For the diagnosis of nasal bone fracture and medial orbital wall fracture, plain radiography and computerized tomography(CT) have been utilized. But plain radiography is less reliable due to its low specificity. So CT has been given a preference to plain radiography in examining both fractures. However, CT has some disadventages; high expense, heavy radiation hazard, and coexistent injuries may restricted a patient,s positioning and so thus preventing or delaying the diagnosis. By comparison, ultrasonography(US) represents a safe, inexpensive, noninvasive, portable, and wide availability. This paper compares the relative values of CT and US in the diagnosis of both fractures. In nasal bone fracture, US proved to be more accurate than CT. Thirty-seven nasal bone fractures were diagnosed by US; whereas only thirty-two of these were revealed on CT. Compared with US, CT demonstrated 87% sensitivity. In examining medial orbital wall fracture, eight cases were diagnosed by CT; whereas seven of these were revealed on US. Compared with CT, US demonstrated 88% sensitivity. In medial orbital wall fracture, US was almost as accurate as CT. In this research, it is concluded that in the investigation of nasal bone fracture and medial orbital wall fracture, US is an accurate diagnostic modality and correlates well with CT.
Diagnosis* ; Nasal Bone* ; Orbit* ; Radiography ; Sensitivity and Specificity

PURPOSE: This study was done to evaluate the absorbed doses in organs of the head and neck for the conventional temporomandibular joint tomography. MATERIALS AND METHODS: Dosimetry was performed with 32 LiF thermoluminescent dosimeters, which were placed in a tissue-equivalent phantom when the temporomandibular joint was examined by both lateral and frontal temporomandibular joint tomography. RESULTS: For lateral tomography, parotid gland and preauricular area towards tube showed relatively high absorbed dose of 1056.9 microGy and 519.9 microGy respectively. For frontal tomography, the two largest absorbed doses were 259.2 microGy in orbit towards tube and 212.0 microGy in lens towards tube. CONCLUSION: Conventional temporomandibular joint tomography showed relatively low absorbed doses on critical organs. Thus, responsible use of it may not be limited.
Head* ; Neck* ; Orbit ; Parotid Gland ; Radiation Dosage ; Radiography ; Temporomandibular Joint*

OBJECTIVETo fabricate a rapid prototyping (RP) 3-D image models for individual reconstruction of orbital bony loss.

METHODSThe skull was placed on a helical CT scanner table and the Frankfort plane was perpendicular to the table. The CT data was obtained by a Aquilion (TOSHIBA, Japan) with 1 mm thickness section in spiral mode. By adjusting of CT threshold value and pixels in order to stack the segmental defects, we obtained an approximate 3-dimension visual model of the scanned skull using MedGraphics software. An orbital RP model based on the dataset of the 3-dimension visual model was fabricated by RP machine. Both 3-dimension visual model and RP model were measured against the skull with several anatomic landmarks to examine the accuracy of the models, and the errors were analysed.

RESULTSIntegrity precision rapid RP models of the orbital region were reconstructed. The anterior orbital rim, middle orbital section and posterior orbital section were all fabricated. Optic foramen, superior orbital fissure, infraorbital foramen, inferior orbital fissure, lacrimal sac socket and naso-lacrimal duct were shown clearly. But some fine hole and slot, such as the anterior ethmoidal foramen, posterior ethmoidal foramen and zygomaticofrontal suture were not obviously seen. The mean difference between the 3-dimension visual model and the skull was 0.10 +/- 1.02mm. For the RP and dry skull, the mean difference was 0.22 +/- 1.04mm. There were no statistical differences between them.

CONCLUSIONSIntegrity precision orbital RP models were fabricated which fulfilled the requirements of the individual reconstruction with bony orbital pathologic changes. The keys to fabricate the precision orbital RP models included a closer cooperation between the surgeon and engineer, thin CT slice in 1mm thick and an appropriated threshold value. Better results for the orbital deformities should be achieved for the contour of orbital region or eye function.

PURPOSE: To investigate relationships between age, weight, refractive error, and morphologic changes in children's eyes by computerized tomography (CT). METHODS: Of the 772 eyes of 386 patients under the age of 20 years, who visited our Department of Ophthalmology between January 2005 to August 2006 and underwent CT of the orbit, 406 eyes of 354 patients with clear CT images and normal eyeball contour were enrolled in the present retrospective study. The axial lengths, widths, horizontal and vertical lengths, refractive errors, and body weight of eyes were measured, and relationship between these parameters were investigated. RESULTS: Axial length was found to correlate significantly with eye width (r=0.914), and in emmetropic eyes and myopic eyes, axial lengths and widths were found to increase as age and body weight increased. Axial lengths increased rapidly until age 10, and then increased slowly. In emmetropic eyes, widths / axial lengths increased with age, but in myopic eyes these decreased as age or severity of myopia increased. Moreover, as age increased, the myopic population and severity also increased. CONCLUSIONS: The axial length was longer in case of myopia compared to emmetropia in all age groups and there was almost no difference in the increase rate of axial length by the age of myopia and emmetropia. However, the width was wider in case of myopia compared to emmetropia in all age groups and the increase rate of width in myopia by age was smaller than that of emmetropia. Myopia showed decreasing rate of width/axial length with increase of age, from 1.004 in 5 years to 0.971 in 20 years. However, emmetropia showed increasing rate of width/axial length with increase of age, from 0.990 in 5 years to 1.006 in 20 years.
Adolescent ; *Aging ; *Body Weight ; Child ; Child, Preschool ; Eye/*radiography ; Female ; Humans ; Male ; Myopia/*radiography ; Orbit/radiography ; Retrospective Studies ; *Tomography, X-Ray Computed

A 41-year-old man visited our clinic complaining of esodeviation of the right eye. He had been operated on for corneal laceration 3 years before. One month later, exodeviation of the right eye had developed. The result of computed tomography (CT) was reported as orbital abscess and cellulitis. Although antibiotic treatment was administered for 2 weeks, the exodeviation didn't improve. On ocular examinations performed in our hospital in November-2001, his right eye was esotropic and had a relative afferent pupillary defect. Vision of the right eye was decreased to 0.02. Fundus examination showed optic atrophy. A new CT scan disclosed a foreign body introduced into the right medial orbital wall, nasal cavity and ethmoidal sinus. Although foreign body was surgically removed, vision and eye movement were not improved. In the case of a patient who has undergone orbital trauma, complete history taking and physical examinations must be performed. On suspicion of a foreign body, imaging study such as CT or MRI must be performed. However, because CT findings can be variable, careful follow-up is needed.
Adult ; Eye Foreign Bodies/*radiography/surgery ; Eye Injuries, Penetrating/*radiography/surgery ; Human ; Male ; Ophthalmologic Surgical Procedures ; Orbit/*injuries/radiography ; Tomography, X-Ray Computed ; *Wood

OBJECTIVE: Knowledge of cranial suture morphology is crucial in emergency medicine, forensic medicine, and maxillofacial reconstructive surgery. This study assessed the visibility of sutures of the orbit and periorbital region on multidetector computed tomography. MATERIALS AND METHODS: Multidetector computed tomography scans of 200 patients (127 males, 73 females; mean age 51.3 years; range, 6-92 years) were evaluated retrospectively. The slice thicknesses varied from 0.5 to 1 mm, and the tube current from 25 to 370 mAs, depending on the CT indication. The visibility of sutures was estimated according to a 4-point scale from "not visible" to "well visible". The chi-squared test was used to test the association of the visibility of sutures with the slice thickness, tube current, and age of patients. Statistical significance was assumed at p < 0.05. RESULTS: Overall, best visibility was found for the sutura frontozygomatica (98%), sutura frontonasalis (88.5%), and sutura sphenozygomatica (71.5%), followed by the sutura zygomaticomaxillaris (65.8%), sutura temporozygomatica (41.8%), sutura frontomaxillaris (44.5%), and sutura sphenofrontalis (31%). Poor visibility was found for the sutura frontolacrimalis (16.8%) and sutura frontoethmoidalis (1.3%). The sutura ethmoidomaxillaris, sutura lacrimomaxillaris, and sutura ethmoidolacrimalis were not visible. CONCLUSION: Although the sutures of the superior, lateral, and inferior orbit are well visible, those of the medial orbit are poorly visible on CT scans.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Child ; Craniocerebral Trauma/pathology/radiography ; Female ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography ; Orbit/*radiography ; Retrospective Studies ; *Sutures ; Young Adult

Gastric pseudolymphoma can be defined as a benign proliferation of lymphoid tissue and is also called the lymphoid hyperplasia or reactive lymphoreticular hyperplasia of the stomach. This lesion has been described in the orbital area, skin, salivary glands, mediastinum and other organs. The etiology of this disease is unknown but chronic inflammation and ulceration have been proposed as the etiologic mechanism in many cases. Most patients exhibit chronic, nonspecific, mild symptoms with the vast majority having symptoms for more than 1 year before undergoing diagnosis and treatment. Unfortunately, upper GI radiography rarely clarifies the diagnosis and gastroacopy is ineffective in establishing the diagnosis of pseudolpnphoma. Therefare, gastric resection is the only sure way to diagnose gastric pseudolympboma, as well as providing curitive therapy in most cases because of its possible malignant potential. There is no typical gross appearance of gastric pseudolymphoma and histologic diagoosis is essential. Smaller tumor size, infiltration with small, round mature lymphoeytos and various inflammatory cells, and formation of a true lymphoid germinal center favor a diagnosis of pseudolymphoma, We report 3 cases of histopathologically confirmed gastric pseudolymphoma after gastrectomy, which were initially suspected to be gastric lymphoma and early gastric cancer
Diagnosis ; Gastrectomy ; Germinal Center ; Humans ; Hyperplasia ; Inflammation ; Lymphoid Tissue ; Lymphoma ; Mediastinum ; Orbit ; Pseudolymphoma* ; Radiography ; Salivary Glands ; Skin ; Stomach ; Stomach Neoplasms ; Ulcer

When a patient is presented with a subconjunctival cyst, it is not only hard to reveal its true nature clinically but also easy to rupture during excision. We experienced cases with cysts of the accessory lacrimal gland in two patients with subconjunctival cysts. They had lid swelling at initial presentation and underwent surgical excision of subconjunctival cysts located in superior portion of the upper tarsal plate. The lining of these cysts composed of ductal epithelia. Biochemical analyses for serum and cystic fluid were performed in one case, in which was found high Ig A titer in the cystic fluid. These cysts seemed to originate from the duct of Wolfring's accessory lacrimal gland, considering their anatomic locations and pathologic findings. Complete removal of the cyst is important, because recurrences have been reported in cases of incomplete removal or simple aspiration.
Adult ; Conjunctival Diseases/pathology/surgery ; Cysts/*pathology/surgery ; Female ; Humans ; Lacrimal Apparatus Diseases/*pathology/surgery ; Orbit/radiography ; Tomography, X-Ray Computed

Transcutaneous and transconjunctival approaches are still frequently used to repair orbital wall fractures. However, medial orbital wall fracture remains a challenging area for plastic surgeons due to technical difficulties and postoperative scars. The transcaruncular approach is described and we present our experience with this approach to access the medial orbital wall in 10 patients with blowout fracture in the medial orbital region. All patients were corrected satisfactorily without cutaneous scar. The transcaruncular approach is a useful technique to repair medial orbital wall fractures.
Adolescent ; Adult ; Female ; Human ; Male ; Middle Aged ; *Ophthalmologic Surgical Procedures ; Orbit/radiography/*surgery ; Orbital Fractures/diagnosis/*surgery ; Postoperative Period ; Tomography, X-Ray Computed ; Treatment Outcome

In order to describe the demographics, etiologic and clinical factors, and outcomes of orbital fractures in children, we have reviewed a case series of 17 patients under 18 years of age with internal orbital fractures (i.e., without involvement of the orbital rim) presenting to the Ghil hospital between March 2000 and June 2001. For 15 of the patients, we performed orbital wall reconstruction with Medpor (R) barrier sheet implantation (thickness 1mm) through transconjunctival approach under endoscopic guidance, while maintaining mere observation on the other 2 patients. There were 14 male and 3 female patients. The most common cause of fractures was accident (7 cases). Inferior wall involvement was most commonly seen, and the trapdoor type fracture was the most common. Thirteen patients had extraocular muscle restriction, 9 had nausea/vomiting and 5 had bradycardia. Diplopia of 9 patients disappeared after 43+/-23 days. Nausea/vomiting and bradycardia disappeared rapidly after surgical intervention in all cases. These results suggest that trapdoor fractures with soft tissue entrapment are the most common in pediatric orbital wall fractures, and that most of them are associated with nausea/vomiting. We suggest that early diagnosis, and prompt surgical intervention are required for those patients with oculocardiac reflex.
Adolescent ; Adult ; Child ; Child, Preschool ; *Endoscopy ; Female ; Human ; Male ; *Ophthalmologic Surgical Procedures ; Orbit/surgery ; Orbital Fractures/*diagnosis/radiography/*surgery ; Retrospective Studies ; *Surgery, Computer-Assisted ; Tomography, X-Ray Computed