Abscess ; etiology ; surgery ; Drainage ; methods ; Endoscopy ; Humans ; Male ; Middle Aged ; Nose ; surgery ; Orbital Diseases ; etiology ; surgery

OBJECTIVETo explore the transcranial surgical method with lateral orbital approach for the treatment of cranio-orbital fibrous dysplasia.

METHODSLateral orbital transcranial extradural approach was adopted to correct complicated fibrous dysplasia in which the frontal, orbital, sphenoid, temporal bones were involved. Partial lesion removal and optic nerve decompression were performed through the transcranial extradural route by fronto-temporal cranial bone flap exposure. The fronto-orbital skeleton was shaped after bone flap deactivation.

RESULTS8 cases were treated successfully with no complication. The period of follow-up ranged from 9 months to 3 years. The appearance and the vision improved greatly. Cranial CT showed good bony union with no relapse.

CONCLUSIONSLateral orbital transcranial surgical approach is an optimal technique to correct cranio-orbital fibrous dysplasia.

Adolescent ; Adult ; Female ; Fibrous Dysplasia of Bone ; surgery ; Humans ; Male ; Orbit ; surgery ; Orbital Diseases ; surgery ; Skull ; surgery ; Young Adult

Abscess ; etiology ; Female ; Humans ; Middle Aged ; Orbital Diseases ; etiology ; Postoperative Complications ; Sinusitis ; surgery

We report the successful removal of a retrobulbar foreign body using a transcranial approach in a 63-year-old patient with a penetrating injury to the left eye. Initial ocular examination revealed a corneoscleral laceration, hyphema, a traumatic cataract, and vitreous hemorrhage. Visual acuity consisted only of the perception of hand motion. Computed tomography demonstrated an orbital foreign body in the retrobulbar area. Emergency corneoscleral suturing, phacoemulsification of the cataract, and vitrectomy with posterior vitreous detachment were performed. Fifteen days after the emergency operation, we successfully removed the orbital foreign body using a transcranial approach, although the foreign body was very close to the optic nerve. On fundus examination 6 months later, a white, fibrous lesion was seen inferior to the optic disc, and the corrected visual acuity was 20/30. These positive results may be due to the complete vitrectomy at the correct time performed by a retina specialist and the minimal pressure on the eyeball while removing the foreign body, which resulted from the use of a transcranial approach.
Wounds, Penetrating/etiology/*surgery ; Orbital Diseases/*surgery ; Middle Aged ; Male ; Humans ; Foreign Bodies/*surgery ; Fluorescein Angiography ; Accidents, Occupational

OBJECTIVE: To study curative effects of endoscopic sinus surgery performed on orbital periosteum abscess. METHOD: Application of ceftazidime and vancomycin 24 h later, operation on maxillary sinus and ethmoidectomy were performed under general anesthesia, Meanwhile bacterial culture and drug sensitive test were performed to the purulent secretion from accessory nasal sinuses. Nasal septum and middle turbinate, which hampered the drainage or clearing in nasal cavity, were undertaken operation in same or second stage. After operation 24 h, the wadding in nasal cavity was removed, and the effusion in nasal cavity was suctioned for 2 times daily until wound surface was covered by fresh granulation. Patients were used ceftazidime and vancomycin for 5 days, in which some patients was replaced antibiotics by drug sensitive test. RESULT: No complications occurred. Ophthalmagia, expanding of eye and headache were obviously improved, dropsy of blepharon and chemosis were decreased obviously and the movement of eye was increased much. After operation 13 - 22 days, the physical sign in ocular region recovered normal in all patients, no recurrence occurred during a 6 months follow-up, and only 6 patients presented discontinue pain in ocular region. CONCLUSION Endonasal endoscopic surgery for acute orbital of intraorbital abscess is safe and effective technique with obvious privillege.
Abscess ; surgery ; Adolescent ; Adult ; Child ; Endoscopy ; Female ; Humans ; Male ; Orbital Diseases ; etiology ; surgery ; Sinusitis ; complications ; surgery ; Young Adult

Female ; Hemorrhage ; etiology ; Humans ; Middle Aged ; Orbital Diseases ; etiology ; Orbital Fractures ; surgery ; Prostheses and Implants ; adverse effects ; Silicones ; adverse effects ; Staphylococcal Infections ; etiology

OBJECTIVETo investigate the treatment outcome of surgical intervention for orbital complications of acute pediatric sinusitis.

METHODSFive children with orbital complications of acute sinusitis were retrospectively reviewed. The patients underwent pediatric endoscopic sinus surgery (PESS) after conservative treatment failed.

RESULTSThere were 1 case with orbital cellulitis, 3 cases with subperiosteal abscess and 1 case with orbital abscess. After operation, the body temperature in all 5 patients returned to normal and ocular symptoms disappeared. CT or MRI was rechecked after PESS. The imaging showed that the orbital and nasal lesions disappeared.

CONCLUSIONSIf conservative treatment fails, it is important to perform PESS for children with orbital complications of acute sinusitis to clean the focus of infection as soon as possible. The surgery is safe and effective.

Acute Disease ; Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male ; Orbital Diseases ; complications ; surgery ; Retrospective Studies ; Sinusitis ; complications ; surgery ; Treatment Outcome

PURPOSE: We present a case of orbital abscess following porous orbital implant infection in a 73-year-old woman with rheumatoid arthritis. METHODS: Just one month after a seemingly uncomplicated enucleation and porous polyethylene (Medpor(R)) orbital implant surgery, implant exposure developed with profuse pus discharge. The patient was unresponsive to implant removal and MRI confirmed the presence of an orbital pus pocket. Despite extirpation of the four rectus muscles, inflammatory granulation debridement and abscess drainage, another new pus pocket developed. RESULTS: After partial orbital exenteration, the wound finally healed well without any additional abscess formation. CONCLUSIONS: A patient who has risk factors for delayed wound healing must be examined thoroughly and extreme care such as exenteration must be taken if there is persistent infection.
Prosthesis-Related Infections/diagnosis/*etiology/surgery ; Porosity ; Orbital Implants/*adverse effects ; Orbital Diseases/diagnosis/*etiology/surgery ; Magnetic Resonance Imaging ; Humans ; Follow-Up Studies ; Female ; Eye Enucleation ; Device Removal ; Aged ; Abscess/diagnosis/*etiology/surgery

OBJECTIVETo investigate the clinical features, diagnosis and therapy of surgical intervention for orbital complications of acute rhinosinusitis in adults.

METHODSFour adults with orbital complications of acute rhinosinusitis were retrospectively reviewed. The patients underwent transnasal endoscopic sinus surgery or combined with eyebrow incision after conservative treatments failed.

RESULTSThere were 2 cases with orbital abscess, 2 cases with subperiosteal abscess. Two of them suffered from diabetes. After operation, constitutional symptoms and ocular symptoms disappeared in all 4 patients. CT was rechecked during the postoperative follow-up. The imaging showed that the orbital and nasal lesions were obviously relieved or disappeared.

CONCLUSIONSThe orbital complications of acute rhinosinusitis in adults are clinically rare. The patients are usually with low immunity or underlying conditions, such as diabetes. Based on the basis of controlling basic diseases, the treatment outcome of orbital complications of acute rhinosinusitis in adults is affirmative by surgery and conservative managements.

Acute Disease ; Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Orbital Diseases ; etiology ; Retrospective Studies ; Sinusitis ; complications ; surgery ; Young Adult

Dermoid tumors in the medial canthal area are rare, but when present they commonly adhere to the lacrimal canaliculi. Three patients presented with a mass in the medial canthal area. The authors performed excisional biopsies, and the masses were diagnosed as dermoid tumors. In two patients, canalicular lacerations were found after mass excision, which suggested that the masses had been firmly adherent to the lacrimal canaliculi. The lacerated canaliculi were repaired after bicanalicular silicone intubation. In the remaining patient, lacrimal silicone intubation was performed at the beginning of surgery, and the mass was successfully dissected from the canaliculi, leaving them intact. Excision of dermoid tumors in the medial canthal area requires careful dissection to avoid canalicular laceration. Bicanalicular silicone intubation at the beginning of surgery is helpful for the identification of the canaliculi and for the prevention of canalicular laceration during dermoid tumor excision.
Adolescent ; Adult ; Dermoid Cyst/pathology/*surgery ; Female ; Humans ; Intubation ; Lacrimal Apparatus Diseases/pathology/*surgery ; Male ; Middle Aged ; Orbital Neoplasms/pathology/*surgery ; Postoperative Care ; Preoperative Care ; Silicones