PURPOSE: The purpose of this study was to propose the mean exophthalmometric values of Korean using both Hertel and Naugle exophthalmometers. METHODS: We measured 176 eyes in 88 (Male 45, Female 43) normal subjects without any orbital disease using both Hertel and Naugle exophthalmometers. RESULTS: The analysis of Hertel measurements showed a mean reading of 17.2+/-1.5 mm in the male group, and of 16.1+/-1.4 mm in the female group, respectively. And the analysis of Naugle measurements showed a mean reading of 19.5+/-1.1 mm in the male group, and of 18.3+/-1.3mm in the female group, respectively. There was no difference among different age groups in male and female groups, respectively. The exophthalmometric value of Naugle measurement was significantly higher than that of Hertel measurement in both male and female groups by 2.3 mm and 2.2 mm respectively (p<0.05). CONCLUSIONS: In Korean, the exophthalmometric value of Naugle instrument is larger than Hertel in both male and female. And there is significant difference between male and female, but no difference among different age groups. These data can be useful for mean exophthalmometric value of Korean.
Female ; Humans ; Male ; Orbital Diseases

Objective: To present a case of a benign orbito-maxillary tumor behaving as an invasive, expansive malignancy. Design: Case report Setting: A tertiary care hospital in Metro Manila Patient: A 4 1/2-year-old boy with a seven month history of right orbito-maxillary mass, proptosis and epiphora. Result: A series of biopsies were done before a definite diagnosis was made due to inconsistencies in the histopathologic findings, clinical picture, and the radiologic presentation of the case. After diagnosis, appropriate intervention resulted in a dramatic decrease in the size of the mass. At present, the patient is disease-free and asymptomatic. Conclusion: Histopathologic diagnosis of Inflammatory Pseudotumor is difficult and differentiating it from malignant tumors is often a concern for otolaryngologists and pathologists. In spite of an initial malignant biopsy result, the combination of clinical signs and symptoms and radiologic findings of an infiltrative mass lesion, should not discount the possibility of a benign entity such as Inflammatory Pseudotumor for which treatment is conservative. (Author)
GRANULOMA ; PLASMA CELL GRANULOMA ; PLASMA CELL ; ORBITAL ORBITAL DISEASES

To evaluate the efficacy of STIR (short tau inversio recovery) image in the diagnosis of orbital diseases, we compared the STIR images with conventional SE(spin-echo) images in 17 patients. The fat signal was reliably nulled at inversion time of approximately 160-170 msec in all cases. We analyzed all the cases in the aspects of the detection of lesion and the lesion-to-back ground contrast retrospectively. Regarding lesion, the detection rates of STIR, T1 and T2-weighted images were 89, 88 and 83% respectively. In the aspect of lesion-to-background contrast, the contrast ratios of STIR and T1, T2-weighted image were 87% and 64, 56%, respectively. In conclusion, STIR images were similar to T1-and T2-weighted images in the detection of lesion, but superior in the aspect of lesion-to-background contrast. So the STIR images may be a useful adjunct to conventional SE images for the diagnosis of orbital disease.
Diagnosis* ; Humans ; Orbit* ; Orbital Diseases* ; Retrospective Studies

PURPOSE: To investigate the normal exophthalmometric values in children and facilitate the exophthalmic evaluation in pediatric patients with orbital disease. METHODS: We measured 516 eyes in 258 children aged 3 to 9 years without any orbital disease such as thyroid ophthamopathy, orbital pseudotumor and orbital wall fracture. We considered the association of age, sex, binocular variance, inter rim distance and axial length with the exophthalmometric values. Axial length was measured in only 120 eyes of60 patients who underwent operation for strabismus. RESULTS: The mean exophthalmometric values in the patients was 12.43+/-1.55 mm. The exophthalmos had a significant positive correlation with the age, axial length and inter rim distance. There were significant differences in exophthalmometric values by sex in children aged from 8 to 9 years but no significant difference by binocular variance. There were significant differences in the inter-rim distance related to sex. CONCLUSIONS: The exophthalmometric values in children had significant correlation with age, sex, axial length, and inter-rim distance. There was a significant increase of inter-rim distance in males compared to females. Knowing the mean exophthalmometric values in children would be useful with the exophthalmometric reference in pediatric patients with orbital disease.
Aged ; Child ; Exophthalmos ; Eye ; Female ; Humans ; Male ; Orbit ; Orbital Diseases ; Orbital Pseudotumor ; Strabismus ; Telescopes ; Thyroid Gland

Acute visual loss may occur in association with sinusitis either as a complication of orbital cellulitis or, less frequently, as a part of the orbital apex syndrome. Originally, an orbital apex syndrome is associated with an affection of the vessels and nerves passing through the superior orbital fissure and the optic foramen. A classical feature of orbital apex syndrome is presented with visual loss and ophthalmoplegia, but with minimal or no signs of orbital inflammation such as proptosis, chemosis, or lid edema. We present a case of male patient with alternating bilateral visual loss with ophthalmoplegia secondary to paranasal sinusitis.
Edema ; Exophthalmos ; Humans ; Inflammation ; Male ; Ophthalmoplegia ; Orbit* ; Orbital Cellulitis ; Orbital Diseases ; Sinusitis*

Orbital mass is about 17% of orbital disease and only 7-8% of mass is lymphoma. Lymphoma involved extraocular muscles are unusual. Lymphoma occurred in lateral rectus muscle, rarely. The authors experienced a case of malignant lymphoma occurred in the lateral rectus muscle in 17-year-old male. His main symptom was exopthalmos and diplopia. The patient was treated with excision via bicoronal approach and radiation. We report the unusual case of malignant lymphoma occurred in lateral rectus muscle.
Adolescent ; Diplopia ; Humans ; Lymphoma* ; Male ; Muscles ; Orbit ; Orbital Diseases

Intraorbital expansion is not rare in frontoethmoidal mucoceles and various rhinological surgeries have been reported for the management of this condition. However, although intraorbital mucoceles are apt to be accompanied by ophthalmological or neurological complications, their treatment by neurosurgical procedures has been reported considerably less frequently than that by rhinological approach. The authors report a patient with intraorbital mucopyocele that was extended from the frontoethmoidal sinus but separated by the thick fibrous septum. The patient had suffered from progressive proptosis with orbital pain and was successfully treated with transorbital complete removal of cyst by the subfrontal extradural approach. We suggest that an subfrontal transorbital approach such as this method is needed for complete marsupialization of an intraorbital mucocele and to prevent recurrence, especially in cases like our presentation.
Exophthalmos ; Humans ; Mucocele ; Neurosurgical Procedures ; Orbit ; Orbital Diseases ; Recurrence

The visual loss owing to acute optic nerve injury after blunt head trauma has been reported about 5% at the incidence. But it has been real circumstances that we still don`t have the exact knowlege about surgical indication, operation time and steroid dosage for this candidate. Lately, endoscopic surgery was introduced for treatment of orbital disease instead of classic external approach and we have performed and report endoscoic endonasal optic canal decompression followed by megadose steroid injection in 5 patients who experienced visual loss due to optic canal fracture following trauma.
Craniocerebral Trauma ; Decompression* ; Humans ; Incidence ; Optic Nerve Injuries ; Orbital Diseases

PURPOSE: To perform and compare differential diagnosis of patients with thyroid-associated myopathy, idiopathic orbital myositis and normal controls based on orbital computed tomography. Orbital fat and extraocular muscle densities were quantified using Hounsfield Unit (HU) and their characteristics were compared and analyzed. METHODS: From February 2005 to January 2013, orbital computed tomography was performed on 90 eyes of 47 thyroid-associated myopathy patients, 18 eyes of 14 idiopathic orbital myositis patients and 280 eyes of 140 normal subjects. The average values of orbital fat and extraocular muscle densities were measured and compared using HU. The density differences between the patients with thyroid-associated myopathy and the normal group were analyzed by age, clinical activity score, ocular protrusion and disease duration. RESULTS: In the thyroid-associated myopathy group, orbital fat and extraocular muscle densities were -87.8 +/- 12.5 HU and 48.7 +/- 7.1 HU, respectively. In the idiopathic orbital myositis group, the orbital fat and extraocular muscle densities were 79.9 +/- 9.9 HU and 49.2 +/- 9.1 HU, respectively. There was a statistically significant lower result of orbital fat in the thyroid-associated myopathy group (p = 0.002), however, the extraocular muscle density did not show a statistically significant difference (p = 0.775). The orbital fat and extraocular muscle densities of the normal group were -79.0 +/- 11.2 HU and 54.3 +/- 6.3 HU, respectively. There were significantly lower results in both orbital fat and extraocular muscle densities in the thyroid-associated myopathy group than normal group (p = 0.000). In active cases and those accompanied by ocular protrusion, there was no significant difference in orbital fat density (p = 0.345 and p = 0.952, respectively), while extraocular muscle density significantly decreased (p = 0.007 and p = 0.003, respectively). CONCLUSIONS: A difference between the orbital fat and extraocular muscle densities in thyroid-associated myopathy and idiopathic orbital myositis could be quantitatively found using HU and orbital computed tomography.
Diagnosis, Differential ; Humans ; Muscles* ; Muscular Diseases* ; Orbit* ; Orbital Myositis*

PURPOSE: To investigate the role of gangliosides in the differentiation of orbital fibroblasts into adipocytes, a component in the pathogenesis of Graves' ophthalmopathy. METHODS: Orbital tissues were obtained during orbital surgery for subjects without Graves' ophthalmopathy or other inflammatory orbital disease, and orbital fibroblasts were primarily cultured from each obtained tissue. Morphological examination of orbital fibroblasts was performed after treatment with commercially available gangliosides mixture (Gmix) comprised of several subtypes. To determine the effect of Gmix on the differentiation of orbital fibroblasts into adipocytes and the differentiation-related genes, Oil Red-O staining and RT-PCR were performed. RESULTS: The treatment with Gmix induced the morphological changes, which at least in part were explained with the differentiation of orbital fibroblasts into adipocytes in accordance with the increase of mRNA level of genes known to be related to adipogenesis, whereas dermal fibroblasts and preadipocytes were irresponsive to the same treatment. CONCLUSIONS: The results from the present study suggest gangliosides may have a role in pathologic mechanisms of Graves' ophthalmopathy by the induction of differentiation of orbital fibroblasts into adipocytes.
Adipocytes ; Adipogenesis ; Fibroblasts ; Gangliosides ; Orbit ; Orbital Diseases ; RNA, Messenger