Choristoma ; pathology ; surgery ; Dermoid Cyst ; diagnosis ; Diagnosis, Differential ; Dissection ; methods ; Eyelids ; pathology ; Hemangioma ; diagnosis ; Humans ; Infant, Newborn ; Male ; Neuroglia ; pathology ; Orbit ; diagnostic imaging ; Orbital Neoplasms ; diagnosis ; Treatment Outcome ; Ultrasonography ; methods

To compare diagnostic value of 4 kinds of target-to-nontarget ratio (T/NT), and to choose a better one to assess thyroid associated ophthalmopathy (TAO) activity.
 Methods: The clinical data were collected for 29 newly-diagnosed patients (58 eyes) with TAO who underwent orbital 99mTc-DTPA single photon emission computed tomography/computed tomography (SPECT/CT) fusion images according to the clinical activity score (CAS). They were divided into an active group (18 cases, 36 eyes), an inactive group (11 cases, 22 eyes), and a control group (9 cases, 18 eyes). Diagnostic value of orbital/occipital lobe radioactive uptake count ratio (T/NT1), orbital/occipital radioactive uptake count ratio (T/NT2), orbital/thalamus radioactive uptake count ratio (T/NT3), and orbital/cerebellar radioactivity uptake count ratio (T/NT4) were calculated, and the CAS of Spearman rank correlation and receiver operating characteristic (ROC) curve were analyzed.
 Results: T/NT1, T/NT2 and CAS were correlated (r1=0.873, r2=0.527; P<0.001), with the better correlation between T/NT1 and CAS and there was no correlation between T/NT3, T/NT4 and CAS (r3=0.039, r4=0.090; P>0.05). Area under the ROC curve of T/NT1 was 0.860, area under the ROC curve of T/NT2 was 0.581, and the accuracy for T/NT1 on TAO activity was good. T/NT1=9.74 could be used as active threshold for judge of TAO in patients.
 Conclusion: There is a good correlation between T/NT1 and CAS. TAO activity assessment possesses high diagnostic value, and SPECT/CT together with imaging anatomical location is more accurate.
Case-Control Studies ; Graves Ophthalmopathy ; diagnostic imaging ; Humans ; Orbit ; diagnostic imaging ; ROC Curve ; Radiopharmaceuticals ; Statistics, Nonparametric ; Technetium Tc 99m Pentetate ; Tomography, Emission-Computed, Single-Photon ; methods

Virtual surgical planning (VSP) has recently been introduced in craniomaxillofacial surgery with the goal of improving efficiency and precision for complex surgical operations. Among many indications, VSP can also be applied for the treatment of congenital and acquired craniofacial defects, including orbital fractures. VSP permits the surgeon to visualize the complex anatomy of craniofacial region, showing the relationship between bone and neurovascular structures. It can be used to design and print using three-dimensional (3D) printing technology and customized surgical models. Additionally, intraoperative navigation may be useful as an aid in performing the surgery. Navigation is useful for both the surgical dissection as well as to confirm the placement of the implant. Navigation has been found to be especially useful for orbit and sinus surgery. The present paper reports a case describing the use of VSP and computerized navigation for the reconstruction of a large orbital floor defect with a custom implant.
Adult ; Female ; Humans ; Ketones ; Orbit ; diagnostic imaging ; injuries ; surgery ; Polyethylene Glycols ; Printing, Three-Dimensional ; Reconstructive Surgical Procedures ; methods ; Surgery, Computer-Assisted ; methods ; Tomography, X-Ray Computed

Bone Cysts, Aneurysmal ; diagnosis ; diagnostic imaging ; Female ; Humans ; Middle Aged ; Orbit ; Tomography, X-Ray Computed

OBJECTIVETo evaluate the efficiency of navigation system for orbital wall reconstruction in unilateral orbital fractures.

METHODSFifteen patients (7 male and 8 female) with unilateral orbital fracture underwent orbital reconstruction with the help of intraoperative navigation system. The average age was 34.3 ± 9.5 years. All patients underwent spiral CT scanning preoperatively, and the CT data was imported to the BrainLab navigation system (Germany, BrainLab company). The orbit of the intact side was mirrored to the opposite side as the reference for pre-operative planning. The titanium mesh was mounted on the resin template made by rapid prototyping machine based on the mirrored CT data. When the injury was limited, the hydroxyapatite sheet was used for the orbital wall reconstruction. During the operation, the real-time navigation helped to ensure precise placement. The re-establishing result was assessed based on the postoperative CT data with the following four variables: the volumetric difference between the bilateral orbit, the volume of the herniated soft tissue, the global projection and the discrepancy between the simulated and the achieved position of the reconstructed orbital wall. The reconstructive discrepancy was measured only in the titanium plate grafting cases.

RESULTSThere were no serious complications such as infection, graft rejection and optic nerve injury in any case. Preoperatively, the average degree of enophthalmos was (3.5 ± 1.6) mm, the average volumetric difference between the injured and the unaffected orbit was (4.5 ± 1.8) ml, and the average volume of the herniated orbital soft tissue was (2.1 ± 0.7) ml. Postoperatively, the three values were respectively reduced to (1.3 ± 0.6) mm, (1.8 ± 0.9) ml and (0.7 ± 0.3) ml. The discrepancy of the medial and inferior wall were (2.5 ± 0.6) mm and (2.1 ± 0.4) mm.

CONCLUSIONSThe intraoperative use of navigation system for the orbital wall reconstruction in unilateral orbital fractures can provide reliable accuracy and achieve satisfactory results.

Adult ; Computer Simulation ; Enophthalmos ; diagnostic imaging ; etiology ; surgery ; Female ; Humans ; Male ; Orbit ; diagnostic imaging ; surgery ; Orbital Fractures ; complications ; diagnostic imaging ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgery, Computer-Assisted ; Surgical Mesh ; Titanium ; Tomography, X-Ray Computed

OBJECTIVE: To evaluate the surgical method and intraorbital foreign body extraction. METHODS: Individualized plan was made based on radiology and foreign body extraction was performed in 27 cases (27 eyes). The outcome of extraction was analyzed. Visual acuity, eye movement, and ptosis were recorded before and after the operation. RESULTS: Intraorbital foreign bodies in the 27 eyes were extracted successfully, 24 eyes (88.9%) extracted once and the other 3 eyes (11.1%) twice. The follow-up was 3-24(9.39±6.25) months. Visual acuity increased in 13 eyes (48.1%), and invariable in 13 eyes (48.1%) at the last follow-up. Disturbance of eye movement was found in 18 (66.7%) and 15 (55.5%) eyes before and after the extraction, respectively. Ptosis was found in 2 eyes (7.4%) and 1 eye (3.7%) before and after the extraction, respectively. CONCLUSION Individualized plan is helpful for the intraorbital foreign body extraction and eye recovery.
Adolescent ; Adult ; Aged ; Child ; Female ; Follow-Up Studies ; Foreign Bodies ; diagnostic imaging ; surgery ; Humans ; Male ; Middle Aged ; Orbit ; diagnostic imaging ; surgery ; Radiography ; Visual Acuity ; Young Adult

OBJECTIVE: To explore morphological classification of the Caldwell view of frontal sinuses in computer radiography (CR) for forensic identification and to construct a forensic identification system with digital X-ray films with assistance of identification indexes coding. METHODS: Four hundred CR films of the Caldwell view of frontal sinus were selected from Sichuan Han ethnic Chinese. The frontal sinuses were classified according to the relationship between the tangential line above the upper edge of the bilateral orbits and the location of the frontal sinus. Then to code the identification indexes for the frontal sinus. RESULTS: The Caldwell view of frontal sinuses were classified into 6 categories. Eight identification indexes for the frontal sinus were identified, including degree of asymmetry, superiority of side, ratio of the left frontal sinus area and orbit area (A(LFS)/A(LOR)), ratio of the right frontal sinus area and orbit area ((RFS)/A(ROR)), outline of the left upper border, outline of the right upper border, occurrence of partial septa and location of frontal median margin. CONCLUSION Initial identification by the Caldwell view classification of frontal sinuses followed with coding the frontal sinuses with 8 indexes is likely a novel approach for forensic identification of the frontal sinuses in CR.
Adult ; Asian People ; China ; Female ; Forensic Anthropology/methods* ; Frontal Sinus/diagnostic imaging* ; Humans ; Male ; Middle Aged ; Orbit/diagnostic imaging* ; Reference Values ; Sex Characteristics ; Sex Factors ; Tomography, X-Ray Computed/methods* ; Young Adult

OBJECTIVETo evaluate the accuracy of measurement of the globe proptosis by CT in patients with unilateral orbital fracture.

METHODS25 patients with unilateral orbital fracture were included. CT was performed before and after operation. The globe proptosis on the unaffected side was measured before and after operation by using Hertel exophthalmometer (HE), CT images with orbital lateral rim (OLR) and the optic nerve foramen (ONF) as reference points. The accuracy was evaluated comparably by statistical analyses.

RESULTSThe preoperative and postoperative average globe proptosis were (13.9 +/- 3.1) mm and (12.5 +/- 2.2) mm in HE group, (16.1 +/- 2.6) mm and (15.7 +/- 2.3) mm in the OLR group, (45.3 +/- 4.8) mm and (46 +/- 3.9) mm in the ONF group, showing a significant difference between the pre-and post-operative results in HE group, but not in OLR and ONF groups.

CONCLUSIONSCT measurement with the orbital lateral rim as reference point is more reliable than Hertel exophthalmometer measurement for globe proptosis.

Adolescent ; Adult ; Exophthalmos ; diagnostic imaging ; Humans ; Middle Aged ; Orbit ; diagnostic imaging ; Orbital Fractures ; diagnostic imaging ; Tomography, X-Ray Computed ; methods ; Young Adult

Adult ; Head Injuries, Penetrating ; diagnostic imaging ; etiology ; surgery ; Humans ; Male ; Orbit ; injuries ; Tomography, X-Ray Computed

OBJECTIVETo distinguish trochlear calcification and intraorbital foreign body after eye injury in order to avoid misdiagnosis as well as mistreatment.

METHODSThe orbital CT images of 403 patients, who visited the Eye Hospital or the Second Affiliated Hospital of Wenzhou Medical College during May 2005-April 2007, were reviewed. The diagnosis of trochlear calcification and intraorbital foreign body was made together by a skilled radiologist as well as an ophthalmologist. General information and CT characteristics in the patients with trochlear calcification were collected.

RESULTSUsing CT scan images, 27 among 403 patients (6.69%) were identified with trochlear calcification. Three patients (3/27, 11.11%) were misdiagnosed by radiologists as intraorbital foreign body. Among the 27 patients with trochlear calcification, 23 (85.19%) were male and 4 (14.81%) were female, with an unilateral calcification in 7 patients (7/27, 25.93%) and bilateral in 20 (74.07%) . The highest occurrence of trochlear calcification was in 31-40 years old group (13/403, 3.23%) which reached to 12.87% (13/101) after age-correction. There were 3 types of trochlear calcification on the basis of CT images: commas, dot and inverted "U".

CONCLUSIONSThe trochlear calcification is not an uncommon phenomenon and should not be diagnosed as intraorbital foreign body, especially when it co-exists with eye injury in 31-40 years old group. Injury history and our classification method on the basis of CT images could help to avoid misdiagnosis.

Adolescent ; Adult ; Aged ; Calcinosis ; diagnostic imaging ; etiology ; Child ; Child, Preschool ; Eye Foreign Bodies ; diagnostic imaging ; etiology ; Eye Injuries ; complications ; diagnostic imaging ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Orbit ; diagnostic imaging ; Orbital Diseases ; diagnostic imaging ; etiology ; Tomography, X-Ray Computed