of other often more invasive surgical techniques for Canaliculus communis stenosis.

Adult↗
PubMed1994

[Considerations concerning respiratory physiopathology in a case of total arhinia].

The Authors describe their personal experience in a rare case of total arhinia in a young boy, now seven years old, whose psycho-physical development is normal and who is healthy except for recurrent conjunctivitis due to the absence of nasolacrimal ducts. The Authors consider the possibility that in the case of total absence of the nasal function, as in total arhinia, the oropharyngeal and laryngotracheobronchial mucosa may acquire those functional and defensive properties typically belonging to nasal mucosa. In the subject in question, in fact, functional respiratory and immunosecretory parameters are normal. On the other hand, being well known how problematic acquired severely compromised nasal functions are one would think that only in the case of congenital absence of the nose can the lower aerodigestive structures compensate successfully. In the Authors' opinion this clinic observation contradicts the widely held belief that nasal respiration is absolutely necessary from the moment of birth on.

Child↗
PubMed1994

Lacrimal testing. Age as a factor in Jones testing.

PURPOSE: A modified Jones test is used to assess whether lacrimal transit time varies with age. METHODS: The right eyes of 101 control subjects and 18 patients suspected of having lacrimal system abnormalities were tested with one drop of 2% sodium fluorescein solution. A cotton applicator was placed in the nose next to the inferior turbinate and participants were asked to lean forward. Dye passage was assessed every 3 minutes for 24 minutes. RESULTS: The results were assessed by age. In control subjects, there seemed to be a natural break in the distribution of the data at the age of 45 to 50 years. In control subjects younger than 45 years of age, 10/11 (91%) passed dye in 6 minutes or less (median = 3 minutes), whereas in those 45 years of age and older, 79/90 (84%) passed dye in 12 minutes or less (median = 6 minutes). The results were statistically significant (P = 0.0091). In contrast, patients with symptoms of epiphora due to a nasolacrimal duct obstruction had lacrimal transit times in excess of the above limits. CONCLUSION: This study confirms that the lacrimal transit time slows with age. The modification of the Jones test presented here requires a cutoff of 6 minutes in patients younger than 45 years of age and 12 minutes in patients 45 years of age and older.

Adult↗
PubMed1993

Randomized trial of silver nitrate, erythromycin, and no eye prophylaxis for the prevention of conjunctivitis among newborns not at risk for gonococcal ophthalmitis. Eye Prophylaxis Study Group.

OBJECTIVE: To compare the efficacy of commonly used forms of eye prophylaxis for newborns with no prophylaxis in the prevention of nongonococcal conjunctivitis. DESIGN: Randomized doubly masked clinical trial. SETTING: University of Washington Hospital and affiliated clinics, Seattle, between 1985 and 1990. SUBJECTS: The medical records of 8499 women were evaluated for possible participation; 2577 were eligible. Of the 758 enrolled, the infants of 630 were evaluable. INTERVENTION: Comparison of silver nitrate, erythromycin, and no eye prophylaxis given at birth for the prevention of conjunctivitis. MAIN OUTCOME MEASURES: Conjunctivitis during the first 60 days of life and nasolacrimal duct patency in the first 2 days of life. RESULTS: The frequency of impatent tear ducts at the 30- to 48-hour examination did not differ significantly by prophylaxis group. Among the 630 infants randomized and observed, 109 (17%) developed mild conjunctivitis. Sixty-nine (63%) of the cases appeared during the first 2 weeks of life. After 2 months of observation, infants allocated to silver nitrate eye prophylaxis at birth had a 39% lower rate of conjunctivitis (hazard ratio = 0.61, 95% confidence interval = 0.39 to 0.97), and those allocated to erythromycin had a 31% lower rate of conjunctivitis (hazard ratio = 0.69, 95% confidence interval = 0.44 to 1.07), than did those allocated to no prophylaxis. CONCLUSION: Silver nitrate eye prophylaxis caused no sustained deleterious effects and even provided some benefit to infants born to women without Neisseria gonorrhoeae. However, the effect was modest and against microorganisms of low virulence. The results suggest that parental choice of a prophylaxis agent including no prophylaxis is reasonable for women receiving prenatal care and who are screened for sexually transmitted diseases during pregnancy.

Adult↗
PubMed1993

[Recurrent canaliculitis and dacryocystitis as a sequela of persistent infection with Chlamydia trachomatis].

We report on 4 patients aged 39-62 years with follicular conjunctivitis, canaliculitis, canalicular obstruction, dacryocystitis and nasolacrimal duct obstruction caused by chronic oculogenital infection with Chlamydia trachomatis. Microbiological diagnosis was accomplished by means of the McCoy cell culture technique as a highly specific tool for detection of the chlamydial infection. In addition, serological tests (IgA-IPA and IgG-IPA techniques) were performed. Bacteriological examination of conjunctival smears showed coinfection in 3 patients (Proteus mirabilis in 1, Staphylococcus aureus coagulase-positive in 3). Despite successful operation techniques, the obstructive inflammation caused by oculogenital chlamydial infection could only be cured by systemic treatment with specific antibiotics, such as doxycycline or erythromycin. All cases of chronic follicular conjunctivitis with lacrimal inflammation that are resistant to topical antibiotics should suggest the possibility of infection with Chlamydia trachomatis.

Adult↗
PubMed1993

Indications, technique and results of endonasal endoscopic ethmoidectomy.

Endoscopic ethmoid sinus surgery was introduced in Erlangen in 1976. Posterior-to-anterior ethmoidectomy under the optical control of a 70 degrees telescope with a suction-irrigation handpiece was established for treatment of chronic-diffuse hyperplastic paranasal sinusitis. This technique complements partial resections of the ethmoid. The different procedures are applied depending upon the extent of the disease. The indication for endonasal endoscopic surgery was expanded with practical experience. Diseases of the nasolacrimal duct and the frontal sinus, the frontal skull base as well as the orbita often proved to be accessible for endonasal surgery. A survey of the technical aspects of endoscopic ethmoid surgery and an introduction of the extended range of indications are presented together with the results of each procedure.

Adolescent↗
PubMed1977

The lacrimo-auriculo-dento-digital syndrome.

A mother and son had an autosomal-dominant malformation syndrome that included absence of the lacrimal puncta, obstruction of the nasolacrimal ducts, hearing loss, poor dentition, and abnormal thumbs. The son also had severe hypertension with renal anomalies and absence of several salivary glands. Affected members of the only other reported family also had cup-shaped ears and synostosis of the radius and ulna. Early recognition of this disorder is important because of the possibility that the affected infant may have hearing loss and kidney malformations.

Abnormalities, Multiple↗
PubMed1996

Surgical anatomy of lateral nasal wall in northeast Thai cadavers.

A morphometric osteological study of the lateral nasal wall of Thai cadavers proved essential for the endoscopic sinus surgery on Thai patients in order to increase effectiveness and decrease the number of intraoperative complications. The middle turbinate should be preserved during the operation because it is a useful landmark for finding the natural maxillary sinus ostium and for avoiding nasolacrimal duct injury.

Asian People↗
PubMedDate not supplied

[Raverdino's operation, a procedure to resolve lacrimal dacryostenosis with deficient pituitary mucosa].

The paper presents the efficiency of the Raverdino operatorial technique, which creates a large anastomosis between the lacrimal sac and nose, followed by an effective drainage in those cases with persistent obstruction of the nasolacrimal duct. The paper also exposes clinical cases in which the mentioned technique was used as first intervention or as reintervention after an inefficient dacryocystorhinostomy. The Raverdino technique offers a successful, long lasting result, without major intra- or postoperative complications.

Adolescent↗
PubMed1996

Surgery of the lacrimal system.

Several surgical techniques of the lacrimal system are presented and analyzed regarding indications and results. Endonasal dacryocystorhinostomy is performed in cases of postsaccal stenosis. Pre- and intrasaccal stenosis are operated on with conjunctivorhinostomy or with placement of Heermann-Jones tubes. After interruption of the canaliculi, splinting and primary suturing are best suited. During tumor surgery, the nasolacrimal duct can be temporarily or permanently relocated in the soft tissues of the cheek. Performing these techniques, a good lacrimal drainage is usually achieved. The results are based upon subjective and objective findings.

Conjunctiva↗
PubMed1996

Wound infection after cataract surgery.

Nineteen patients were treated for bacterial and fungal infection of the sclerocorneal incision following cataract extraction during a 19-year period. The infections were caused by Staphylococcus aureus (2), Staphylococcus epidermis (2), Streptococcus pneumoniae (3), Streptococcus viridans (1), Pseudomonas aeruginosa (1), Mycobacterium fortuitum (3), Aspergillus flavus (6), and Candida tropicalis (1). The predisposing factors involved were an obstructed nasolacrimal duct (S. pneumoniae, S. viridans), airborne contamination of the wound by fungal spores (A. flavus), and defective sterilization of instruments (M. fortuitum). Ten of the 19 infections resulted in complete loss of the eye from endophthalmitis. Early recognition of wound infection by frequent meticulous examination of the sclerocorneal incision for infectious infiltration is of utmost importance so that specific therapy can be instituted immediately to prevent the development of endophthalmitis.

Aged↗
PubMed1996

Complications of endoscopically guided sinus surgery.

The authors reviewed a series of 553 consecutive patients who underwent endoscopically guided sinus surgery. Major complications occurred in six patients (2.2%). There was one death due to incorrect positioning of the frontal drain. One patient developed a cerebrospinal fluid leak which had to be closed with an osteomucosal graft. Two patients who developed severe bleeding after removal of the nasal packing, needed ligation of the sphenopalatine artery and the internal maxillary artery, respectively. Two patients developed a complete stenosis of the nasolacrimal duct, necessitating a dacryocystorhinostomy. Minor complications occurred in 36 patients (13.4%). These included damage to the lamina papyracea (n = 11), severe bleeding after removal of the nasal packing treated conservatively (n = 6), intranasal mucosal adhesions (n = 17), and atrophic rhinitis (n = 2). The aetiology, prevention and treatment of complications during and after sinus surgery are also discussed.

Adolescent↗
PubMed1998

Using the phacoemulsification crescent knife in dacryocystorhinostomy.

Dacryocystorhinostomy is an effective treatment for nasolacrimal duct obstruction. Most techniques employ a conventional blade or knife in making the incision of the nasal mucosa and lacrimal sac. The authors describe the use of a phacoemulsification crescent knife for this purpose. This technique can be effective and at the same time safer and easier to perform.

Dacryocystorhinostomy↗