A 14-year-old Maltese dog presented with progressive exophthalmos and external deviation of the right eye. Ultrasonography revealed the presence of a retrobulbar mass and fine-needle aspiration cytology was performed, which detected a malignant mass. There was no evidence of metastasis on thoracic and abdominal radiography. Computed tomography showed no invasion into the bony orbit and no metastasis to the lung or lymph nodes. Exenteration was performed to remove the mass completely. Malignant peripheral nerve sheath tumor was confirmed by histopathological examination.
Adolescent ; Animals ; Biopsy, Fine-Needle ; Dogs ; Exophthalmos ; Humans ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Neurilemmoma* ; Orbit* ; Peripheral Nerves ; Radiography, Abdominal ; Recurrence* ; Ultrasonography

PURPOSE: There are marked differences in facial skeletal characteristics between Asian and Caucasian. However, ethnic differences in age-related facial skeletal changes have not yet been fully established. The aims of this study were to evaluate age-related changes in Asian midfacial skeletons and to explore ethnic differences in facial skeletal structures with aging between Caucasian and Asian. MATERIALS AND METHODS: The study included 108 men (aged 20-79 years) and 115 women (aged 20-81 years). Axial CT images with a gantry tilt angle of 0 were analyzed. We measured three-dimensional (3D) coordinates at each point with a pixel lens cursor in a picture archiving and communication system (PACS), and angles and widths between the points were calculated using 3D vector mathematics. We analyzed angular changes in 4 bony regions, including the glabellar, orbital, maxillary, and pyriform aperture regions, and changes in the orbital aperture width (distance from the posterior lacrimal crest to the frontozygomatic suture) and the pyriform width (between both upper margins of the pyriform aperture). RESULTS: All 4 midfacial angles in females and glabellar and maxillary angles in males showed statistically significant decreases with aging. On the other hand, the orbital and pyriform widths did not show statistically significant changes with aging. CONCLUSION: The results of this study suggest that Asian midfacial skeletons may change continuously throughout life, and that there may be significant differences in the midfacial skeleton between both sexes and between ethnic groups.
Adult ; Aged ; Aging/ethnology/*physiology ; Asian Continental Ancestry Group ; Facial Bones/*anatomy & histology/*radiography ; Female ; Humans ; Image Processing, Computer-Assisted ; Male ; Mathematics ; Maxilla/anatomy & histology/radiography ; Middle Aged ; Orbit/anatomy & histology/radiography ; Radiology Information Systems ; Republic of Korea ; Tomography, X-Ray Computed/*methods ; Young Adult ; Zygoma/anatomy & histology/radiography

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

PURPOSE: The authors report a case of orbital sarcoidosis without evidence of systemic involvement. CASE SUMMARY: A 33-year-old female had a 1 month history of erythematous eyelid swelling. On physical examination, a firm and non-tender mass was observed diffusely along the upper, lower and medial canthal areas. A computed tomography (CT) scan showed a diffuse mass in the anterior orbit. We performed an incisional biopsy and histopathological examination revealed non-caseating granulomas and no evidence of a foreign body. Acid-fast-bacilli (AFB), methenamine silver and periodic-acid-schiff (PAS) stain showed no evidence of infection and chest radiograph was normal. Polymerase chain reaction (PCR) and interferon gamma secretion test showed no evidence of tuberculosis. Antinuclear antibody (ANA) and antineutrophil cytoplasmic antibody (ANCA) were negative and angiotensin converting enzyme (ACE) was within the normal range. Further systemic evaluations were compatible with a diagnosis of orbital sarcoidosis and oral prednisone was prescribed. Six weeks later, the erythematous eyelid swelling had disappeared and there was no evidence of recurrence to date.
Adult ; Antibodies, Antineutrophil Cytoplasmic ; Antibodies, Antinuclear ; Biopsy ; Diagnosis ; Eyelids ; Female ; Foreign Bodies ; Granuloma ; Humans ; Interferons ; Methenamine ; Orbit* ; Peptidyl-Dipeptidase A ; Physical Examination ; Polymerase Chain Reaction ; Prednisone ; Radiography, Thoracic ; Recurrence ; Reference Values ; Sarcoidosis* ; Tuberculosis

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

Child ; Edema ; diagnostic imaging ; etiology ; Emphysema ; diagnostic imaging ; etiology ; Ethmoid Bone ; diagnostic imaging ; injuries ; Eyelid Diseases ; diagnostic imaging ; etiology ; Humans ; Male ; Orbit ; diagnostic imaging ; Orbital Diseases ; diagnosis ; diagnostic imaging ; pathology ; Radiography ; Skull ; diagnostic imaging ; pathology ; Skull Fractures ; complications ; diagnostic imaging

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

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.

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