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Journal articles on the topic 'Diagnosis of orbital disorders'
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1
Sires, Bryan S. "Diagnosis and Management of Oculoplastic and Orbital Disorders." Archives of Ophthalmology 115, no. 7 (July 1, 1997): 948. http://dx.doi.org/10.1001/archopht.1997.01100160118036.
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Gausas, Roberta. "DIAGNOSIS AND MANAGEMENT OF OCULOPLASTIC AND ORBITAL DISORDERS." Ophthalmic Surgery, Lasers and Imaging Retina 29, no. 11 (November 1998): 951. http://dx.doi.org/10.3928/1542-8877-19981101-15.
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Lebădă, Ioana-Codruţa, and Mihaela Stanciu. "The Efficiency of Pulse Therapy with Glucocorticoids in Inflammatory Orbital Disorders: Case Report." Acta Medica Transilvanica 25, no. 4 (December 1, 2020): 22–24. http://dx.doi.org/10.2478/amtsb-2020-0063.
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Abstract Orbital pseudotumor represents a benign inflammatory disorder of the orbit, with unspecified etiology, whose clinical presentation can mimic the ocular pathology of Basedow disease, namely Graves’ ophthalmopathy, the two of them representing two of the most common orbital conditions. Imagistic methods and laboratory analyses can establish the diagnosis through orbital MRI images specific for the orbital pseudotumor, especially by dosage of the TSH receptor antibodies (TRAb) which will have increased values in Basedow disease with ocular damage. In both situations, the treatment is represented as a first therapeutic line by administration of corticotherapy in high dosage orally or intravenously, with favorably evolution, which is also observable in the case of our patient who was diagnosed with orbital pseudotumor based on MRI images, with associated thyroid dysfunction with negative TRAb, in which the pulse therapy with Solumedrol has determined the improvement of ocular symptoms and signs.
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Hsu, Jennifer, and Brian G. Mohney. "Infantile Hemangiomas Masquerading as Other Periocular Disorders." Case Reports in Pediatrics 2012 (2012): 1–3. http://dx.doi.org/10.1155/2012/290645.
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Periocular tumors are common in infancy. The most common periocular tumors are capillary hemangiomas, which are present in 1-2% of newborns and develop in 10%–12% of children by the age of 1 year old. Deep capillary hemangiomas may be more challenging to diagnose than superficial capillary hemangiomas and can be confused with other orbital lesions. Deep orbital hemangiomas can mimic teratoma, lymphangioma, rhabdomyosarcoma, metastatic neuroblastoma, and granulocytic sarcoma. In this paper, we describe 2 pediatric cases where previously diagnosed dermoid cyst and dacrocystocele were found to be capillary hemangiomas upon biopsy. Approaches to distinguish capillary hemangiomas from other periocular tumors are further discussed. To our knowledge, this is the first case report of periocular hemangiomas imitating a dermoid cyst and a dacrocystocele. These cases emphasize the importance of including infantile hemangiomas in the differential diagnosis of subcutaneous periocular abnormalities.
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Takahira, Masayuki, Yoshiaki Ozawa, Mitsuhiro Kawano, Yoh Zen, Shoko Hamaoka, Kazunori Yamada, and Kazuhisa Sugiyama. "Clinical Aspects of IgG4-Related Orbital Inflammation in a Case Series of Ocular Adnexal Lymphoproliferative Disorders." International Journal of Rheumatology 2012 (2012): 1–5. http://dx.doi.org/10.1155/2012/635473.
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The most frequent ocular adnexal tumors and simulating lesions are lymphoproliferative disorders (LPDs), including malignant lymphomas and orbital inflammation with lymphoid hyperplasia or infiltration. IgG4-related orbital inflammation (IgG4-ROI) often involves lacrimal glands and other orbital tissues and is an important differential diagnosis. The present study evaluated clinical aspects of IgG4-ROI in a case series of orbital LPD. Sixty-two consecutive cases of orbital LPD, pathologically diagnosed from November, 2004, through March, 2011, were investigated. Histological types were 22 cases with MALT lymphoma, 11 cases with diffuse large B-cell lymphoma (DLBCL), 3 cases with other malignant lymphomas, 16 cases with IgG4-ROI, and 10 cases with non-IgG4-ROI. Ages of the IgG4-ROI group (56±10?yrs) were significantly lower than the MALT lymphoma (71±12?yrs) and DLBCL (75±14?yrs) groups. Orbital lesions other than lacrimal glands were present in six cases including extraocular muscle swelling, mass lesions surrounding the optic nerve, and supraorbital and infraorbital nerves enlargements. Although none of the malignant lymphomas were related to IgG4, previous evidence suggested that malignant lymphomas can arise from IgG4-ROI. Based on this study (26%) and another report (33%), it is likely that nearly a quarter of orbital LPD are IgG4-ROI.
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Krauss, Howard R. "Orbital Surgical Guidelines—Clinical Evaluation." Journal of Neurological Surgery Part B: Skull Base 82, no. 01 (February 2021): 129–41. http://dx.doi.org/10.1055/s-0040-1722699.
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AbstractOrbital disorders may present with change in form or function or may be discovered incidentally during clinical or imaging evaluations. A standardized orbital clinical examination, with appropriate ancillary tests, is helpful in narrowing the differential diagnosis and in the development of plans for management, with an eye toward minimizing the morbidity of the disease or its treatment. Evaluation and management may best be performed with a multidisciplinary team, which has become more common in skull base surgery.
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Oprean, Cristina Marinela, Larisa Maria Badau, Nusa Alina Segarceanu, Andrei Dorin Ciocoiu, Ioana Alexandra Rivis, Vlad Norin Vornicu, Teodora Hoinoiu, Daciana Grujic, Cristina Bredicean, and Alis Dema. "Unilateral Orbital Metastasis as the Unique Symptom in the Onset of Breast Cancer in a Postmenopausal Woman: Case Report and Review of the Literature." Diagnostics 11, no. 4 (April 19, 2021): 725. http://dx.doi.org/10.3390/diagnostics11040725.
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The orbit represents an unusual metastases site for patients diagnosed with cancer, however, breast cancer is the main cause of metastases at this level. These orbital metastases were discovered in patients with a history of breast cancer as unique or synchronous lesions. We present a rare case of a unique retroocular metastasis as the first initial symptom of a tubulo-lobular mammary carcinoma in a postmenopausal woman. A 57-year-old patient complains of diplopia, diminishing visual acuity, orbital tenderness, slight exophthalmia and ptosis of the left eyelid, with insidious onset. Clinical examination and subsequent investigations revealed a left breast cancer cT2 cN1 pM1 stage IV. Breast conserving surgery was performed on the left breast. Pathological examination with immunohistochemistry staining established the complete diagnostic: pT2pN3aM1 Stage IV breast cancer, luminal B subtype. After two years from the initial breast cancer diagnosis, the patient was diagnosed by the psychiatrist with a depressive disorder and was treated accordingly. Orbital metastases are usually discovered in known breast cancer patients and they are found in the context of a multi-system end-stage disease. Most reports cite that up to 25% of the total orbital metastases cases are discovered before the diagnosis of the primary tumor, as our case did. MRI is the gold standard for evaluating orbital tumors. The ILC histological subtype metastasizes in the orbitals more frequently than invasive ductal carcinoma. The prognosis of patients with orbital metastases is poor. The median survival after diagnosis of orbital metastases from a breast cancer primary is ranging from 22 to 31 months. Overall survival of our patient was 56 months, longer than the median survival reported in literature. Orbital metastases must be taken into account when patients accuse ophthalmologic symptoms even in the absence of a personal history of cancer. Objective examination of every patient that incriminates these types of symptoms is essential, and breast palpation must be made in every clinical setting. Orbital biopsy is necessary for the confirmation of the diagnosis and for an adequate treatment. Although recommendations for management of orbital metastases are controversial, it appears that multidisciplinary treatment of both metastases and primary cancer improves overall survival.
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Guo, Jin, and Jun Wang. "Adult Orbital Xanthogranulomatous Disease: Review of the Literature." Archives of Pathology & Laboratory Medicine 133, no. 12 (December 1, 2009): 1994–97. http://dx.doi.org/10.5858/133.12.1994.
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Abstract This article provides an overview of the pathologic features of adult orbital xanthogranulomatous disease, a rare heterogeneous group of disorders that includes 4 clinical syndromes: adult-onset xanthogranuloma, necrobiotic xanthogranuloma, adult-onset asthma and periocular xanthogranuloma, and Erdheim-Chester disease. The diagnosis is made by biopsy of the lesion, demonstrating tissue infiltration by the hallmarks of xanthoma cells and Touton giant cells. The differential diagnosis is broad, including syndromes within the adult xanthogranulomatous disease category as well as other entities involving the eyelid and the orbital tissues. Because of its rarity and sometimes close similarity to other disease entities, it is often misdiagnosed initially. This article focuses on the morphology and immunohistochemical patterns in diagnosis of adult orbital xanthogranulomatous disease with emphasis on adult-onset asthma and periocular xanthogranuloma in particular, its clinical features and associated systemic manifestations in differential diagnosis, as well as the current management strategy.
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Caminha, Luciana Souza Cruz, Elisa Rebelo Pinto, Priscila Alves Medeiros de Sousa, Ricardo Andrade Oliveira, Flavia Lucia Conceiçao, and Mario Vaisman. "Orbital pseudotumor: a differential diagnosis of Graves' ophthalmopathy." Arquivos Brasileiros de Endocrinologia & Metabologia 55, no. 1 (February 2011): 85–88. http://dx.doi.org/10.1590/s0004-27302011000100013.
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The objective of this study is to report and discuss a rare and inflammatory cause of exophthalmos. This report describes a patient with exophthalmos, who was initially diagnosed with euthyroid Graves' with good response to therapy. After 8 years of follow-up, she had recurrence of symptoms and a new evaluation revealed the final diagnosis of orbital pseudotumor. Orbital pseudotumor is an uncommon disorder that both radiologically and clinically mimics a malignant process or other inflammatory disease, such as Graves' ophthalmopathy.
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Altynbaeva, L. R., and A. F. Gabdrakhmanova. "Modern radionuclide methods in diagnosing orbital masses." Kazan medical journal 96, no. 3 (June 15, 2015): 381–84. http://dx.doi.org/10.17750/kmj2015-381.
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Anatomic and topographic features of orbit structure and similar clinical symptoms in many diseases of different etiologies explain the complicated early diagnosis of orbital diseases. Therefore, the diagnostic algorithm for orbital masses is mainly based on instrumental diagnostic methods, especially radiology. Over the past 20-30 years, radiologic diagnosis of orbital tumors took a step forward thanks to the introducing such methods as computer tomography, magnetic resonance imaging and ultrasound into clinical practice. However, these methods of investigation, despite their great diagnostic possibilities, not always allow to obtain objective information on the tumor biology, tumor malignancy grade and characteristics of their metabolism. A significant step forward in this direction was the development and introduction of modern nuclear medicine techniques such as single photon emission computed tomography and positron emission (two-photon) tomography into clinical practice. These methods allow to visualize the functional processes in normal conditions and to perform a kind of non-invasive biopsy in case of neoplastic disorders. The use of nuclear medicine in oncology is based on hyperfixation of some radiopharmaceuticals in malignant tumors that provides important data for diagnosis and differential diagnosis based on the study of physiological and biological tumor features. The review highlights brief historical facts, as well as the results of using the most informative and safe radiopharmaceuticals. Literature analysis concludes that radionuclide tests at some point might be a method of choice for differential diagnosis of orbital masses.
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Ariatti, Alessandra, Giuliana Galassi, Raffaella Rovati, and Annalisa Chiari. "Cutting the edge of idiopathic recurrent orbital myositis." Open Medicine 8, no. 6 (December 1, 2013): 732–35. http://dx.doi.org/10.2478/s11536-013-0201-6.
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AbstractThe spectrum of orbital inflammatory diseases ranges broadly from specific diseases as connective tissue disorders, thyroid ophthalmopathy to non-specific inflammations, which may involve one or multiple structures of the orbit and/ or the surrounding sinus. Idiopathic orbital myositis (IOM) may be a localized process or it can be secondary to systemic diseases. We report 4 patients affected by IOM; in all relapsing diplopia was the main complaint, associated with orbital pain in 3 and with abnormal visual evoked responses in 2. Computed tomography (CT), magnetic resonance imaging (MRI) supported the diagnosis revealing enlargement, altered signal intensity of affected muscles. Repeated MRI scans and extensive laboratory examinations comprising of the search for a remote malignacy, lymproliferative, connective tissue diseases, thyroid ophthalmopathy were necessary to confirm the diagnosis. Oral or/and intravenous steroids were main treatments; relapses often occurred when steroid was tapered down. Intravenous immuneglobulins and azathioprine was used in one refractory case
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Durno, Carol A., Robert Ehrlich, Robert Taylor, J. Raymond Buncic, Peter Hughes, and Anne Marie Griffiths. "Keeping an Eye on Crohn’s Disease: Orbital Myositis as the Presenting Symptom." Canadian Journal of Gastroenterology 11, no. 6 (1997): 497–500. http://dx.doi.org/10.1155/1997/974282.
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Episodic periorbital swelling due to presumed orbital inflammation and myositis caused intermittent apparent proptosis and was the presenting symptom of ileocecal Crohn's disease (CD) in a teenage female with a family history of autoimmune disorders and CD. Orbital myositis, a very rare extraintestinal manifestation of inflammatory bowel disease (IBD), likely represents a process of impaired immunoregulation related to the underlying intestinal inflammation. This rare manifestation of IBD simulates the more commonly encountered thyroid orbitopathy (ophthalmopathy), but IBD should be considered if all thyroid tests are negative. It is important to recognize that orbital myositis may be an extraintestinal manifestation of Crohn's disease so that the diagnosis can be made and appropriate therapy commenced.
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Kokorev, V. Yu, A. A. Ryabtseva, V. A. Stuchilov, K. S. Larionov, and A. S. Grishin. "COORDIMETRY IN DIAGNOSIS OF OCULOMOTOR DISORDERS IN PATIENTS WITH ‘BLOW-UP’ ORBITAL FRACTURES: CASE REPORTS." Almanac of Clinical Medicine, no. 36 (February 21, 2016): 78–81. http://dx.doi.org/10.18786/2072-0505-2015-36-78-81.
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Goel, Ruchi, Akash Raut, Ayushi Agarwal, Shweta Raghav, Sumit Kumar, Simmy Chaudhary, Priyanka Golhait, Sushil Kumar, and Ravindra Saran. "A Rare Presentation of Orbital Castleman’s Disease." Case Reports in Ophthalmological Medicine 2020 (January 4, 2020): 1–4. http://dx.doi.org/10.1155/2020/1012759.
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Castleman’s disease (CD) is an uncommon group of atypical lymphoproliferative disorders. Extranodal involvement such as the orbit is extremely rare. We aim to report a case of a 62-year-old male who presented with left painless proptosis for the past three years. Examination revealed a firm, lobulated mass in the left superotemporal orbit, displacing the globe inferomedially. A well-defined extraconal orbital lesion encasing the left lateral rectus muscle with intraconal extension was seen on Magnetic Resonance Imaging (MRI) that led to the provisional diagnosis of left solitary encapsulated venous malformation. Excision of the mass via lateral orbitotomy was performed. However, on histopathology, the features were consistent with a mixed-cell variant of Castleman’s disease. A detailed systemic workup was unremarkable. Proptosis resolved after surgery and no recurrence was noted in the three-year follow-up. To the best of our knowledge, this is the first case report of a mixed-cell variant of unicentric orbital CD without any systemic features. This case highlights the importance of including CD in the differential diagnosis of well-defined orbital lesions so as to enable its early detection and timely management.
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Podgorac, Ana, Jasna Zidverc-Trajkovic, Zagorka Jovanovic, Aleksandar Ristic, Aleksandra Radojicic, Aleksandra Pavlovic, Milija Mijajlovic, Tamara Svabic-Medjedovic, and Nadezda Covickovic-Sternic. "Tolosa-Hunt syndrome: is it really necessary to show granuloma? - The report of eight cases." Vojnosanitetski pregled 74, no. 3 (2017): 287–93. http://dx.doi.org/10.2298/vsp150703180p.
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Introduction. Tolosa?Hunt syndrome (THS) is a rare entity, characterized by unilateral orbital pain associated with paresis of one or more of the oculomotor cranial nerves and caused by a granulomatous inflammation in the cavernous sinus, superior orbital fissure or orbit. The low prevalence of THS with a broad spectrum of other disorders that could cause painful ophtalmoplegia resulted in a stricter diagnostic criteria of THS in the latest edition of the International Classification of Headache Disorders. Current criteria require demonstration of granuloma by magnetic resonance imaging or biopsy. The diagnosis could be difficult and the initiation of treatment delayed due to a high variablity of clinical presentation of TSH. Reducing the number of patients that, based on clinical presentation, could be classified as having THS, but do not fullfil all diagnostic criteria further complicates establishing of correct diagnosis. Case report. Hereby we presented eight patients diagnosed with and treated for THS. Inspite the exclusion of other causes of painful ophtalmoplegia, granuloma could not be demonstrated in a half of patients. Clinical presentation of THS in patients with and without shown granuloma, did not significantly differ concerning headache characteristics (localization, intensity, quality, duration preceding cranial nerve palsy, response to steroids), the affected cranial nerve, disease course and response to the treatment, as well as types of diagnostic procedures that were performed in ruling out other diseases from the extensive differential diagnosis of painful ophthalmoplegia. Conclusion. There is no significant difference between the THS patients with and without demonstrated granuloma.
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Kim, Jane S., and Jason Liss. "Masses of the Lacrimal Gland: Evaluation and Treatment." Journal of Neurological Surgery Part B: Skull Base 82, no. 01 (February 2021): 100–106. http://dx.doi.org/10.1055/s-0040-1722700.
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AbstractLacrimal gland lesions account for approximately 9 to 10% of all biopsied orbital masses. Potential causes include nongranulomatous and granulomatous inflammation, autoimmune disease, lymphoproliferative disorders, benign epithelial proliferation, malignant neoplasia, and metastatic disease. Inflammatory lesions and lymphoproliferative disorders are the most common and may be unilateral or bilateral; they may also be localized to the orbit or associated with systemic disease. Both benign and malignant epithelial lacrimal gland masses tend to be unilateral and involve the orbital lobe, but a more rapid onset of symptoms and periorbital pain strongly suggest malignant disease. On orbital imaging, both inflammatory and lymphoproliferative lesions conform to the globe and surrounding structures, without changes in adjacent bone, whereas epithelial lacrimal gland masses often show scalloping of the lacrimal gland fossa. Malignant epithelial lacrimal gland tumors can also have radiographic evidence of bony invasion and destruction. Masses of the lacrimal gland may be due to a broad range of pathologies, and a good working knowledge of common clinical characteristics and radiographic imaging findings is essential for diagnosis and treatment. All patients with inflammatory, lymphoproliferative, and epithelial neoplastic lesions involving the lacrimal gland require long-term surveillance for disease recurrence and progression.
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Poli, Tito, Francesco Laganà, Luigi Caradonna, Roberta Gobbi, Domenico Corradi, and Enrico Sesenna. "Primary Orbital Liposarcoma in Li-Fraumeni Cancer Family Syndrome: A Case Report." Tumori Journal 91, no. 1 (January 2005): 96–100. http://dx.doi.org/10.1177/030089160509100121.
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Aims and background The aim of this study was to describe a case of primary orbital liposarcoma in Li-Fraumeni syndrome. Methods and study design In July 1998 a 20-year-old woman with a histological diagnosis of orbital myxoid liposarcoma underwent surgical treatment in our department. Since the patient's family pedigree met the clinical criteria for the diagnosis of LFS, molecular analysis was performed, which resulted in a molecular profile consistent with Li-Fraumeni syndrome. Results The patient underwent orbital exenteration extended to the upper eyelid; surgical reconstructive steps were performed to permit placement of an orbital prosthesis. Two years after primary surgery the patient underwent a quadrantectomy with lymphadenectomy of the right axilla because of the presence of a nodule of 1.5 cm in diameter in the upper-lateral quadrant of the right breast. One year after the last surgery, the patient is disease free. Conclusion The diagnosis of an orbital malignancy in a young patient with a family history of cancer should suggest the presence of an underlying genetic disorder like LFS; with molecular analysis we can now determine the genetic disorder and the exact location of the mutation, and also obtain important prognostic data using specific cellular markers. More prognostic information increases the chances of adequate personalized treatment.
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Abdelghany, Mahmoud, Daniel Orozco, William Fink, and Christopher Begley. "Probable Tolosa-Hunt syndrome with a normal MRI." Cephalalgia 35, no. 5 (June 17, 2014): 449–52. http://dx.doi.org/10.1177/0333102414539053.
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Background We are reporting a rare case of a 60-year-old woman with a past history of end-stage renal disease and non-Hodgkin lymphoma who presented to our hospital with confusion, unilateral headache, painful ophthalmoplegia and ptosis. The patient was diagnosed clinically with Tolosa-Hunt syndrome (THS). Results THS is a diagnosis of exclusion. Other diseases were ruled out. Magnetic resonance imaging (MRI) of the brain and orbit was negative twice within a week. The patient was treated with corticosteroids with marked improvement of the orbital pain and headache and mild improvement of the cranial nerves palsy. Conclusion Clinical diagnosis of THS could be supported by radiological findings. According to the International Classification of Headache Disorders (ICHD)-3 beta diagnostic criteria, the diagnosis must be confirmed with an abnormal MRI and/or pathological sample. We add to the previous findings of THS with a normal MRI. Although MRI plays a crucial role in differential diagnosis, it should not, nor should the biopsy, be a must for the diagnosis. Limitations of using MRI in some patients are another problem.
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Gariuc, Lucia, Alexandru Sandul, and Lupoi Daniel. "Invasive fungal rhinosinusitis." Romanian Journal of Rhinology 9, no. 33 (March 1, 2019): 13–19. http://dx.doi.org/10.2478/rjr-2019-0001.
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Abstract Invasive fungal rhinosinusitides are a group of disorders with three subtypes (acute invasive fungal rhinosinusitis, chronic invasive fungal rhinosinusitis and granulomatous invasive fungal rhinosinusitis), requiring urgent diagnosis and early treatment due to the reserved vital and functional prognosis. This disorder occurs in immunocompromised patients, but it can also occur in immunocompetent people. Aspergillus and Mucormicosis species are the most common microorganisms found in invasive fungal rhinosinusites. The otorhinolaryngologic clinical examination and imaging techniques provide important diagnostic information in patients with risk factors for invasive fungal rhinosinusitis, including intracranial or orbital extension identification. The treatment of invasive fungal rhinosinusites (acute or chronic) consists of reversing immunosuppression, appropriate systemic antifungal therapy and aggressive and prompt surgical debridement of the affected tissues.
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Barnard, Benjamin Wybrand. "Tolosa-Hunt syndrome." South African Journal of Radiology 16, no. 1 (February 7, 2012): 14–15. http://dx.doi.org/10.4102/sajr.v16i1.225.
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Tolosa-Hunt syndrome (THS) is a rare disorder indicated by recurrent painful ophthalmoplegia caused by non-specific inflammation of the cavernous sinus or superior orbital fissure (SOF). The disease shares histopathological features with idiopathic orbital pseudotumour; however, owing to its anatomical location, it produces characteristic clinical manifestations.1 Recurrent retro-orbital pain, with palsies of the third, fourth or sixth cranial nerves as well as the first and second divisions of the trigeminal nerve, are typical. Clinically, immediate response to steroid therapy is a hallmark of the condition. The clinical presentation of THS has a wide differential diagnosis, and timely and appropriate imaging – as an adjunct to pertinent laboratory investigations – can greatly assist clinicians with early accurate diagnosis and management.
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Tabakovic, Sasa, and Ivana Ilic-Dimitrijevic. "Surgical treatment of orbital floor blowout fracture in children: A case report." Vojnosanitetski pregled 72, no. 9 (2015): 841–44. http://dx.doi.org/10.2298/vsp140620080t.
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Introduction. Orbital floor blowout fracture is a common traumatic lesion of the craniofacial complex, but rarely in children population, consequently representing challenge in surgical treatment. Timely diagnosis and surgical treatment prevent the probability of the occurrence of the functional complications. Case report. We presented surgical treatment of on 8-year-old girl with a blowout orbital floor fracture one month after the injury. The predominant symptoms were: ocular bulb motility disorder with consecutive strabismus and double vision. Orbital floor reconstruction was made by an autogenous mandibular symphyseal graft. A year after the orbital floor reconstruction additional correction of strabismus was performed due to functional disorder of the bulbomotor muscles. Conclusion. Delayed surgical treatment of blowout orbital floor fracture in children leads to unsatisfactory functional results in the majority of cases. In such a situation surgical correction of strabismus is necessary in order to obtain functionally quality vision and satisfactory aesthetic appearance.
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Bumpous, Jeffrey M., David S. Martin, Perrin Curran, and John A. Stith. "Non-Hodgkin's Lymphomas of the Nose and Paranasal Sinuses in the Pediatric Population." Annals of Otology, Rhinology & Laryngology 103, no. 4 (April 1994): 294–300. http://dx.doi.org/10.1177/000348949410300406.
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Paranasal and nasal neoplasms often elude early diagnosis in the pediatric population. This report examines 3 cases of nasal and paranasal sinus lymphomas out of 29 lymphomas and lymphoproliferative disorders seen from 1983 to 1990. Diagnostic delays are common. The development of orbital signs and symptoms often leads to diagnosis. Computed tomography and magnetic resonance imaging are important in delineating the extent of disease and allow appropriate staging. Transnasal biopsy yields the definitive diagnosis, with low associated morbidity. Aggressive chemotherapy and irradiation prolongs survival; with this regimen all of our patients have remained alive, although 1 has residual disease. B-cell lymphomas are more common than T-cell varieties in children. One patient demonstrated B-cell immunodeficiency and preleukemia prior to developing primary paranasal sinus non-Hodgkin's lymphoma; this case reiterates the systemic nature of lymphoma. Key differences between children and adults in the manifestations of nasal and sinus lymphomas are emphasized.
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Van Went, C., A. Ozanne, G. Saliou, G. Dethorey, I. De Monchy, T. Krings, D. Ducreux, and M. Labetoulle. "Spontaneous Thrombosis of an Orbital Arteriovenous Malformation Revealing Hereditary Haemorrhagic Telangiectasia (Rendu-Osler-Weber Disease)." Interventional Neuroradiology 17, no. 4 (December 2011): 466–71. http://dx.doi.org/10.1177/159101991101700411.
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Hereditary Haemorrhagic Telangiectasia (HHT) is a genetic disorder responsible for cutaneous or mucosal telangiectasia and arteriovenous malformations (AVMs). The most frequent locations are lung and brain. In contrast, orbital AVMs are very rare. We describe a case of symptomatic orbital arteriovenous malformation due to spontaneous thrombosis. A 65-year-old woman was referred for chronic right eye proptosis associated with dilation of conjunctival vessels with a jellyfish pattern. Right visual acuity was 20/40 and intraocular pressure was 40 mmHg. Personal and familial history of recurrent epistaxis, associated with multiple telangiectasia within lips and palate, led to the diagnosis of HHT. Magnetic resonance imaging (MRI) completed with cerebral angiography found a giant and occluded AVM within the right orbit. Other AVMs were also found in brain and chest, confirming the diagnosis. Antiglaucomatous eyedrops were added to reduce intraocular pressure and a steroid therapy was begun. Two months later, visual acuity decreased in the right eye, due to a central retinal vein thrombosis. In conclusion, Most brain or pulmonary AVM can be treated by embolization. By contrast, this treatment in case of orbital location can lead to central retinal artery and/or central retinal vein occlusion, which may also appear as a spontaneous complication of the orbital AVM. Therapeutic management of orbital AVM is thus not standardized, and the balance between spontaneous and iatrogenic risk of visual loss has to be taken into account.
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Viglianesi, A., M. Messina, R. Chiaramonte, G. A. Meli, L. Meli, I. Chiaramonte, and G. Pero. "An Interpretation of Optic Nerve Tortuosity." Neuroradiology Journal 22, no. 4 (August 2009): 381–85. http://dx.doi.org/10.1177/197140090902200403.
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Magnetic resonance imaging disclosed both optic nerve tortuosity and kinking in a 64-year-old man with orbital pain and monolateral abducens nerve palsy. The association between optic nerve tortuosity and abducens nerve palsy is often described in literature reports of idiopathic intracranial hypertension. However the diagnosis of idiopathic intracranial hypertension was excluded in our patient because of the absence of other signs such as papilledema (universally present in the cases of idiopathic intracranial hypertension), visual loss, headache and flattening of the posterior sclera. Other possible diagnoses to be considered when looking at a case of optic nerve tortuosity are neurofibromatosis and/or optic nerve glioma. Tortuosity of both optic nerves seems to be isolated in our patient and not associated with other diseases or disorders. We suggest that in some patients optic nerve tortuosity could be correlated with an aberrant anatomical development of the optic nerve. Further studies are necessary to confirm this hypothesis which currently remains conjectural.
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Narmurotov, Bakhtiyar Karshievich, Shukhrat Abdujalilovich Boymuradov, and Jamolbek Abdukakhkhorovich Djuraev. "Comparative Characteristics Of Rheological Properties Of Blood In Combined Face Injuries Before And After Treatment." American Journal of Medical Sciences and Pharmaceutical Research 03, no. 01 (January 19, 2021): 67–75. http://dx.doi.org/10.37547/tajmspr/volume03issue01-10.
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Fractures are one of the most common components in multiple and associated injuries. Fractures of the lower jaw are observed in 76%, of the upper jaw in 24%, a fracture of the zygomatic-orbital complex in 12%. The actual problem of modern traumatology is the violation of reparative osteogenesis with injuries combined with facial trauma. The duration of the consolidation of fractures is determined by the degree of microcirculation disorders in the fracture zone, changes in cellular and coagulation hemostasis and mineral metabolism. In this connection, increasing the effectiveness of treatment of fractures of the bones of the face on the basis of early diagnosis of vascular and hemostasiological changes is of great importance for practical health care.
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Korlyakova, M. N., Elvira I. Saidasheva, and D. V. Voronin. "PRENATAL ULTRASONIC DIAGNOSTICS OF ABNORMALITIES OF THE ORGAN OF VISION." Russian Pediatric Ophthalmology 12, no. 3 (September 15, 2017): 128–32. http://dx.doi.org/10.18821/1993-1859-2017-12-3-128-132.
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Aim. The objective of the present work was to evaluate the possibilities for the prenatal ultrasonic examination with a view to diagnostics of developmental abnormalities in the organ of vision and its accessory apparatus. Material and methods. A total of 1300 protocols of the comprehensive assessment of the ultrasonic picture of the orbital structures in the fetuses obtained between the 10th and 40th weeks of physiological pregnancy were available for the analysis. The screening of 1045 (80%) fetuses was carried out during the 10th-14th, 20th-24th, and 32nd -34th weeks of pregnancy. The data on 3026 fetuses with the prenatally diagnosed and postnatally verified congenital malformations were analyzed retrospectively for determining the frequency and the structure of the developmental disorders in the organ of vision. Results. The frequency of identification of congenital malformations of the organ of vision by means of prenatal echography of the fetal orbital structures was 0,262 per 1,000 full-term pregnancies. It was shown that the abnormalities in the position of the eyeballs (hypotelorism, hypertelorism, exophthalmos) are possible to diagnose during I and II trimesters of the pregnancy whereas the abnormalities of their size (microphthalmia) and number (anophthalmos, aphakia) are especially well apparent in the second half of the pregnancy; simultaneously, the abnormalities in the structure of the organs of vision (cataract), complicated disorders (cyclopia), and the abnormalties in the lacrimal sac (dacryocystocele) can be diagnosed. The abnormalities of the organ of vision and its accessory apparatus accounted for 2,8% of all congenital malformations. In the overall structure of congenital malformations, the orbital abnormalities most frequently occurred in the combination with the facial malformations (53-75%), nervous system disorders (75-78%), disturbances in the blood circulatory system (38-41%), and the diseases of the locomotor apparatus (43-63%). Conclusion. Prenatal expert ultrasonography performed in the optimal for the screening studies periods of pregnancy provides a highly efficacious (91%) tool for the diagnostics of congenital and hereditary malformations and developmental disorders including pathology of the orbit, eye, and its accessory structures.
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Riggio, Silvana. "Behavioral Manifestations of Frontal Lobe Seizures." CNS Spectrums 14, no. 2 (February 2009): 66–70. http://dx.doi.org/10.1017/s1092852900000201.
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Patients with seizure of frontal lobe origin can present with bizarre behavior. At times, this bizarre behavior can be unrecognized or confused with seizure of other origin with nonepileptic events or with psychiatric disorder.I recently saw a patient who began to experience events that were characterized by terrible fear which was followed by irritability. It was as if she could not stand in place where she was at and felt like running away. She was referred to a psychiatrist who diagnosed her to have panic disorder. She was subsequently treated for panic disorder. Her symptoms did not improve; therefore, she came to see me for a second opinion. Upon asking, the patient reported that the episodes were always the same and that they lasted approximately seconds to minutes. Due to the stereotypicity of the event and a normal routine electroencephalography (EEG), we requested that she would undergo a 24-hour video-monitoring EEG. Stereotypicity can help the physician in the differential diagnosis of psychiatric disorder versus a seizure disorder. During 24-hour video-monitoring EEG, she experienced several of these events. Also, a computer tomography scan was performed, which showed a small meningioma in the orbital frontal region.
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MARTORELLI, Sérgio Bartolomeu de Farias, Érica Passos de Medeiros LACERDA, Felipe Bravo Machado de ANDRADE, and Felipe Leonardo de Melo Almeida FONSECA. "Impacted canine in orbita: case report." RGO - Revista Gaúcha de Odontologia 65, no. 3 (September 2017): 270–75. http://dx.doi.org/10.1590/1981-863720170002000143306.
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ABSTRACT The canines are important teeth as regards function, occlusion and esthetics. Disturbances with the eruption of permanent maxillary canines are common. Ectopic eruption of a tooth germ can occur at any time after eruption. It has also been observed that upper canines are affected with eruption disorders more than the third molars. The diagnosis of retained teeth is performed through clinical and radiographic examination, or through the investigation of various complaints, such as pain or orthodontic problems. The dental surgeon should be familiar with the anatomical and functional changes of the impaction, ectopic teeth and the possible repercussions for the patient, because recommendations on the decisions to be taken in cases of canine impaction, are determined through a careful study of each case. The purpose of this paper is to report a rare case of a buried canine in the proximity of the orbital border.
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Tripi, Gabriele, Sylvie Roux, Domenica Matranga, Laura Maniscalco, Pasqualino Glorioso, Frédérique Bonnet-Brilhault, and Michele Roccella. "Cranio-Facial Characteristics in Children with Autism Spectrum Disorders (ASD)." Journal of Clinical Medicine 8, no. 5 (May 9, 2019): 641. http://dx.doi.org/10.3390/jcm8050641.
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Background: Cranio-facial anomalies frequently occur in neurodevelopmental disorders because both face and brain are derived from neuroectoderm. The identification of differences in the facial phenotype of children with Autism Spectrum Disorders (ASD) may reflect alterations in embryologic brain development in children with ASD. Methods: we evaluated 33 caucasian children with ASD using a 2D computerized photogrammetry. Anthropometric euclidean measurements and landmarks located on the soft tissue of the face and head, were based on five cranio-facial indexes. Relationships between anthropometric z-scores and participant characteristics (i.e., age, Global IQ, severity of autistic symptoms measured using the CARS checklist) were assessed. Results: Cephalic index z-score differed significantly from 0 in our ASD group (p = 0.019). Moreover, a significant negative correlation was found between Facial Index z-score and CARS score (p = 0.003); conversely, a positive correlation was found between Interchantal Index z-score and CARS score (p = 0.028). Conclusion: our measurements shows a dolichocephalic head shape which is not correlated with autism severity. Importantly, two craniofacial markers were significantly correlated with autism severity: increased orbital hyperthelorism and decrease of height of the facial midline. These data support previous findings of craniofacial anomalies in autism spectrum disorder suggesting an “ASD facial phenotype” that could be used to improve ASD diagnoses.
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Yuan, Ye, Guangyu Chu, Tingting Gong, Lianze Du, Lizhi Xie, Qinghai Yuan, and Qinghe Han. "To Explore MR Imaging Radiomics for the Differentiation of Orbital Lymphoma and IgG4-Related Ophthalmic Disease." BioMed Research International 2021 (February 4, 2021): 1–8. http://dx.doi.org/10.1155/2021/6668510.
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Among orbital lymphoproliferative disorders, about 55% of diagnosed cancerous tumors are orbital lymphomas, and nearly 50% of benign cases are immunoglobulin G4-related ophthalmic disease (IgG4-ROD). However, due to nonspecific characteristics, the differentiation of the two diseases is challenging. In this study, conventional magnetic resonance imaging-based radiomics approaches were explored for clinical recognition of orbital lymphomas and IgG4-ROD. We investigated the value of radiomics features of axial T1- (T1WI-) and T2-weighted (T2WI), contrast-enhanced T1WI in axial (CE-T1WI) and coronal (CE-T1WI-cor) planes, and 78 patients (orbital lymphoma, 36; IgG4-ROD, 42) were retrospectively reviewed. The mass lesions were manually annotated and represented with 99 features. The performance of elastic net-based radiomics models using single or multiple modalities with or without feature selection was compared. The demographic features showed orbital lymphoma patients were significantly older than IgG4-ROD patients ( p < 0.01 ), and most of the patients were male (72% in the orbital lymphoma group vs. 23% in the IgG4-ROD group; p = 0.03 ). The MR imaging findings revealed orbital lymphomas were mostly unilateral (81%, p = 0.02 ) and wrapped eyeballs or optic nerves frequently (78%, p = 0.02 ). In addition, orbital lymphomas showed isointense in T1WI (100%, p < 0.01 ), and IgG4-ROD was isointense (60%, p < 0.01 ) or hyperintense (40%, p < 0.01 ) in T1WI with well-defined shape (64%, p < 0.01 ). The experimental comparison indicated that using CE-T1WI radiomics features achieved superior results, and the features in combination with CE-T1WI-cor features and the feature preselection method could further improve the classification performance. In conclusion, this study comparatively analyzed orbital lymphoma and IgG4-ROD from demographic features, MR imaging findings, and radiomics features. It might deepen our understanding and benefit disease management.
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Modestowicz, Michał, and Wojciech Kozubski. "Trigeminal autonomic cephalalgias: a review." Aktualności Neurologiczne 16, no. 4 (December 30, 2016): 180–86. http://dx.doi.org/10.15557/an.2016.0023.
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Trigeminal autonomic cephalalgias are a group of primary headache disorders presenting as unilateral pain in the somatic distribution of the trigeminal nerve, associated with ipsilateral cranial autonomic symptoms. This clinicopathologic group includes cluster headache, paroxysmal hemicrania, hemicrania continua and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing/cranial autonomic features, which differ mainly as regards the duration and frequency of pain as well as response to treatment. These disorders are not as rare as they were thought to be and due to the severity of the pain can substantially affect the patients’ quality of life. Many other forms of primary headaches, such as migraine, trigeminal neuralgia and primary stabbing headache, as well as secondary headaches, particularly those caused by pituitary, posterior fossa, orbital, paranasal sinus and vascular pathology, need to be carefully considered in the diagnosis of trigeminal autonomic cephalalgias. Research in this field, particularly using functional neuroimaging, has resulted in a much better understanding of these disorders. Dysfunction in the nociceptive modulatory pathways in brain’s pain matrix is currently thought to produce a permissive state for the occurrence of a trigeminal autonomic cephalalgia attack, with posterior hypothalamus serving as a terminator rather than the generator of the attack. The current treatment strategies include medical and surgical approaches; of the latter, neuromodulation techniques, particularly deep brain stimulation of posterior hypothalamus, have proven to be particularly effective and promising.
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Turaeva, Yorkinoy, Bakhtiyor Urinboev, and Nurillo Sobirov. "Damage To Eyes, Orbit And Visual Nerve , Combined With Cranial Injury In Emergency Medicine." American Journal of Medical Sciences and Pharmaceutical Research 03, no. 03 (March 31, 2021): 83–88. http://dx.doi.org/10.37547/tajmspr/volume03issue03-12.
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The features of the clinical course, symptoms and the difficulty of diagnosing traumatic injuries of the eye, orbit and optic nerve are described. A total of 952 patients with concomitant craniocerebral injuries and injuries to the eye, orbit, optic nerve were studied in 2018. The possibilities of computer tomography in the diagnosis of traumatic injuries of the visual tract combined with traumatic brain injury and differential diagnosis of intracranial injuries of the visual tract before the hospital and hospital stages were studied. In the structure of craniocerebral trauma, craniofacial accounted for 187 (19.6%), of which 118 (6%) eye injuries, 20 (10.6%) orbit injuries, 4 (2.1%) optic nerve injuries, 19 (10 %) of patients were diagnosed with a fracture of the walls of the orbit. In 5 (2.6%) patients, an isolated fracture of the lower orbital wall was revealed. Total: 158 men (84.4%), 29 women (15.5%). The patients underwent examination, including examination by a multidisciplinary team (neurosurgeon, maxillofacial surgeon, ENT and ophthalmologist). Anamnesis was studied in all patients, a comprehensive ophthalmological examination was performed: visometry (with optimal correction), refractometry, biomicroscopy, ophthalmoscopy and neuro-ophthalmological examination. All patients underwent radiography of the orbits and skull in frontal and lateral projections, CT, MRI of the brain and orbits. To obtain additional information, 24 (12.8%) patients underwent a two-dimensional ultrasound examination - ultrasound - B SCAN of the eyeball, extraocular muscles and retrobulbar space. Timely topical diagnostics and qualified reconstructive surgeries performed in the early period of craniofacial trauma allows achieving regression of oculomotor disorders in 86.6%, prevents severe consequences and preserves the patient's vision.
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Timkovic, Juraj, Jiri Stransky, Petr Handlos, Jaroslav Janosek, Hana Tomaskova, and Jan Stembirek. "Detecting Binocular Diplopia in Orbital Floor Blowout Fractures: Superiority of the Orthoptic Approach." Medicina 57, no. 9 (September 19, 2021): 989. http://dx.doi.org/10.3390/medicina57090989.
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Background and Objectives: In patients with orbital floor blowout fracture (OFBF), accurate diagnosis of ocular motility disorder is important for decisions about conservative or surgical therapy. However, the accuracy of the traditional test for detecting binocular diplopia/ocular motility disorder using a moving pencil or finger (hereinafter, “finger test”) has been generally accepted as correct and has not been subject to scrutiny so far. Hence, its accuracy relative to full orthoptic examination is unknown. Materials and Methods: In this paper, the results of the “finger test” were compared with those derived from a complex examination by orthoptic tests (considered “true” value in patients with OFBF). Results: “Finger test” detected ocular motility disorder in 23% of patients while the full orthoptic examination proved much more efficient, detecting ocular motility disorder in 65% of patients. Lancaster screen test and test with color filters were the most important tests in the battery of the orthoptic tests, capable of identifying 97.7% and 95.3% of patients with ocular motility disorder, respectively. Still, none of the tests were able to correctly detect all patients with ocular motility disorder in itself. Conclusions: As the presence of ocular motility disorder/binocular diplopia is an important indication criterion for the surgical solution of the orbital floor blowout fracture, we conclude that a complex orthoptic evaluation should be always performed in these patients.
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Pradeep, Thanuja Gopal, Paul Cannon, Thomas Dodd, and Dinesh Selva. "Lacrimal Gland Involvement in Lymphomatoid Granulomatosis and Review of the Literature." Journal of Ophthalmology 2010 (2010): 1–6. http://dx.doi.org/10.1155/2010/358121.
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Objective. To describe the clinicoradiological and histopathological findings in a case of lacrimal gland enlargement secondary to lymphomatoid granulomatosis (LG) and to review the literature.Design. Case report and systematic literature review.Methods. A 75-year-old woman presented with right ptosis. Computerised tomography showed lacrimal gland enlargement, and biopsy done was inconclusive. She subsequently developed pulmonary symptoms and underwent transbronchial biopsy that was diagnosed as LG. Pub Med and OVID databases were searched using the term “orbit/eye involvement in lymphomatoid granulomatosis”. Articles that predated the databases were gathered from current references.Results. The patient underwent lacrimal gland biopsy which revealed necrotic and inflamed tissue with no further categorisation but transbronchial biopsy helped in establishing the diagnosis of LG. On initiation of prednisolone and cyclophosphamide, her orbital lesion resolved but the patient died following massive pulmonary hemorrhage within a month of diagnosis.Conclusion. Ophthalmic involvement in LG is very rare. Varied presentations are due to central nervous system involvement, vasculitis, or infiltration of ocular or orbital structures. LG is an angiocentric and angiodestructive granulomatous disorder and can involve any tissue, thus accounting for the variable presentations reported in literature.
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Shah, Pratik Dipak, and Srijon Mukherji. "Management Dilemma in a Challenging Case of Inflammatory Pseudotumor of an Orbitomaxillary Mass: A Review of Literature." An International Journal of Otorhinolaryngology Clinics 7, no. 1 (2015): 9–12. http://dx.doi.org/10.5005/aijoc-7-1-9.
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ABSTRACT Objective To present management dilemma in a challenging case of a benign orbitomaxillary pseudotumor and its importance of inclusion in the differential diagnosis of orbital disorders. Design Case Report Setting Private multispecialty hospital in Kolkata, West Bengal. Patient A 36-year-old female patient with 1 year history of orbitomaxillary mass, deviation and protrusion of left eyeball, diplopia and left sided headache. Results Resection of entire orbitomaxillary mass performed after assessing history, clinical and radiologic presentation of the case. Biopsy report came as mixed inflammatory lesion. Appropriate surgical intervention resulted in a dramatic improvement in patient's clinical condition. At present, patient is disease-free and asymptomatic. Conclusion Complete surgical resection is the treatment of choice for inflammatory orbitomaxillary pseudotumors followed by corticosteroids in case of incomplete resection. Radiation therapy is indicated only in case when corticosteroids or surgical intervention is unsuccessful or contraindicated.
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Oweity, Thaira, Bernd W. Scheithauer, Hin San Ching, Chang Moh C. Lei, and Koh Ping Wong. "Multiple system Erdheim—Chester disease with massive hypothalamic—sellar involvement and hypopituitarism." Journal of Neurosurgery 96, no. 2 (February 2002): 344–51. http://dx.doi.org/10.3171/jns.2002.96.2.0344.
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✓ Erdheim—Chester disease (ECD) is a rare multiple system histiocytosis that is characterized pathologically by xanthogranulomatous infiltrates and radiologically by symmetrical sclerosis of long bones. The diagnosis is often confirmed by biopsy of bone or of orbital or retroperitoneal soft tissue. Intracranial involvement is rare. The authors report a case of ECD in which the diagnosis was made after biopsy of a hypothalamic mass. The mass had been discovered during a workup for panhypopituitarism in a 55-year-old man with urological and bone disease. Aside from diabetes insipidus, other features of pituitary insufficiency have seldom been reported and no patients have presented with a hypothalamic tumor. The endocrinological and neurological aspects of ECD are discussed, as is its differential diagnosis. Reported cases of the disorder associated with hypopituitarism or found during biopsy of central nervous system structures are also reviewed.
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Shishkina, E. V., T. N. Bazilevskaya, R. F. Izokhvatova, Yu V. Panfilova, I. V. Novikova, M. Yu Galaktionova, and D. A. Maiseenko. "Tolosa-Hunt syndrome in pediatric practice." Russian Journal of Woman and Child Health 3, no. 4 (2020): 336–39. http://dx.doi.org/10.32364/2618-8430-2020-3-4-336-339.
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Tolosa-Hunt syndrome (THS) is a rare disease manifested with one or more cranial nerve disorders and orbital pain. In children, THS is diagnosed very rarely due to the lack of vigilance among physicians. Careful examination including MRI or helical CT help diagnose this disease. This paper discusses case history of THS in a child in the first ten years of life who has previously experienced similar episodes of ptosis and right-sided orbital pain; however, the cause of these symptoms has remained elusive. Disease anamnesis, clinical signs, neurological status, and additional diagnostic data are described in detail. Clinical course of THS with its relapses and remissions, rapid symptom regress after corticosteroid pulse therapy, and no specific granulomatous inflammation of the lateral wall of the cavernous sinus as demonstrated by MRI suggest idiopathic THS. The importance of in-depth neurological and general examination of patients with clinical signs of THS due to a variety of the causes of this syndrome is highlighted. KEYWORDS: pediatrics, Tolosa-Hunt syndrome, ophthalmoplegia, superior orbital fissure, cavernous sinus, corticosteroids. FOR CITATION: Shishkina E.V., Bazilevskaya T.N., Izokhvatova R.F. et al. Tolosa-Hunt syndrome in pediatric practice. Russian Journal of Woman and Child Health. 2020;3(4):336–339. DOI: 10.32364/2618-8430-2020-3-4-336-339.
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Magbuhat, Diane Clarice D., Jeannette Marie S. Matsuo, and Rhodieleen Anne R. De la Cruz. "Basal Cell Carcinoma, Odontogenic Cysts, Brain and Skeletal Abnormalities (Gorlin Goltz) Syndrome in a 46-Year-Old Woman." Philippine Journal of Otolaryngology-Head and Neck Surgery 32, no. 2 (July 24, 2018): 38–42. http://dx.doi.org/10.32412/pjohns.v32i2.77.
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Objective: To present the case of a 46-year-old woman with basal cell carcinoma, odontogenic cysts, brain anomalies and skeletal abnormalities.
Method:
Design: Case Report
Setting: Tertiary National University Hospital
Patient: One
Results: A 46-year-old woman consulted for a non-healing, necrotic left orbital ulcer that started as a skin-colored, papilla-like lesion on the upper eyelid. There were also hyperpigmented lesions with ill-defined borders over both paranasal areas. Tissue biopsies revealed basal cell carcinoma. Radiologic imaging showed cystic lesions in the mandible, straightening of cervical vertebrae and calcifications of the falx cerebri, tentorium cerebelli, pineal gland and choroid plexus. Based on established major and minor clinical and radiologic criteria, we arrived at a diagnosis of Gorlin Goltz Syndrome or Nevoid Basal Cell Carcinoma Syndrome (NBCCS). She underwent wide excision of the left orbital mass with exenteration, excision of left and right paranasal masses, left total parotidectomy with facial nerve preservation, enucleation of mandibular cyst, and cervicofacial reconstruction with skin grafts of the left orbital area and ala.
Conclusion: NBCCS is a rare autosomal dominant disorder with a high tendency for neoplasms and developmental anomalies. Diagnosis can easily be missed if the physician is unaware of its classic but bizarre presentation. Early recognition and prompt specialist referral is very important in order to prevent complications and provide better prognosis. Patients should be reminded of the importance of follow-up as other presentations of the syndrome may manifest later in life, and family genetic screening and counseling should be undertaken.
Keywords: Gorlin Goltz Syndrome; Nevoid Basal Cell Carcinoma Syndrome; odontogenic keratocyst
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Brown, A’sha, Sara V. Branson, and Ghazala A. Datoo O’Keefe. "Extranodal Rosai-Dorfman of the Pancreas Presents with Bilateral Granulomatous Anterior Uveitis." Ocular Oncology and Pathology 5, no. 4 (October 25, 2018): 229–33. http://dx.doi.org/10.1159/000493639.
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Background/Aims: To report a case of a 65-year-old female who presented with bilateral anterior granulomatous uveitis, which led to the diagnosis of Rosai-Dorfman Disease (RDD) and the discovery of an associated pancreatic mass. Methods: This is a retrospective case report of a single patient. Results: A 65-year-old African American Female received a full workup for bilateral anterior granulomatous uveitis and was found to have a pancreatic mass on imaging. Biopsy of this mass was diagnostic for RDD, a rare proliferative histiocytic disorder, which classically presents with painless cervical lymphadenopathy, leukocytosis, and hypergammaglobulinemia. Conclusion: Although rare, ocular involvement, including eyelid and orbital masses, and anterior uveitis, can herald the development of other systemic manifestations or RDD and can aid in the diagnosis of this systemic disease.
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Shah, Pratik Dipak, and Srijon Mukherji. "Management Dilemma in a Challenging Case of Inflammatory Pseudotumor of an Orbitomaxillary Mass: A Review of Literature." An International Journal of Otorhinolaryngology Clinics 6, no. 2 (2014): 61–64. http://dx.doi.org/10.5005/jp-journals-10003-1154.
Full textAbstract:
ABSTRACT Objective To present management dilemma in a challenging case of a benign orbitomaxillary pseudotumor and its importance of inclusion in the differential diagnosis of orbital disorders. Setting Private multispecialty hospital in Kolkata, West Bengal. Patient A 36-year-old female patient with 1 year history of orbitomaxillary mass, deviation and protrusion of left eyeball, diplopia and left sided headache. Results Resection of entire orbitomaxillary mass performed after assessing history, clinical and radiologic presentation of the case. Biopsy report came as mixed inflammatory lesion. Appropriate surgical intervention resulted in a dramatic improvement in patient's clinical condition. At present, patient is disease-free and asymptomatic. Conclusion Complete surgical resection is the treatment of choice for inflammatory orbitomaxillary pseudotumors followed by corticosteroids in case of incomplete resection. Radiation therapy is indicated only in case when corticosteroids or surgical intervention is unsuccessful or contraindicated. How to cite this article Shah PD, Mukherji S. Management Dilemma in a Challenging Case of Inflammatory Pseudotumor of an Orbitomaxillary Mass: A Review of Literature. Int J Otorhinolaryngol Clin 2014;6(2):61-64.
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Zhurkova, Natalia V., Klavdiya A. Kazakova, Mariya V. Varichkina, Elena A. Kulebina, Andrey N. Surkov, Olga B. Kondakova, Evgeniya V. Uvakina, Aleksandr A. Pushkov, and Kirill V. Savostyanov. "Noonan-like syndrome with loose anagen hair: three clinical cases." L.O. Badalyan Neurological Journal 1, no. 3 (September 23, 2020): 188–96. http://dx.doi.org/10.17816/2686-8997-2020-1-3-188-196.
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Noonan-like syndrome with loose anagen hair is a rare inherited disease caused by heterozygous mutation in theSHOC2gene. The disease was first described in 1991. The main clinical manifestations of the disease are phenotype features similar to those observed in Noonan syndrome: orbital hypertelorism, eyelid ptosis, low-set, and posteriorly rotated auricles, as well as skin and hair lesions, development delay, loose anagen hair, cardiovascular disorders, and mental retardation. It has an autosomal dominant mode of inheritance. We have described three clinical cases of this disease for the first time in Russia. All children in this group had a Noonan-like phenotype, macrocephaly, wide, short neck, hair and skin lesions, congenital heart disease, development delay of different severity, and hypotonia. One child had hypertrophic cardiomyopathy, nonobstructive form, aneurysmal dilatation of interatrial septum, minor dilation of the pulmonary artery and atria, apical aneurysm other cases showed a congenital defect of the urinary system. These patients have thin, sparse, slowly growing hair, dark skin. One girl was diagnosed with multiple capillary haemangiomas on her head and trunk. Pathogenic nucleotide variant c.4AG, p.S2G in heterozygous state of the SHOC2 gene was revealed in all our patients. The same was described previously in patients with this syndrome. Differential diagnosis at suspicion on Noonan-like syndrome with loose anagen hair should be carried out with Noonan syndrome, Cardiofaciocutaneous syndrome (CFC), Costello syndrome.
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Nosaki, Yasunobu, Ken Ohyama, Maki Watanabe, Takamasa Yokoi, and Katsushige Iwai. "Clinical Features of Painful Ophthalmoplegia with a High-Intensity Ring Appearance around the Optic Nerve on MRI: A Case Series." Case Reports in Neurological Medicine 2020 (March 30, 2020): 1–7. http://dx.doi.org/10.1155/2020/6737018.
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Objective. Painful ophthalmoplegia includes nonspecific magnetic resonance imaging (MRI) manifestations and various clinical features including orbital pain and cranial nerve palsies. Treatment for painful ophthalmoplegia remains controversial. The aim of this report was to describe detailed clinical features, MRI findings, treatments, and prognosis of patients with painful ophthalmoplegia. Patients and Methods. We retrospectively investigated four cases of patients with painful ophthalmoplegia diagnosed using the International Classification of Headache Disorders, 3rd edition. Results. All patients experienced unilateral orbital pain and oculomotor nerve palsy with diplopia but no vision loss. One of the four patients was diagnosed with Tolosa–Hunt syndrome based on the appearance of a granulomatous inflammation of the cavernous sinus on MRI. No specific lesions were detected on brain MRI for the other three patients; therefore, their headaches were attributed to ischaemic ocular motor nerve palsy. In all patients, a high-intensity ring appearance around the ipsilateral optic nerve was observed on MRI. Steroid therapy was administered to these patients, and good prognoses were anticipated. Conclusion. These results indicate that prednisolone is a useful treatment for painful ophthalmoplegia that displays ipsilateral hyperintense ring lesions around the optic nerve on MRI, regardless of the presence of granulomatous inflammation of the cavernous sinus.
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You, Ya-Yan, Xin-Yan Wang, Jin Chen, Zheng-Rong Wang, Xing-Hua Wang, and Fa-Gang Jiang. "Intraorbital wooden foreign bodies: case series and literature review." International Journal of Ophthalmology 14, no. 10 (October 18, 2021): 1619–27. http://dx.doi.org/10.18240/ijo.2021.10.21.
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Intraorbital wooden foreign bodies (IOWFBs) constitute a relatively rare ocular trauma, which occupy a special type of intraorbital foreign bodies (IOFBs). Data regarding IOWFBs must be obtained from case reports or small case series due to their rarity. Here, we reported 5 cases of IOWFBs and reviewed the related literatures, which could provide comprehensive information regarding the clinical manifestations, diagnosis, and surgical treatment of IOWFBs. Combined with the published literature, a total of 51 independent cases were counted after we added 5 cases. Among them, the number of male and female patients was 35 and 16 respectively; the mean age was 27.3±18.2 (range 1-66)y. Obviously, the disorder seemed to occur mainly in young and middle-aged people. Because of the diversity in the clinical manifestations and imaging characteristics of IOWFBs, misdiagnosis and missed diagnosis often occur during the initial visit. Delayed diagnosis may lead to a high risk of orbital infection caused by IOWFBs. Surgery is the treatment of choice for most patients; however, the missed diagnosis and residue of foreign bodies after previous surgery cannot be ignored. Therefore, an accurate diagnosis is governed by the detailed trauma history, careful ocular examination, close observation of clinical manifestations, correct imaging diagnosis [e.g., magnetic resonance imaging (MRI) or computerized tomography (CT)], and timely and completely elimination of IOWFBs.
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El-Eshmawy, Mervat M., and Maha Shahin. "Thyroid and Eye: Where They Meet in Clinical Practice." Endocrine, Metabolic & Immune Disorders - Drug Targets 20, no. 1 (January 7, 2020): 39–49. http://dx.doi.org/10.2174/1871530319666190618120107.
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Objective: Thyroid Hormones (TH) are essential for normal growth, development and continued optimal function of most of the body organs including the eye. TH signaling plays a central role in the regulation of retinal development and maturation. Deficiency in TH during fetal and early postnatal development impairs growth of the eye and proliferation of all retinal cell types. The present article reviews the most important topics of the different derangements in thyroid function and structure and its relation with eye diseases. Methods: A literature search strategy was conducted for all English-language literature. Results: From a clinical practice viewpoint, it should be mentioned that both hypothyroidism and hyperthyroidism are accompanied by ocular diseases i.e. thyroid-associated ophthalmopathy, diabetic retinopathy and age-related macular degeneration. Although the orbit and globe are not common sites for metastatic thyroid cancers, orbital metastasis may be the primary clinical manifestation of thyroid carcinoma. Finally, some medications as amiodarone may be accompanied by both thyroid dysfunction and adverse ocular events. Conclusion: Thyroid disorders and eye diseases are interrelated through several mechanisms thus, awareness of this relation has a great impact on early diagnosis and treatment.
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Wahdania J, Sri Rezki, and Indrasari Indrasari. "POTENSI GO-FUN (GOLD AND FUCOIDAN (SARGASSUM SP.) NANOPARTICLE) DALAM DIAGNOSTIK DAN TERAPI RETINOBLASTOMA." Al-Iqra Medical Journal : Jurnal Berkala Ilmiah Kedokteran 1, no. 2 (August 30, 2019): 84–91. http://dx.doi.org/10.26618/aimj.v1i2.2757.
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Retinoblastoma is one of the malignant diseases of the eye originating from embryonal tissue. This disease most often occurs in children aged less than 5 years. The prevalence of retionoblastoma ranges from 2-4% of all pediatric malignancies with an incidence of 1 from 15,000-20,000 birth rates. This disease can occur unilaterally or bilaterally. The most common initial symptom is leukoria. The diagnosis of retinoblastoma are biopsy, X photos, ultrasound, Ct-Scan and MRI. However, this detection methods has side effects in children, so a diagnostic method is needed that has minimal side effects. As for the treatment of retinoblastoma are chemotherapy, surgery, focal therapy (cryotherapy, laser thermotherapy), external radiation and enucleation. However, this methods of therapy has side effects in the form of orbital bone growth disorders and mortality due to secondary malignancy. The use of chemotherapy not only attacks cancer cells but also can attack healthy cells so that patients can experience disorders such as diarrhea, anemia, etc. So from tha , the right and effective method of detection and therapy is needed. The writing of this review is to examine the most effective and efficient detection and therapy methods for treating retinoblastoma. In this review, there were Pubmed and Google Scholar-based data searches and no factor index restrictions using the keywords Gold Nanoparticle, fucoidan, nanoparticle, retinoblastoma and Surgassum sp. A review showed that Gold Nanoparticle (GNP) effectively used in the detection of retinoblastoma and Fucoidan nanoparticle is effective for the treatment of retinoblastoma. Gold Nanoparticle (GNP) and Fucoidan nanoparticle are potentially diagnostic and therapy on retinoblastoma .
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Chandrasekaran, Jagadeesh, and Phani Krishna Machiraju. "Immunoglobulin G4-related disease - diagnostic dilemma and importance of clinical judgement: a case report." International Journal of Research in Medical Sciences 8, no. 11 (October 28, 2020): 4144. http://dx.doi.org/10.18203/2320-6012.ijrms20204922.
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Immunoglobulin G4 (IgG4)-related disease is a multi-organ, immune-mediated, fibro-inflammatory disorder characterized by tumefactive masses in the affected organs. Incidence and prevalence of IgG4-related disease (RD) are not clearly known and have slight male preponderance. It often involves multiple organs at the time of presentation or over the course of disease mimicking malignancy, Sjogren's syndrome, antineutrophil cytoplasmic antibodies associated vasculitis, infections. A thorough workup is needed to rule out these mimickers. A 33-year-old gentleman presented to us with history of progressive swelling in the right peri-orbital region for four years. On evaluation, abdominal imaging was notable for the sausage-shaped pancreas and hypoenchancing nodules in bilateral kidneys. Histological examination of right lacrimal gland revealed lymphoplasmacytic infiltrate and storiform fibrosis. Serum IgG4 levels were normal, and immunostaining was negative. A diagnosis of IgG4-RD was suggested because of multi-organ involvement, classical radiological and histopathological features. Awareness about IgG4-RD, an under-recognized entity is essential, as it is treatable, and early recognition may help in a favourable outcome. Appropriate use of clinicopathological, serological and imaging features in the right clinical context may help in accurate diagnosis. Elevated serum IgG4 levels and biopsy are not mandatory for the diagnosis.
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Petruzzelli, Maria Giuseppina, Mariella Margari, Flora Furente, Maria Carmela Costanza, Anna Rosi Legrottaglie, Franca Dicuonzo, and Lucia Margari. "Recurrent Painful Ophthalmoplegic Neuropathy and Oculomotor Nerve Schwannoma: A Pediatric Case Report with Long-Term MRI Follow-Up and Literature Review." Pain Research and Management 2019 (September 25, 2019): 1–11. http://dx.doi.org/10.1155/2019/5392945.
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Background. Recurrent painful ophthalmoplegic neuropathy (RPON), previously known as ophthalmoplegic migraine (OM), is an uncommon disorder with repeated episodes of ocular cranial nerve neuropathy associated with ipsilateral headache. The age of presentation is most often during childhood or adolescence. MRI has a central role in the assessment of the RPON, especially to distinguish orbital, parasellar, or posterior fossa lesions that mimic symptoms of RPON. Actually, oculomotor nerve tumors may be masquerade as RPON so that MRI follow-ups are required to detect the possibility of tumor etiology. Case presentation. We report a 16-year-old boy with a 7-year follow-up and multiple brain MRI data, previously diagnosed as OM. The last brain MRI, performed during an acute phase of oculomotor paresis with ipsilateral headache, showed a nodular lesion described as schwannoma of III cranial nerve. Then, we reviewed the literature on OM and RPON in pediatric age with a focus on brain MRI findings. Conclusions. This review highlights the important role of serial brain MRIs in the long-term follow-up of RPON, especially in the cases with childhood onset, in order to not delay the diagnosis of a possible oculomotor nerve schwannoma.
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Phillips, K., L. Thorpe, and G. Innes. "LO13: Eye care in the emergency department: what proportion of patients presenting to the emergency department with isolated eye related complaints could alternatively be seen by an optometrist?" CJEM 20, S1 (May 2018): S11. http://dx.doi.org/10.1017/cem.2018.75.
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Introduction: Approximately 2-3 percent of emergency department (ED) visits are due to eye-related complaints, adding to the ED workload. Many of these could be seen instead by an optometrist who specializes in the examination, diagnosis and treatment of eye-related disorders. We sought to determine the proportion of ED patients with isolated eye-related complaints that could be managed by an optometrist. Methods: We performed an administrative database study and descriptive analysis of all patients presenting to Calgary EDs with eye-related complaints during a one-year period. We determined optometry eligibility by reviewing discharge diagnoses and assessing whether that condition was within the Alberta Association of Optometrys (AAO) defined scope of practice. Patients were considered ineligible if their condition was related to bites, stings, thermal burns, assault, MVA or operative complications; if they required hospitalization or referral to a non-eye specialist (e.g. neurology); if they had associated headache, dizziness, syncope, hypertension, neurologic abnormality (e.g. diplopia); if they had facial cellulitis, orbital infections, adverse drug effects, or if they underwent observation in the ED because of concerns about a cardiac or neurological condition. Results: In 2015, 7686 patients were seen in Calgarys 5 EDs with eye related complaints. Of these, 76.2% were optometry-eligible and 75% of optometry-eligible patients arrived during day or evening hours (0800-2100). The most common presenting complaints were visual disturbance (24.8%), redness (22.1%), and pain or photophobia (16.4%). Optometry-eligible patients waited an average of 110 min and had an ED LOS of 149 min. Conclusion: Approximately 3 in every 4 patients seen in the ED for eye related complaints could alternatively be seen by an optometrist. Further research is required to establish the feasibility of diversion to an optometrist from the ED for eye-related complaints.
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Niro, Alfredo, Giancarlo Sborgia, Rossella Favale, Alessandra Sborgia, Valentina Pastore, Cristiana Iaculli, Francesco Boscia, and Giovanni Alessio. "Eye-related emergencies incidence at a tertiary referral center in Southern Italy during COVID-19 related lockdown." F1000Research 10 (April 23, 2021): 316. http://dx.doi.org/10.12688/f1000research.51526.1.
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Background: In order to contain the community spread of coronavirus disease (COVID-19) in Italy, a stringent lockdown was imposed, which also impacted the healthcare services. The purpose of this study is to investigate the drop in the number of outpatients in the Ophthalmic Emergency Service (OES) in the Eye Clinic of University of Bari during the COVID-19 lockdown. Methods: A retrospective analysis of electronic medical records from a tertiary referral center in Southern Italy was performed. Demographics and medical characteristics of patients examined in the OES between March 10th, 2020 and May 3rd, 2020 were assessed and compared with records from the same period in 2019. We categorized the patients by sex, age group, and by the type of eye disease that was recorded as the principal diagnosis. The change (%) in the number of patients and diseases between the study periods was analyzed. Results: We observed a reduction in the number of OES visits during the lockdown (-63.4%) compared to the number of visits in 2019. The greatest changes were observed in the youngest (≤20 years; -76.6%) and the most elderly patients (≥81 years; -70.9%). The decrease in the number of patients presenting with each pathology ranged from -82% to -28.5%, depending on the pathology, and mainly involved the orbital and palpebral pathologies, anterior segment disorders, non-specific visual symptoms, and minor injuries. The diagnosis of chronic pathologies, rhegmatogenous retinal detachment, and vitreous haemorrhage increased by 134%, 100%, and 75%, respectively. Conclusions: Our results revealed the impact of the COVID-19 lockdown on OES activities in the Eye Clinic of University of Bari. A drop in number of visits across all age groups was observed. The number of patients presenting with minor and nonurgent conditions decreased, whereas the number of patients presenting with chronic diseases and urgent but deferrable conditions increased.
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Valeriani, Davide, and Kristina Simonyan. "A microstructural neural network biomarker for dystonia diagnosis identified by a DystoniaNet deep learning platform." Proceedings of the National Academy of Sciences 117, no. 42 (October 1, 2020): 26398–405. http://dx.doi.org/10.1073/pnas.2009165117.
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Isolated dystonia is a neurological disorder of heterogeneous pathophysiology, which causes involuntary muscle contractions leading to abnormal movements and postures. Its diagnosis is remarkably challenging due to the absence of a biomarker or gold standard diagnostic test. This leads to a low agreement between clinicians, with up to 50% of cases being misdiagnosed and diagnostic delays extending up to 10.1 y. We developed a deep learning algorithmic platform, DystoniaNet, to automatically identify and validate a microstructural neural network biomarker for dystonia diagnosis from raw structural brain MRIs of 612 subjects, including 392 patients with three different forms of isolated focal dystonia and 220 healthy controls. DystoniaNet identified clusters in corpus callosum, anterior and posterior thalamic radiations, inferior fronto-occipital fasciculus, and inferior temporal and superior orbital gyri as the biomarker components. These regions are known to contribute to abnormal interhemispheric information transfer, heteromodal sensorimotor processing, and executive control of motor commands in dystonia pathophysiology. The DystoniaNet-based biomarker showed an overall accuracy of 98.8% in diagnosing dystonia, with a referral of 3.5% of cases due to diagnostic uncertainty. The diagnostic decision by DystoniaNet was computed in 0.36 s per subject. DystoniaNet significantly outperformed shallow machine-learning algorithms in benchmark comparisons, showing nearly a 20% increase in its diagnostic performance. Importantly, the microstructural neural network biomarker and its DystoniaNet platform showed substantial improvement over the current 34% agreement on dystonia diagnosis between clinicians. The translational potential of this biomarker is in its highly accurate, interpretable, and generalizable performance for enhanced clinical decision-making.