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At least 19 recordsLinked to original sources
PubMed1992

Stimulation of orbital growth by the use of expandable implants in the anophthalmic cat orbit.

We evaluated the efficacy of expandable orbital implants to stimulate bone growth in the anophthalmic cat orbit. Eighteen cats unilaterally enucleated at 2 weeks of age received either expandable orbital implants (groups A1 and A2), solid silicone sphere implants of 12 mm or 8 mm (groups B1 and B2), or no implant (group C). Those cats with expandable implants (group A) had the implant size increased by 0.5 ml injections of saline at 2-week intervals starting at 8 weeks of age until a final volume of 4 cc was reached. Four of the expandable implants were found to be only partially inflated at 20 weeks and were subgrouped A2. At 20 weeks of age, the anophthalmic orbits with fully inflated expanders showed no significant difference in either orbital volume or orbital entrance area when compared with control orbits: volume (91.2%), area (95.7%) (p = 0.01). These same orbits also showed a significant increase in both orbital volume and orbital entrance area when compared with the growth obtained by any other group. These other groups showed growth, expressed as a percentage of normal growth, as follows: partially inflated implant: volume (63.0%), area (69.0%); 12-mm sphere implant: volume (57.0%), area (54.5%); 8-mm sphere implant: volume (46.5%), area (44.6%); no implant: volume (47.6%), area (43.6%) (p = 0.01). This study suggests that the use of expandable orbital implants stimulates bony growth in the immature cat orbit. Bony stimulation was proportional to volume implanted, and expandable orbital implants achieved maximum bony stimulation in the groups studied.

Animals↗
PubMed1992

Complex orbital fracture repair using rigid fixation of the internal orbital skeleton.

Large orbital fractures involving more than one orbital wall are frequently associated with enophthalmos and vertical globe dystopia. The authors repaired 22 orbits in 20 patients using the technique of rigid fixation of the internal orbital skeleton. Eleven orbits were reconstructed with titanium or vitallium implants that were custom-shaped to span the bony defect and fixed to the orbital rim. Seven orbits were reconstructed with bone grafts rigidly supported by a miniplate, and, in four cases, direct lag screw support of bone grafts was used. The intraoperative goal was to restore the native orbital anatomy and volume. Autologous calvarial bone grafts were used to supplement the repair to achieve the desired volumetric effect and to cover additional wall defects. A reoperation for additional orbital augmentation was needed in one enophthalmic and one anophthalmic orbit. There were no cases of overcorrection, migration, infection, or extraocular muscle entrapment. In complex orbital fractures, the technique of rigid internal orbital fixation appears to yield a stable and predictable result with the prevention of postoperative globe malposition.

Adult↗
PubMed1976

Carcinoma metastatic to the eye and orbit III. A clinicopathologic study of 28 cases metastatic to the orbit.

Two hundred and twenty-seven cases of carcinoma metastatic to the eye and orbit have been reviewed previously. The orbit alone was involved in 28 cases: theses lesions constitute the basis of this clinicopathologic study. The most common signs and symptoms produced by orbital metastasis included exophthalmos (75%1, pain (29%), decreased vision (29%), periorbital swelling (25%), a visible mass (21%), ophthalmoplegia, and diplopia (18%). The ophthalmologists' preoperative (or premortem) clinical diagnoses were: orbital mass, 36%; metastatic carcinoma, 29%; leukemia, 7%; melanosarcoma, 4%; mixed tumor of lacrimal gland, 4%; and meningioma, 4%. The sites of the primary tumors in the 28 patients with orbital metastasis were as follows: breast, eight; lung, four; genitourinary tract, four; pancreas, one; and ileum, one. In 10 patients the site of the primary carcinoma was not determined. In 17 of the 28 patients, symptoms of orbital metastasis preceded detection of a primary tumor elsewhere in the body. In 10 of the remaining 11 patients, detection of the primary tumor had preceded the onset of orbital symptoms. In one patient, symptoms of the primary tumor and of orbital metastasis appeared at about the same time. The median survival of patients with carcinoma metastatic to the orbit was 15.6 months from the time of orbital surgery. This was much better than the median survival of the 227 patients in the overall study (7.4 months) and far better than the median survival of the patients with metastasis to the anterior segment of the eye (only 5.4 months).

Adenocarcinoma↗
PubMed1992

Miniplate reconstruction of the lateral orbital rim after orbital decompression for Graves disease.

BACKGROUND: Removal of lateral orbital bone with or without simultaneous removal of the lateral orbital rim is an accepted method of orbital decompression for Graves disease. Once removed, the bone is no longer available for reconstruction and secondary complications such as rounding of the canthal angle, canthal dystopia, and globe dystopia may result. METHODS: The authors replaced the excised bone with a titanium miniplate to protect the globe and fixate the lateral canthal tendon in 18 patients (33 orbits). The orbital rim and lateral orbital wall were completely removed, and the inner aspect of the orbit was enlarged with a cutting burr. A standard titanium miniplate was then anchored to remaining bone, and soft tissue was secured to the miniplate to reconstruct the lateral canthus. RESULTS: The results, as manifest by appearance of the lateral canthus and position of the eyelid in apposition to the globe, were graded as excellent in all patients and orbits. There were no early or late complications. CONCLUSION: Miniplate reconstruction of the lateral orbital rim after decompression for Graves disease allows the beneficial affect of lateral decompression and preserves the functional aspect of the lateral orbital wall.

Adult↗
PubMed1992

Severe orbital infection as a complication of orbital fracture.

Orbital fractures secondary to blunt trauma, and their complications, have been the subject of numerous reports, with little mention of an association with severe orbital infection. Conversely, studies of severe (postseptal) orbital infections rarely make reference to orbital fractures as being a significant pathogenetic factor. In a retrospective study of 130 orbital infections, three cases of severe orbital infection were identified as being associated with an orbital fracture, and are thus presented. In the literature, only anecdotal reports and inconclusive studies address this problem, and its possible prevention. The consequences of a pathologic communication between the paranasal sinuses and the orbit secondary to blunt facial trauma are discussed, along with recommendations for prophylactic management.

Adult↗
PubMed1978

Microsurgical anatomy of the orbital apex and principles of transcranial orbital exploration.

Although many problems may present with unilateral proptosis, a careful clinical investigation can narrow the differential diagnosis to those problems which can be treated best by the neurosurgeon. The primary indication for transcranial exploration is when the pathological process is found to involve both the orbit and the cranial cavity as in all cases of optic nerve glioma, orbital meningioma, encephalocele, and some mucoceles, hemangiomas, aneurysmal bone cysts, and ossifying fibromas. Transcranial exploration may also be indicated for some tumors which crowd the orbital apex, such as, neurofibromas and osteomas; tumors in this location can be more widely exposed and safely dealt with by this route. A prime objective in these cases, however, must be preservation of function with a good cosmetic result. It is of equal importance to be aware that many conditions producing exophthalmos can be cured by direct orbital exploration, radiotherapy, or medical management. Malignant orbital tumors should never be exposed to the cranial cavity by transcranial exploration, whereas, radical exenteration may be curative in some carefully studied cases. Accuracy in clinical diagnosis and the proper selection of treatment modality for conditions in the orbit requires a clear understanding of this regional anatomy. I hope that this brief review of the pertinent microsurgical anatomy of the orbital apical region has helped to substantiate a strong neurosurgical claim to all primary optic nerve tumors; and, incidentally, I hope it provides an explanation for why I sent so many other patients back to Dr. Algernon Reese with the recommendation that transcranial surgery did not seem indicated. The success of this attitude may be attested to by the fact that we performed no unnecessary craniotomies nor did we pass by problems which would have best been treated by transcranial orbital exploration.

Cranial Nerve Neoplasms↗
PubMed1991

Solitary extramedullary plasmacytoma of the maxillary antrum and orbit presenting as acute bacterial orbital cellulitis.

Orbital involvement by plasma cell tumours is rare. Orbital tumours do not generally present as an acute orbital inflammatory disease in adults, though tumours such as rhabdomyosarcoma may cause clinical signs similar to an acute orbital cellulitis in children. We describe a patient with bacterial orbital cellulitis and sinusitis who was found to have an extra-medullary plasmacytoma of the maxillary antrum and orbit and coexisting testicular seminoma.

Cellulitis↗
PubMed1992

Histological changes in the orbital region of rats after orbital puncture.

To contribute to the assessment of the degree of discomfort in rats after orbital puncture, we have examined the histological changes in the intraorbital tissues caused by this technique of blood sampling. Orbits were studied from rats euthanized either within 1 min, 4 days, 28 days or 56 days after puncture while under diethyl-ether anaesthesia. The techniques of 2 animal technicians were compared, one using a broken haematocrit capillary and the other using an intact Pasteur's pipette. Non-punctured orbits served as controls. Microscopic slides containing the eye in situ at 2 horizontal levels in the orbital region were examined for 37 parameters; the slides were scored blind and in random order. Orbital puncture caused haemorrhages in the puncture track and, depending on the technique used, also in the periosteum. Four days after puncture, inflammatory reactions were present in the puncture track. Depending on the technique of puncture, these reactions were also seen in the eye muscles and periosteum or in the Harderian gland. Within 4 weeks after puncture, the lesions had healed without detectable scars. The different histological effects of the 2 techniques of orbital puncture are discussed in the light of the characteristics of these techniques.

Animals↗
PubMedDate not supplied

Combined cranio-orbital surgery for extensive malignant neoplasms of the orbit.

Extensive, invasive neoplasms of the cranio-orbital region are generally considered to be inoperable and are treated with local radiation therapy and occasionally with chemotherapy. Upon local recurrence of these neoplasms, further treatment efforts are usually deemed futile. Over the past 4 years, 10 patients with extensive neoplasms of the cranio-orbital region that were previously thought to be inoperable were referred to us for further evaluation. Five of these patients had failed an intensive course of radiation therapy. Radical regional cranio-orbital resection was performed. The resection included the skin, globe, sphenoid wings, and orbitofrontal bone. The maxillary sinus and nasal septum were left exposed. The exposed dura mater and the frontal and temporal bones were resurfaced with split-thickness skin grafts. All patients in this series have survived free of local disease to date. Combined cranio-orbital resection offers both palliation and a possible cure for patients with extensive, invasive neoplasms of the cranio-orbital region. Reconstructive surgery can be performed using full-thickness flaps after 2 years of observation for local recurrence.

Adolescent↗
PubMed1975

[Metastatic orbital tumors:a case of orbital metastasis in malignant melanoma of the skin (author's transl)].

The authors feel that orbital tumor metastases are more common than generally presumed. The occurence of orbital metastases of malignant melanomas of the skin is discussed in this paper. Until now 20 cases have been published. Therapy of metastases is an unsolved problem, immunologic factors might be of some importance. The authoress describes a case of histologically verified orbital metastasis of a primary malignant melanoma of the skin, which was surgical removed three years ago. In contrast to similar cases other haematogen tumor manifestations were absent first, and the orbital metastasis seemed to be totally removed by orbital exenteration. One year later however, probably as a second metastasis, rapidly progressive tumor tissue appeared. General melanomatosis having appeared at the same time finally lead to death.

Adult↗
PubMed1976

Orbital neurofibromatosis: involvement of the orbital floor.

Neurofibromatosis has been reported to involve the eye and orbit by causing irregularities of the sphenoid and other facial bones and enlargement of the foramina. To our knowledge, abnormalities of the orbital floor, however, have not been attributed to this disease in the literature until now. Two patients with neurofibromatosis had orbital floor involvement. Multiple neurofibromas eroding the orbital floor threatened vision in one patient. The other case, seen after trauma, had a condition simulating that of a blow-out fracture. Diagnostic workup with adequate roentgenography, especially tomography, helped to establish the diagnosis. We believe this is of importance in modifying the surgical approach, obviating the need for surgical intervention at times.

Female↗
PubMed1976

Computed tomography in orbital pseudothumor (idiopathic orbital inflammation).

CT scans of 9 patients with orbital pseudotumor (bilateral in 6 and unilateral in 3) showed findings distinct from those observed in Graves' ophthalmopathy. In bilateral involvement, they ranged from localized mass lesions to complete obiliteration of normal orbital CT anatomical landmarks; diffuse or multifocal lesions involving the posterior globe and muscle insertions were most typical of the diagnosis. However, findings in unilateral psedotumor may be indistinguishable from orbital mass lesions other than Graves' ophthalmopathy. Serial CT scans were used to show progression of disease and response to treatment.

Adolescent↗
PubMed1977

[Total expansion of the orbit for micro-orbitism].

Micro-orbitism which follows the very early arrested development of the optic vesicles hinders the fitting of a prosthesis. A total enlargement of the orbit is proposed which restores the normal dimensions and enables facial symmetry to be re-established. The risks and advantages of this procedure are discussed.

Anophthalmos↗
PubMed1977

Orbital expansion for anophthalmia and micro-orbitism.

In severe cases of microphthalmos or anophthalmos, the bony orbital cavity is often too small to allow one to create a satisfactory socket for a prosthesis. An omnidirectional expansion of the orbit, by osteotomies done in a step-like fashion, allows the creation of a larger bony cavity and improves the symmetry of the face. The risks of the craniotomy and of the mobilization of the free bone pieces are discussed.

Anophthalmos↗
PubMedDate not supplied

Subperiosteal orbital masses in children with orbital cellulitis: time for a reevaluation?

Conflicting reports have arisen in the literature regarding the diagnostic criteria and management of children with a suspected subperiosteal orbital abscess (SOA). To highlight the dilemmas that have arisen a child with a posterior subperiosteal mass, as demonstrated by computerized tomography, is presented. This case and others in the literature suggests a need for better radiographic criteria for distinguishing an SOA from reactive inflammatory edema. Until such criteria are developed, the management of suspected SOA in children should be based principally on clinical signs. Radiographic examinations should be used primarily to rule out the need for surgical intervention.

Abscess↗
PubMed1975

Deformities of the midface resulting from malunited orbital and naso-orbital fractures.

In midfacial fractures the crucial area is the upper portion of the midfacial skeleton which lodges the orbits, the interorbital space with its anatomic relationship with the anterior cranial fossa, the lacrimal apparatus, the levator muscle, and the skeletal structures of the nose. Because of the severity of the injuries in a multisystem injured patient, these fractures may be neglected or receive inadequate primary treatment. In some cases the damage is so extensive that primary treatment can only accomplish part of the task. Late reconstruction is necessary, therefore, and is the subject of this paper.

Blepharoptosis↗
PubMed1979

[Gaze induced monocular obscurations with cavernouse hemangioma of the orbit. Computer-tomographic demonstration of orbital anatomy in various positions of gaze (author's transl)].

A young woman with only minimal proptosis from a cavernous hemangioma of the left orbit complained of monocular obscurations of vision evoked by right alteral gaze. By analysis of the symptoms, we excluded direct compression of the globe, the optic nerve, and the ophthalmic artery as well as a retinal electrophysiologic phenomenon as a cause of the obscuration. Some vascular phenomenon occurring within the muscle cone appeared to be the most likely explanation. Computer tomography in various positions of gaze revealed the dynamic anatomical relationship between optic nerve and tumor. During adduction, the nerve pressed against and shifted beneath the tumor in the region where the ophthalmic artery crosses over it.

Adult↗