-
BMC Neurology Apr 2020Cavernous hemangioma of the orbit is a benign tumor mostly located behind the eye globe, but it rarely spread into the brain, which is called cerebral cavernous...
BACKGROUND
Cavernous hemangioma of the orbit is a benign tumor mostly located behind the eye globe, but it rarely spread into the brain, which is called cerebral cavernous malformation as well, the lesion in the brain is irregular and enlarged blood. Here we report one particular case of craniorbital cavernous hemangioma.
CASE PRESENTATION
A 53-year-old woman presented with exophthalmos of the right eye and reduced vision. Computerized tomographical (CT) scan showed osteolytic honeycomb radial changes of the outer plate of the skull. A magnetic resonance imaging (MRI) scan was performed to obtain further details. T1-weighted (T1W) imaging showed slightly low signal mixed with small patchy high signal. T2-weighted (T2W) imaging showed uneven high signal. There was obvious enhancement in the middle and no enhancement in the peripheral bars. A surgically manage was performed using a left frontotemporal approach, the tumor excised fully, and the histopathology results revealed a cavernous hemangioma. The patient recovered well in the follow-up. Post-operative CT scan identified the lesion was successfully resected, MRI scan also showed full resection and enhanced signal from the presence of fat.
CONCLUSIONS
Craniorbital cavernous hemangioma is uncommon, however within the cranium, they can lead to numerous complications particularly if affecting the visual apparatus. it could be diagnosed by imaging, which CT scan shows osteolytic honeycomb radial changes of the outer plate of the skull, T1W imaging shows slightly low signal mixed with small patchy high signal, T2W imaging shows uneven high signal, it is obvious enhancement in the middle and no enhancement in the peripheral bars. The surgically manage is the ideally treatment when there are some symptoms.
Topics: Female; Hemangioma, Cavernous; Humans; Magnetic Resonance Imaging; Middle Aged; Orbit; Tomography, X-Ray Computed
PubMed: 32321464
DOI: 10.1186/s12883-020-01734-z -
Scientific Reports Apr 2022The Active Pulley Hypothesis (APH) is based on modern functional anatomical descriptions of the oculomotor plant, and postulates behaviors of the orbital pulleys...
The Active Pulley Hypothesis (APH) is based on modern functional anatomical descriptions of the oculomotor plant, and postulates behaviors of the orbital pulleys proposed to be positioned by the extraocular muscles (EOMs). A computational model is needed to understand this schema quantitatively. We developed and evaluated a novel biomechanical model of active horizontal rectus pulleys. The orbital (OL) and global (GL) layers of the horizontal rectus EOMs were implemented as separate musculoskeletal strands. Pulley sleeves were modeled as tube-like structures receiving the OL insertion and suspended by elastic strands. Stiffnesses and orientations of pulley suspensions were determined empirically to limit horizontal rectus EOM side-slip while allowing anteroposterior pulley travel. Independent neural drives of the OL greater than GL were assumed. The model was iteratively refined in secondary gazes to implement realistic behavior using the simplest mechanical configuration and neural control strategy. Simulated horizontal rectus EOM paths and pulley positions during secondary gazes were consistent with published MRI measurements. Estimated EOM tensions were consistent with the range of experimentally measured tensions. This model is consistent with postulated bilaminar activity of the EOMs, and the separate roles of the GL in ocular rotation, and OL in pulley positioning.
Topics: Eye; Eye Movements; Magnetic Resonance Imaging; Oculomotor Muscles; Ophthalmologic Surgical Procedures; Orbit
PubMed: 35388039
DOI: 10.1038/s41598-022-09220-x -
Acta Otorhinolaryngologica Italica :... Apr 2021
Review
Topics: Humans; Orbit; Paranasal Sinus Neoplasms; Skull Base Neoplasms
PubMed: 34060523
DOI: 10.14639/0392-100X-suppl.1-41-2021-08 -
Eye (London, England) Feb 2023To evaluate the clinical features of developmental cysts of the orbit.
PURPOSE
To evaluate the clinical features of developmental cysts of the orbit.
PATIENTS AND METHODS
Retrospective study of patients who had excision of cysts between 1992 and 2020.
RESULTS
Three hundred and 58 patients (189 male; 53%) with orbital developmental cysts were identified, all being unilateral. Age at surgery varied from birth to 77 years (mean 17, median 18 years) and the average symptom duration was 5 years (median 18 months; range 1 day-50 years). The commonest presenting features were a peribulbar lump or upper lid swelling, followed by proptosis, pain, diplopia and reduced vision. Most patients (82%) had a palpable mass, with epidermoids, sebaceous dermoids and keratinised dermoids commonly affecting the superotemporal quadrant, and conjunctiva-containing cysts usually being biased to a medial location. Cysts were lined by keratinised epithelium with dermal structures (224/358; 63%), non-keratinised epithelium with dermal structures (69/358; 19%), epidermis without identifiable dermal structures (19/358 'epidermoids'; 5%), conjunctiva (12/358; 3%), respiratory epithelium (4/358; 1%), or mixed dermal and conjunctival epithelia (30/358 'dermo-conjunctival' cysts; 8%). Overall, two-thirds (242/358; 66%) had histological evidence of chronic intramural inflammation, and a half of cysts showed granuloma formation (178/358 cysts). Chronic inflammation was less common with conjunctival cysts (54%, 7/12 patients) and none showed granuloma formation.
CONCLUSION
Developmental cysts of the orbit vary from the relatively common dermoid cysts to the extremely rare respiratory epithelial-lined cysts. Respiratory cysts, being deeper, may present late in life and cysts containing conjunctival epithelium tend to be less inflamed and typically favour the superonasal quadrant.
Topics: Humans; Male; Orbit; Dermoid Cyst; Retrospective Studies; Orbital Diseases; Conjunctival Diseases; Eye Neoplasms; Inflammation; Granuloma
PubMed: 35064209
DOI: 10.1038/s41433-022-01929-3 -
Eye (London, England) Aug 2023Breast cancer is the most common cancer to spread to the choroid and orbit. Depending on a set of prognostic and predictive biomarkers, breast cancer can be divided into...
BACKGROUND
Breast cancer is the most common cancer to spread to the choroid and orbit. Depending on a set of prognostic and predictive biomarkers, breast cancer can be divided into at least four distinct subtypes with separate treatment and clinical course.
SUBJECTS
Thirty-two patients with metastases to the eye and periocular area diagnosed between 2005 and 2020, of which 11 also had primary tumour tissue available. Expression levels of oestrogen- (ER) and progesterone receptors (PR), Human epidermal growth factor receptor 2 (HER2) and the proliferation marker Ki67 were analysed.
RESULTS
Twenty-five of 32 patients (78%) had a history of primary breast cancer, whereas the remaining 7 (22%) presented with metastatic disease. Of available metastases, 83% were positive for ER, 37% for PR, 54% for HER2, and 50% for Ki67. Metastases had significantly lower proportions of PR-positive cells than primary tumours, and the distribution of the Luminal A, Luminal B, HER2 enriched and triple-negative subtypes differed between primary tumours and metastases (P = 0.012): Six of 9 patients with a full set of biomarkers on both primary tumours and metastases switched subtype (67%), and 23 of 32 metastases (77%) were of the Luminal B subtype.
CONCLUSIONS
Nearly 4 in 5 breast cancer metastases in the eyes and orbit are of the Luminal B subtype, and a majority are HER2 positive. The breast cancer subtype frequently switches between primary tumours and metastases. Future studies should evaluate these results in larger cohorts.
Topics: Humans; Female; Breast Neoplasms; Biomarkers, Tumor; Ki-67 Antigen; Orbit; Orbital Neoplasms
PubMed: 36517577
DOI: 10.1038/s41433-022-02363-1 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2021The aim: To clarify the sources and determine the chronological sequence of the germs of anatomical structures of the orbit at the early period of human ontogenesis.
OBJECTIVE
The aim: To clarify the sources and determine the chronological sequence of the germs of anatomical structures of the orbit at the early period of human ontogenesis.
PATIENTS AND METHODS
Materials and methods: Using a complex of methods of morphological examination (morphometry, microscopy, three-dimensional computer reconstruction and statistical analysis) 30 series of consecutive histological sections of human embryos and prefetuses aged from 3 till 8 weeks od IUD (3.0-30.0 mm parietal-coccygeal length (PCL)) were studied.
RESULTS
Results: At the 4rd week of IUD the orbital region is represented by the place of close contact of the neuroectoderm of the optic vesicle with the adjacent integumentary ectoderm,as well as the mesenchyme surrounding this place of contact. In embryos of 4.0 mm PCL, the rudiment of the optic stalk is observed as a result of the transformation of the junction of the area of the eye rudiment with the brain.
CONCLUSION
Conclusions: 1. The rudiments of the organ of vision (lens placodes) appear in the 4rd week of IUD. At the 5th week of IUD as a result of gradual intussusception of crystalline placodes into the adjacent mesenchyme, lens pit are formed, and then - lens vesicles. 2. Rudiments of the extraocular muscles (except for the inferior oblique muscle) was detected at the end of the 5th week of IUD. The rudiment of the inferior oblique muscle develops from a single mesodermal islet located in the mesenchyme medially and below the eyeball. Simultaneously with the rudiments of the extraokular muscles, the trochlear and abductor nerves are develop and ingrown into the orbit. 3. The development of blood vessels of the orbit occurs from two sources - from the islands of local angiogenesis, which begins in the 5th week of IUD, and from extraorganic vessels, which can be traced in the form of a vascular network at the end of the 6th week of IUD. The combination of both sources is observed at the end of the 7th week of IUD. 4. The embryonic period of ontogenesis is the first critical period in the development of the human orbit, due to the formation of the muscles, nerve and vascular structures.
Topics: Aged; Eye; Humans; Morphogenesis; Orbit
PubMed: 33813468
DOI: No ID Found -
Korean Journal of Ophthalmology : KJO Aug 2019Orbital exenteration is a psychologically and anatomically disfiguring procedure which indicated in some patients with malignant or progressive diseases of orbital and...
PURPOSE
Orbital exenteration is a psychologically and anatomically disfiguring procedure which indicated in some patients with malignant or progressive diseases of orbital and periorbital area. In this study, we reviewed 176 patients that underwent orbital exenteration.
METHODS
This was a retrospective study of medical records from all patients who underwent orbital exenteration from March 1991 to March 2014 in oculoplastic department at an eye care center. Demographic data, diagnosis, site of primary involvement and technique of surgery were determined in patients.
RESULTS
One hundred seventy-six cases of orbital exenteration were included that had documented histopathology. The age of patients ranged from 1 to 91 years (mean age ± standard deviation, 55.43 ± 27 years). Ninety-seven (55.11%) males and 79 (44.88%) females were included. Fifteen different tumors were identified. The most common indication was patients with basal cell carcinoma 49 (28%) followed by 41 (23.5%) squamous cell carcinomas, 35 (20%) retinoblastoma, and 13 (7%) adenoid cystic carcinomas. In total, adnexal malignancies were the most common tumors, secondarily involving the orbit. Eyelids 89 (50.5%) and the globe 43 (24%) were the most frequent site of involvement. Three types of exenteration were performed, based on available data of 129 operation sheets, 46 (35.7%) subtotal, 62 (48.1%) total, and 21 (16.3%) cases of extensive exenterations. In total 97 cases were evaluated pathologically for perineural involvement, of which perineural invasion was noted in 9 (7%) reports.
CONCLUSIONS
Frequency of exenteration in our center has increased in past 3 years and the majority of cases were eyelid basal cell carcinoma. Patient education considering periocular lesions can help in earlier diagnosis of malignant lesions and therefore reducing the number of exenteration.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Eye Neoplasms; Female; Follow-Up Studies; Forecasting; Humans; Infant; Male; Middle Aged; Orbit; Orbit Evisceration; Retrospective Studies; Young Adult
PubMed: 31389213
DOI: 10.3341/kjo.2018.0052 -
Pain Physician Jan 2022Previous studies of variations of the infraorbital foramen (IOF) demonstrated conflicting results regarding to the side and gender in which specific variations occur....
BACKGROUND
Previous studies of variations of the infraorbital foramen (IOF) demonstrated conflicting results regarding to the side and gender in which specific variations occur. Significant differences in some measurement points between genders have been found, whereas, other studies did not report such differences. The presence of an accessory IOF (AIOF) can result in incomplete anesthesia or treatment failure. Previous studies have demonstrated variable results regarding the prevalence of an AIOF ranging from 16.9% to 47.6%.
OBJECTIVES
The purpose of this study was to perform a morphological and morphometric study of the IOF and AIOF based on images of 3-dimensional (3D) facial bone computed tomography (CT) scans.
STUDY DESIGN
Retrospective study.
METHODS
Identification and analysis of patients who have undergone facial bone 3D CT were performed using Clinical Data Warehouse v 2.5 (CDW, Planit Healthcare, Seoul, Korea). The search term that we used with the CDW for analysis was "facial bone 3D CT."First, the region below the infraorbital rim was examined to determine the presence of the IOF and AIOF. Second, the shape of the IOF was determined and categorized as circular or oval. Third, the vertical (VD) and horizontal (HD) diameters of the IOF were determined. Lastly, the distances between important anatomic landmarks and the IOF were measured.
RESULTS
A single IOF with a circular shape was most common. The HD and VD of the IOF were significantly larger in men than in women. The distance between the IOF and the infraorbital margin was similar between men and women. The distances measured from the lateral nasal aperture (LNA) to the IOF and the anterior nasal spine (ANS) to the IOF, at both sides, were significantly shorter in women than in men. The prevalence of the AIOF on the right and left side was 7.3% and 8.9%, respectively. The most commonly observed position of the AIOF was on the inferior medial side of the IOF.
LIMITATIONS
This study had an imbalance in the number of male and female patients.
CONCLUSIONS
The size of the IOF was larger in men than in women. The distance of the IOF from the infraorbital margin was similar for men and women, whereas, the distances between the IOF and the ANS and the IOF and LNA were shorter in women than in men.
Topics: Female; Humans; Male; Maxilla; Orbit; Republic of Korea; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 35051160
DOI: No ID Found -
World Neurosurgery Jun 2022The endoscopic endonasal approach (EEA) was originally performed to treat thyroid orbitopathy and proptosis. Since then, this approach also has been used to treat other... (Review)
Review
OBJECTIVE
The endoscopic endonasal approach (EEA) was originally performed to treat thyroid orbitopathy and proptosis. Since then, this approach also has been used to treat other causes of proptosis. This review systematically identifies surgical outcome and complication rates in patients without thyroid proptosis who underwent endoscopic endonasal orbital decompression.
METHODS
Databases were searched using the following search terms: orbital disease, surgical decompression, and endoscopic endonasal approach. Two independent reviewers screened all abstracts and titles for relevance and all articles passing this screen were subjected to full-text review. To assess risk of bias, we used ROBINS-I (Risk Of Bias in Non-randomized Studies-of Interventions).
RESULTS
Eight studies with a total of 74 patients with nonthyroid proptosis were included. Pre- and postoperative eye examination was performed in all studies, but the extent of examination was varying. With a mean age of 35.7 years, most patients were adolescent, and most pathologies induced unilateral proptosis Complications to EEA for orbital decompression were transient diplopia (5 patients/6.8%), transient facial dysesthesia (2 patients/2.7%), ptosis (1 patient/1.4%), infarction (1 patient/1.4%), sinus obstruction (1 patient/1.4%), and enophtalmos (1 patient/1.4%). The authors reported successful reduction of proptosis in all but 2 patients (97.2%), and only 2 authors reported a need for secondary decompression.
CONCLUSIONS
Medial orbital decompression using EEA is a feasible approach for orbital decompression in patients with nonthyroid proptosis. While being comparable in primary outcome to transorbital approaches, the EEA seems superior in terms of complication rates.
Topics: Adolescent; Adult; Decompression, Surgical; Endoscopy; Exophthalmos; Graves Ophthalmopathy; Humans; Orbit; Retrospective Studies; Treatment Outcome
PubMed: 35331947
DOI: 10.1016/j.wneu.2022.03.075 -
BMC Ophthalmology Jul 2023The grease-guns injury is an uncommon injury to the orbit. We present the twelfth and thirteenth cases of grease-gun injury to the orbit to be reported in the English... (Review)
Review
BACKGROUND
The grease-guns injury is an uncommon injury to the orbit. We present the twelfth and thirteenth cases of grease-gun injury to the orbit to be reported in the English language literature since 1964. Here we discus and review the presentation, investigation, and treatment of this unusual trauma.
CASE PRESENTATION
Case 1 was a 29-year-old man who presented 1 day after a grease-gun injury of the left orbit with severe pain, marked periorbital swelling, and proptosis. Computed tomography (CT) revealed penetration of grease into his left orbit. Following surgical removal, proptosis decreased. The limitation of extraocular movement and loss of visual acuity to finger count was discovered after the initial surgery. Motility gradually returned. Visual acuity recovered after phacoemulsification, capsular tension ring and intraocular lens implantation for traumatic cataract and subluxation. Case 2 was a 6-year-old boy who was referred 2 months after a grease-gun injury for worsening swelling with sinus, necrosis and slight ptosis of the upper left eyelids. This is a case of orbital chronic inflammation from grease-gun injuries masquerading as orbital cellulitis. The imaging findings of CT and magnetic resonance imaging (MRI) are not typical. Surgical exploration and debridement was inevitable and actually relieved the symptoms.
CONCLUSIONS
Grease-gun injuries can damage the orbit in different degrees. Careful history inquiry and taking is important to establish the diagnosis. Imaging examinations using CT or MRI are helpful to determine depth of trauma and foreign bodies in the orbit at diagnosis. We suggest that surgical exploration and debridement is a key step in the management.
Topics: Male; Humans; Child; Adult; Orbit; Firearms; Eye Foreign Bodies; Eye Injuries, Penetrating; Hydrocarbons; Exophthalmos
PubMed: 37452303
DOI: 10.1186/s12886-023-03032-x