PURPOSE: To evaluate the preoperative ocular motility disorder and to study the relationship between motility disorder and morphologic change in blowout fracture. METHODS: The ocular motility disorders of 38 patients who had inferior wall orbital fracture were evaluated and classified using Hess test and quantified using field of biocular single vision (FBSV). The type and location of fracture and the morphologic changes of inferior rectus muscle was classified using computed tomography. RESULTS: In Hess test, up gaze disorder was found in 12 patients, down gaze disorder in 1, up and down gaze disorder in 21, and asymmetric disorder in 4. In up and down gaze disorder group, the FBSV score was significantly low (p<0.05) and the rate of entrapment or deviation of inferior rectus muscle was significantly high (p<0.05) in comparison with up gaze disorder group. CONCLUSIONS: The ocuar motility disorder induced by inferior wall orbital fracture could be evaluated using Hess test. The ocular motility disorder was more influenced by entrapment or deviation of inferior rectus muscle rather than the type or location of the fracture. Preoperative assessment of the ocular motility disorder could play an important role in evaluating the disorder of inferior rectus muscle and its treatment.
Humans ; Ocular Motility Disorders ; Orbital Fractures

BACKGROUND/AIMS: Radiofrequency ablation (RFA) and transarterial chemoembolization (TACE) have been applied for treating hepatocellular carcinoma (HCC), but procedure-related complications can be a serious problem. This study was conducted to evaluate the clinical features of HCC patients who developed liver abscess after RFA and TACE, as compared to those patients without malignancy. METHODS: In our center, from December 1999 to March 2004, 31 cases of liver abscess developed after local treatment of HCC (13/751 after RFA and 18/8417 after TAE), which correspond to 5.1% of the total cases (602) of liver abscess. We evaluated the patients' clinical features, the abscess characteristics, the bacteriology, treatment modality, hospital days and mortality, as compared to those characteristics of 263 abscess patients without malignancy. RESULTS: The time required to diagnose liver abscess was longer in the TACE group (24.8+/-16.5 days) compared to that of the other two groups (12.2+/-9.0 days in the RFA group, 9.6+/-7.5 days in the controls, P=0.001). Gas-forming liver abscess is most frequently found in the RFA groups (76.9%). There were more hospitalized days for the TACE groups than for the RFA group and the controls (34.7+/-19.8 vs. 15.2+/-9.2 vs. 18.6+/-10.9 days, respectively, P<0.001). Two patients (11%) in the TACE group died of sepsis and liver failure. CONCLUSIONS: For the patients with prolonged fever after RFA and especially after TACE for HCC, a diagnosis of liver abscess should be suspected earlier to reduce the morbidity and mortality due to liver abscess per se and also the sepsis-related decompensation of the liver.
Middle Aged ; Male ; Liver Neoplasms/surgery/*therapy ; Liver Abscess/diagnosis/*etiology/microbiology ; Humans ; Female ; Chemoembolization, Therapeutic/*adverse effects ; Catheter Ablation/*adverse effects ; Carcinoma, Hepatocellular/surgery/*therapy ; Aged ; Adult