Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery最新文献

{"title":"A minimally invasive, combined approach to the recurrent/recalcitrant sino-orbital mucocele.","authors":"Jara Crear, Tassapol Singalavanija, Sarinee Juntipwong, Honeylen M Tiu Teo, Mark Zacharek, Hakan Demirci","doi":"10.1080/01676830.2024.2375317","DOIUrl":"10.1080/01676830.2024.2375317","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the results of a minimally invasive combined endoscopic and eyelid crease/medial suprabrow incision approach in collaboration with oculoplastic and sinus surgeons for the treatment of recurrent/recalcitrant sino-orbital mucoceles.</p><p><strong>Methods: </strong>Eighteen cases of recurrent/recalcitrant sino-orbital mucoceles, treated in collaboration with oculoplastic and sinus surgeons at the University of Michigan, were retrospectively reviewed. The recurrence of mucocele, reduction in proptosis, and complications were evaluated.</p><p><strong>Results: </strong>The mean age at the time of surgery was 49 years (range: 17-76 years). All cases had a history of previous sinus or orbital surgeries for mucoceles. Among 18 cases, eight were due to chronic sinus infections, six due to trauma, three due to Schneiderian papilloma, and one case was secondary to an inflammatory sinus disease. Thirteen cases (72%) presented with orbital or facial cellulitis, while five cases (38%) experienced periocular swelling and limited extraocular motility. Following a mean follow-up of 19 months (range: 1-76 months)), recurrence was observed in two cases (11%): one in a cystic fibrosis patient with chronic sinusitis, and the other in a case of Schneiderian papilloma. The mean pre-operative proptosis in the affected eye was 2.78 mm, with an average decrease of 2.33 mm after surgery. Complications occurred in two cases, including one case of hypoesthesia in the forehead and one case of post-operative strabismus.</p><p><strong>Conclusion: </strong>Our series of 18 cases of recurrent/recalcitrant mucoceles, with only two cases of recurrence, demonstrates that this minimally invasive approach can be successfully employed for advanced sino-orbital disease, with a low rate of adverse outcomes and aesthetically pleasing results.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"18-23"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A jugular venous compression adjunct for surgical excision of distensible orbital venous malformations.","authors":"Jinhua Liu, Cuihong Liu, Keqin Long, Honglei Liu","doi":"10.1080/01676830.2024.2389304","DOIUrl":"10.1080/01676830.2024.2389304","url":null,"abstract":"<p><strong>Purpose: </strong>Orbital venous malformations (VM) pose challenges in complete resection due to indistinct borders and bleeding proclivity. Current methods for aiding surgical excision of distensible orbital venous malformations are inadequate. We investigated whether external neck compression could facilitate intraoperative distension of venous orbital lesions during surgical excision in patients diagnosed with VM.</p><p><strong>Methods: </strong>Eighteen patients (8 males and 10 females) diagnosed with distensible venous anomalies were enrolled. Neck compression technology, was employed to distend the lesions before puncture embolization using n-butyl-2-cyanoacrylate glue under general anesthesia. The surgical process, along with preoperative to postoperative changes in ocular symptoms, were recorded.</p><p><strong>Results: </strong>The average surgical duration was 95 min. A mean of 3.41 ml surgical glue was used for embolization. The compression belt maintained pressure at 35-40 mmHg. Total lesion resection was achieved in 12 patients, with 6 patients undergoing subtotal removal not requiring supplementary surgery. Symptoms were entirely alleviated in 17 patients, and signs of distensible lesions during the Valsalva maneuver were absent. One patient underwent secondary surgery for residual eyelid lesions. Minor complications included mild ocular movement restriction, residual subcutaneous induration, transiently increased orbital pressure, and lower lid ectropion in four, three, four, and one patient, respectively. Three patients experienced a mild post-operative visual acuity decrease, although none experienced vision loss.</p><p><strong>Conclusions: </strong>Direct orbital embolization aided by a jugular vein compression device is safe and demonstrates satisfactory outcomes in orbital varicose vein treatment.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"39-48"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orbital indeterminate cell histiocytosis.","authors":"Angela J Oh, Connie M Sears, Akhila A Vadivelan, Brigitte N Gomperts, Noah Federman, Jonathan Said, Kelsey A Roelofs","doi":"10.1080/01676830.2024.2317301","DOIUrl":"10.1080/01676830.2024.2317301","url":null,"abstract":"<p><p>An 8-year-old female presented to the oculoplastics clinic with 3 months of left upper eyelid fullness and edema. Examination showed a mass in the left anterior superior orbit with erythema. Imaging demonstrated a well-circumscribed superolateral orbital mass that was T1 hypointense and T2 hypo-to-iso intense with contrast enhancement. An incisional biopsy was performed via an upper lid crease incision. Histopathology showed aggregates of histiocytic cells with fibrosis and infiltration of eosinophils. Immunohistochemistry revealed positive CD68 and CD163 staining and negative langerin staining, confirming the diagnosis of indeterminate cell histiocytosis. There was no systemic involvement or associated dermatologic findings. Repeat exam 3 months later showed no change in the size of the lesion and the patient was referred to hematology-oncology for treatment. On most recent exam, the patient had no new symptoms or side effects following 3 months of oral hydroxyurea (25 mg/kg/day). Repeat orbital imaging showed no progression of the lesion and the patient will be monitored closely. Here, we report a rare case of isolated orbital indeterminate cell histiocytosis in a young child.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"96-100"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139906598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Superior orbital rim grinding as a novel surgical technique to approach superior and posterior orbital tumors.","authors":"Agustina L Mena, Constanza Mansur, Margarita Isa, Patricio Thompson, Rodolfo L Vigo","doi":"10.1080/01676830.2024.2323546","DOIUrl":"10.1080/01676830.2024.2323546","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a novel surgical technique aimed to approach those orbital lesions located superior and posterior to the equator of the globe.</p><p><strong>Methods: </strong>We describe a novel surgical technique that was performed in four patients to approach intraorbital tumors superiorly and posteriorly located. This technique was completed through an upper eyelid skin crease followed by grinding the superior orbital rim to achieve complete removal of the lesions.</p><p><strong>Results: </strong>Complete removal of the lesion was accomplished in every case. No intraoperative complications were observed in any of the patients. During the follow-up period, one patient presented with frontal hypersensitivity and one with diplopia.</p><p><strong>Conclusions: </strong>In the case series presented, the upper eyelid skin crease approach with grinding of the superior orbital rim proved to be a safe and effective surgical technique to remove lesions located superior and posterior within the orbit in our series. More studies are needed to further evaluate the efficacy and long-term results of this approach.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"59-63"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinguishing spheno-orbital metastatic prostate cancer mimicking a meningioma using novel ¹⁸F-PSMA PET/CT imaging.","authors":"Yilin Feng, Carolina A Chiou, Anna M Stagner, Yuh-Shin Chang, Suzanne K Freitag","doi":"10.1080/01676830.2024.2318769","DOIUrl":"10.1080/01676830.2024.2318769","url":null,"abstract":"<p><p>A 78-year-old man presented with acute-onset left temporal pain, eyelid swelling, and double vision. Computed tomography (CT) demonstrated a left sphenoid wing mass with extra-osseous intra-orbital and intracranial extension, thought to be a typical sphenoid wing meningioma by the primary team. The patient was admitted for an urgent craniotomy, which was planned for the following day. However, upon consultation with ophthalmic plastic surgery, concern was raised for an alternative diagnosis given the atypical timeline, inflammatory changes, and uncharacteristic imaging findings of mixed lytic and sclerotic bony changes without hyperostosis on CT and extensive peri-lesional dural thickening and enhancement on magnetic resonance imaging. A serum prostate-specific antigen was elevated to 206 ng/mL. Subsequent positron emission tomography (PET)/CT using 18F-fluorodeoxyglucose radiotracer was negative for metastatic disease. A prostate-specific membrane antigen (PSMA) PET/CT was then obtained and demonstrated extensive metastases. An orbital biopsy revealed poorly differentiated prostatic adenocarcinoma. The significant incongruence between the standard PET/CT and PSMA PET/CT highlights the value of this novel advanced radiographic modality in narrowing the differential diagnosis and determining the extent of disease. Findings of widespread metastasis on the PSMA PET/CT ultimately helped to avoid a large, morbid neurosurgical intervention in this patient, allowing for a minimally invasive orbital biopsy to characterize the tumor for therapeutic targeting.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"108-113"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140207942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous methylprednisolone-induced hypokalaemic periodic paralysis in a thyrotoxic patient: a case report and literature review.","authors":"Ahmed Magid Wanas, Clarice Giacuzzo, Seyed Ghazi-Nouri, Lee Teak Tan","doi":"10.1080/01676830.2023.2296553","DOIUrl":"10.1080/01676830.2023.2296553","url":null,"abstract":"<p><p>Hypokalaemic periodic paralysis (HPP) is an uncommon complication of corticosteroid therapy, which may also be seen in thyrotoxicosis. It was mostly described in the Asian population, and it is rare in other ethnic groups. We present the case of a poorly controlled thyrotoxic Caucasian male with thyroid eye disease (TED) who suffered an acute quadriplegic episode caused by severe hypokalaemia and was admitted to the intensive care unit (ITU) within 24 hours of initiating intravenous methylprednisolone (IVMP) infusion. Once his potassium blood levels were repleted, he completely recovered from the episode. Although HPP is rare in the Caucasian population, it can be precipitated in thyrotoxic patients by systemic steroids. Caution should be exercised when administering IVMP in poorly controlled thyrotoxic patients, and we suggest monitoring the potassium levels at regular intervals with ECG monitoring for at least 24 hours in at-risk individuals.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"77-81"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Penetrating colored pencil injury with <i>Clostridium bifermentans</i> pre-septal cellulitis: case report, literature review, and treatment algorithm.","authors":"Fabliha A Mukit, Cynthia M Noguera, Natalie Sullivan, Barbara D Smith, James C Fleming, Brian T Fowler","doi":"10.1080/01676830.2024.2314054","DOIUrl":"10.1080/01676830.2024.2314054","url":null,"abstract":"<p><p>The incidence of penetrating orbital injuries from writing instruments continues to rise in the pediatric population. Such injuries can cause significant visual morbidity and have a lifelong psychosocial impact. While the description of graphite pencil-related orbital trauma management is well demonstrated with over 40 reported cases, a lack of consistent management protocol for colored pencil-related injuries. Here, we report an inadvertent penetrating orbital colored pencil injury with progressive mechanical ptosis and pre-septal cellulitis necessitating urgent orbitotomy, debridement, and washout to reduce inflammatory and infectious burden. The wooden body serves as a nidus for polymicrobial infection, and the unique composition of colored pencil cores may lead to inflammatory processes that require vigilant multidisciplinary surgical and medical management reflected in our literature review.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"90-95"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-infectious hypertrophic pachymeningitis associated with orbital inflammatory disease: a pooled analysis.","authors":"Terence Ang, Naman Kundu, Sandy Patel, Jessica Y Tong, Dinesh Selva","doi":"10.1080/01676830.2024.2390609","DOIUrl":"10.1080/01676830.2024.2390609","url":null,"abstract":"<p><strong>Purpose: </strong>To describe four cases of non-infectious hypertrophic pachymeningitis (HP)-associated with orbital inflammatory disease (OID). This study summarises the clinico-radiological features, outcomes, and management of HP-associated OID.</p><p><strong>Methods: </strong>Retrospective case-series of patients with radiological evidence of HP and OID. Comprehensive literature review of all published English-language non-infectious causes of HP-associated OID. Reference lists were screened for inclusion of relevant articles.</p><p><strong>Results: </strong>Thirty-seven cases of HP-associated OID (Mean age: 49.2 ± 17.4 years old; Male: 15) were identified, including four cases from our institution. Aetiologies included ANCA-associated vasculitis (12/37), non-specific/idiopathic (11/37), IgG4/multifocal fibrosclerosis (11/37), neurosarcoidosis (1/37), inflammatory myofibroblastic tumour (1/37), and giant cell arteritis (1/37). Orbital pain, headache, visual deterioration, and cranial nerve palsies were common clinical presentations. Both \"focal\" and \"diffuse\" HP were observed, with the most common sign of orbital involvement being an inflammatory orbital mass, typically with orbital apex involvement. Orbital myositis and dacryoadenitis were less common. The cavernous sinus was the most common site of extra-orbital inflammation. There was no single differentiating specific radiological feature between non-specific and specific forms of HP-associated OID.</p><p><strong>Conclusion: </strong>The clinico-radiological manifestations of HP-associated OID differ from those described in isolated HP or OID. There is no single specific radiological marker differentiating non-specific/idiopathic disease from secondary causes; however, the co-existence of HP in OID should prompt suspicion of an underlying cause. The disease may be refractory or resistant to initial treatment, although guidelines surrounding its management and the long-term prognosis remain to be determined.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"49-58"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A swinging upper eyelid approach for excision of lacrimal gland masses.","authors":"Richard C Allen, Mostafa Mohammed Diab","doi":"10.1080/01676830.2024.2350036","DOIUrl":"10.1080/01676830.2024.2350036","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a novel transconjunctival technique for excision of well-defined masses of the orbital lobe of the lacrimal gland.</p><p><strong>Methods: </strong>Case series of three patients undergoing excision of a well-defined mass of the orbital lobe of lacrimal gland using a swinging upper eyelid flap. This technique entails a supratarsal conjunctival incision combined with lateral canthotomy and superior cantholysis.</p><p><strong>Results: </strong>Complete removal of the mass without visible scars was achieved in all cases. There were no complications related to this approach.</p><p><strong>Conclusion: </strong>The swinging upper eyelid approach produces a wide exposure of the superolateral orbit. It allows safe removal of large lacrimal gland masses without the need for bone removal, while affording acceptable cosmesis.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"71-76"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gonococcal dacryoadenitis complicated by orbital cellulitis: a case report.","authors":"Valencia Hui Xian Foo, Gillian Huijun Teh","doi":"10.1080/01676830.2024.2351517","DOIUrl":"10.1080/01676830.2024.2351517","url":null,"abstract":"<p><p>Gonococcal dacryoadenitis is uncommon, and its diagnosis may be delayed especially if there is a low index of clinical suspicion. Making an early diagnosis is extremely important because in some cases the organism may spread contiguously, leading to vision-threatening sequelae such as corneal perforation. The authors present a case report of a patient diagnosed with gonococcal dacryoadenitis complicated by orbital cellulitis. Our case demonstrates that in all cases of purulent dacryoadenitis, urgent evaluation, cultures and treatment is crucial, and it is prudent to consider gonococcal dacryoadenitis as a rare but possible differential in patients who are sexually active with an unexplained cause for dacryoadenitis.</p>","PeriodicalId":47421,"journal":{"name":"Orbit-The International Journal on Orbital Disorders-Oculoplastic and Lacrimal Surgery","volume":" ","pages":"114-116"},"PeriodicalIF":0.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}