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Lin Chuang Er Bi Yan Hou Tou Jing Wai... Feb 2022The aim of this study is to explore the treatment strategy of children's nasal orbital complications. The clinical data of 28 children with nasal orbital complications...
The aim of this study is to explore the treatment strategy of children's nasal orbital complications. The clinical data of 28 children with nasal orbital complications admitted to Dalian Children's Hospital from February 2018 to February 2021 were analyzed and summarized. Among the 28 children, 18 were males (64.3%), 10 females (35.7%), 16 cases of orbital cellulitis, 10 cases of orbital subperiosteal abscess, 1 case of intraorbital abscess, and 1 case of cavernous sinus thrombophlebitis. Of the children with orbital cellulitis, 2 cases were treated with surgery, 4 cases with orbital subperiosteal abscess were treated with surgery, and the children with intraorbital abscess and cavernous sinus thrombophlebitis were treated with surgery. All the children were cured, and the clinical follow-up was more than half a year. No recurrence occurred. Periorbital cellulitis is the most common type of orbital complications. After conservative treatment (3-7 days), most children can get good results. Once the visual acuity is progressively decreased, the infection becomes worse, the eyeball movement disorder and other symptoms occur at this time, surgical treatment should be actively considered, and the timing of surgery is very important for the prognosis.
Topics: Abscess; Anti-Bacterial Agents; Child; Female; Humans; Male; Nose; Orbital Cellulitis; Orbital Diseases; Retrospective Studies
PubMed: 35172552
DOI: 10.13201/j.issn.2096-7993.2022.02.012 -
Aesthetic Surgery Journal Jul 2021Since the emergence of the COVID-19 pandemic facecovers have become a common sight. The effect of facecovers on the gaze when looking at faces has not yet been assessed. (Observational Study)
Observational Study
BACKGROUND
Since the emergence of the COVID-19 pandemic facecovers have become a common sight. The effect of facecovers on the gaze when looking at faces has not yet been assessed.
OBJECTIVES
The aim of the present study was to investigate any potential differences in eye movement pattern in observers exposed to images showing a face without and with a facecover to identify if there is truly a change of gaze when identifying (masked) facial features.
METHODS
The eye movement of 64 study participants (28 males and 36 females) with a mean [standard deviation] age of 31.84 [9.0] years was analyzed in this cross-sectional observational study. Eye movement analysis was conducted based on positional changes of eye features within an x- and y-coordinate system while two images (face without/with facecover) were displayed for 8 seconds.
RESULTS
The results of this study revealed that the sequence of focusing on facial regions was not altered when wearing a facecover and followed the sequence: perioral, nose, periorbital. Wearing a facecover significantly increased the time spent focusing on the periorbital region and also increased the number of repeated eye fixations during the 8-second visual stimulus presentation. No statistically significant differences were observed between male and female participants in their eye movement pattern across all investigated variables (P > 0.433).
CONCLUSIONS
The altered eye movement pattern caused by wearing facecoverings that this study has revealed suggests that, during the COVID-19 pandemic, aesthetic practitioners might consider developing marketing and treatment strategies that principally target the periorbital area.
Topics: COVID-19; Child; Cross-Sectional Studies; Eye Movements; Female; Humans; Male; Pandemics; SARS-CoV-2
PubMed: 33693469
DOI: 10.1093/asj/sjab121 -
Cureus Apr 2021Paediatric orbital cellulitis is a potential sight- and life-threatening condition. It is a serious infection in children that can result in significant complications,...
Paediatric orbital cellulitis is a potential sight- and life-threatening condition. It is a serious infection in children that can result in significant complications, including blindness, cavernous sinus thrombosis, cerebral venous sinus thrombosis, meningitis, subdural empyema, and brain abscess. Of the patients with orbital cellulitis, 17% died from meningitis, and 20% of the survivors had permanent loss of vision. Therefore, the potential for sight- and life-threatening complications makes prompt diagnosis and early treatment very important. We report here a case of a two-year-old girl who presented with a three-day history of left periorbital swelling, preceded by left upper perioral swelling that extended upward to the left cheek and left lower lid and was associated with low-grade fever. The patient had been admitted and was treated as having left preseptal with facial cellulitis; the patient was started on intravenous amoxicillin/clavulanic acid (200 mg three times per day dose), and chloramphenicol ointment was applied to the periorbital area. On day 3, the condition worsened, and dental examination showed multiple dental caries, upper gum swelling and abscess, and mobility of teeth 61 and 62 (two baby teeth). Contrast-enhanced computed tomography (CECT) of the orbit, paranasal, and brain showed a left periosteal abscess collection extending to the inferomedial region of the orbit. Examination and tooth extraction were performed under general anesthesia. The intraoperative results showed the presence of a left upper gum abscess, which was possibly the primary source of infection. Clinical improvement was observed postoperatively. Orbital cellulitis can be a complication of a dental abscess. This case emphasizes the importance of primary tooth care in children. A lack of care can result in fatal complications.
PubMed: 33981511
DOI: 10.7759/cureus.14392 -
JAMA Ophthalmology Jan 2021Critically ill patients with coronavirus disease 2019 (COVID-19) who are unresponsive to maximum optimal ventilator settings may be in a prone position for at least 16...
IMPORTANCE
Critically ill patients with coronavirus disease 2019 (COVID-19) who are unresponsive to maximum optimal ventilator settings may be in a prone position for at least 16 hours per day to improve oxygenation. This extended duration of prone positioning puts patients at risk of developing orbital compartment syndrome if direct pressure to the orbit and the globe occurs and concomitant protection of the eyes is not undertaken.
OBJECTIVE
To report 2 cases of orbital compartment syndrome, as well as optic disc edema and retinal hemorrhages, in the setting of prolonged prone positioning of patients in the intensive care unit during the COVID-19 pandemic.
DESIGN, SETTING, AND PARTICIPANTS
The cases took place from April 27, 2020, to May 4, 2020, at a COVID-19 intensive care unit of a tertiary care hospital. Four of 16 patients in the intensive care unit required prolonged prone-position ventilation. A bedside eye examination was performed on 4 selected patients due to the observed presence of substantial periorbital edema.
MAIN OUTCOMES AND MEASURES
Intraocular pressures and fundus findings of 4 patients with periorbital edema.
RESULTS
Two of 4 patients who were in the prone position for extended periods of time had bilateral fundoscopic findings of optic disc edema and retinal hemorrhages, possibly consistent with a papillophlebitis. Additionally, both patients had a substantial increase in intraocular pressure of 2- to 3-fold in the prone position compared with the supine position.
CONCLUSIONS AND RELEVANCE
Prolonged prone positioning of patients with COVID-19 can be associated with elevated intraocular pressure from periorbital edema, direct compression on the eye, and increased orbital venous pressure. Orbital compartment syndrome can be avoided by the use of protective cushioning around the eyes and maintaining the patient's head position above heart level during prone positioning. Patients with COVID-19 may also develop papillophlebitis with optic disc edema and retinal hemorrhages, which may be associated with a hypercoagulable state caused by COVID-19. These observations suggest awareness for the possible presence of these ophthalmic findings while treating severely ill patients with COVID-19.
Topics: Adult; COVID-19; Compartment Syndromes; Critical Illness; Eye Protective Devices; Humans; Intraocular Pressure; Male; Middle Aged; Orbital Diseases; Patient Positioning; Prone Position; Respiration, Artificial; Time Factors; Treatment Outcome
PubMed: 33211075
DOI: 10.1001/jamaophthalmol.2020.4988 -
American Journal of Ophthalmology Case... Dec 2022To present a case of tattoo side effects not limited to the tattoo site and rise an alarm regarding using non-FDA-approved products.
PURPOSE
To present a case of tattoo side effects not limited to the tattoo site and rise an alarm regarding using non-FDA-approved products.
OBSERVATIONS
A 30-year-old female presented with bilateral ocular pain, dryness, and itching. The ocular exam showed bilateral injection and edema of the superior palpebral and bulbar conjunctiva. Several 1-2 mm dark pigmented lesions and papillae coursing along the upper palpebral conjunctival lid margin and 5 mm above the margin were found in both eyes. The ocular surface was dry with diffuse superficial punctate keratitis. The biopsy report showed granular foreign material in the dermis. SOX-10 and MART-1 immunostaining highlighted melanocyte distribution and the sample was diagnosed as exogenous pigment consistent with tattoo ink by the pathologist. On further investigation following the pathology report, the patient stated that she got bilateral permanent eyebrow tattoos 4 months before presentation in a country other than the United States, and she was not aware about the standards of the ink used, nor the certification of the person performing the tattoo. The patient denied any type of tattoo or manipulation on the eyes or orbit, including sclera or conjunctivae.
CONCLUSIONS
Importance: The complications of periorbital tattooing are not limited to the point tattoo location and can potentially spread to the nearby segments. It is notable that there is no FDA approved tattoo ink available, even with a certified tattoo artist performing the tattoo, the risks of inflammation, infection, and other side effects are still present.
PubMed: 36407011
DOI: 10.1016/j.ajoc.2022.101750 -
Cureus Dec 2022Periorbital cellulitis is an uncommon presentation to primary care and the emergency department. With multiple aetiologies, it is crucial that an appropriate history and...
Periorbital cellulitis is an uncommon presentation to primary care and the emergency department. With multiple aetiologies, it is crucial that an appropriate history and examination are applied to identify the primary cause and initiate therapy in a timely manner. We present a 30-year-old male who presented with recurrent periorbital cellulitis treated repeatedly with antibiotics without consideration of the origin of the infection. Subsequent investigations discovered a widely dehiscent mucopyocoele of the frontal sinus that had been unrecognised and untreated. Once identified, the patient underwent functional endoscopic sinus surgery to clear the mucopyocoele and improve the drainage of the frontal sinus. Symptoms have not recurred since the surgical intervention. A poor understanding of the aetiologies of periorbital cellulitis and the related anatomy likely played a role in his delayed definitive management. Clinicians should be aware that in a patient presenting with periorbital swelling and erythema, consideration should be given to the possibility of underlying sinonasal pathology.
PubMed: 36620801
DOI: 10.7759/cureus.32252 -
Dermatology and Therapy May 2022A few studies have evaluated the efficacy and safety of noninsulated radiofrequency microneedling (RFMN) to treat periorbital wrinkles in Asian patients. Recently, wound...
INTRODUCTION
A few studies have evaluated the efficacy and safety of noninsulated radiofrequency microneedling (RFMN) to treat periorbital wrinkles in Asian patients. Recently, wound healing accelerators, polynucleotides (PNs), have received attention in wound management. However, their efficacy and safety have not been fully elucidated following RFNM. This study aimed to evaluate the efficacy and safety of noninsulated RFMN for periorbital wrinkles and the synergistic effect of PNs after RFMN.
METHODS
Thirty subjects with Fitzpatrick skin types III to V and facial wrinkles (Fitzpatrick grades I and II) were enrolled. All volunteers were treated over the entire face with noninsulated RFMN for three sessions at 2-week intervals. The left and right sides of each patient's face were randomly assigned to receive PNs (treatment group) or normal saline solution (control group). The indentation and maximum depth of wrinkles were objectively measured using Antera 3D. Subjective self-evaluations were obtained at baseline, 2 weeks after the third treatment, and at 1, 2, 3, and 6 months after the final treatment. In addition, pain scores, immediate reactions, and other adverse effects were evaluated.
RESULTS
Twenty-nine subjects completed the treatment protocol. Most presented with grade II wrinkling (69%). At 2-month follow-up, Antera 3D image analysis revealed faster improvement for the treatment group. At 6-month follow-up, the majority of subjects reported an improvement of 25-75% in their periorbital wrinkles. The average pain score was 2.2 out of 10. No serious adverse events (infection, pigmentary alteration, persistent erythema, or scarring) were observed.
CONCLUSIONS
Noninsulated RFMN is safe and effective for treating periorbital wrinkles and can be used as a modality for transdermal drug delivery. Topical polynucleotides as an adjunctive treatment provide additional benefits for periorbital wrinkle treatment.
TRIAL REGISTRATION NUMBER
TCTR20201105007.
PubMed: 35501660
DOI: 10.1007/s13555-022-00729-7 -
Journal of Fungi (Basel, Switzerland) Nov 2022Invasive fungal rhinosinusitis (IFS) with orbital complications has remained a challenging disease over the past few decades. Only a few studies have been conducted to...
BACKGROUND
Invasive fungal rhinosinusitis (IFS) with orbital complications has remained a challenging disease over the past few decades. Only a few studies have been conducted to investigate the factors associated with orbital complications in fungal rhinosinusitis (FRS). We aimed to review the characteristics between IFS and non-invasive fungal rhinosinusitis (NIFS) and determine clinical factors associated with orbital complications and overall survival.
METHODS
A multi-institutional database review study was conducted using the Chang Gung Research Database (CGRD) from January 2001 to January 2019. We identified FRS patients using International Classification of Diseases diagnosis codes and SNOMED CT. We categorized patients into IFS and NIFS groups and analyzed the demographic data, underlying diseases, clinical symptoms, laboratory data, image findings, fungal infection status, and survival outcomes.
RESULTS
We included 1624 patients in our study, with 59 IFS patients and 1565 NIFS patients. The history of an organ or hematopoietic cell transplantation had a significant prognostic effect on the survival outcomes, with surgical intervention and high hemoglobin (Hb) and albumin levels recognized as positive predictors. Posterior ethmoid sinus involvement, sphenoid sinus involvement, facial pain, blurred vision, and periorbital swelling were risk factors of orbital complications.
CONCLUSIONS
In NIFS patients, orbital complications were found to be associated with old age, a high WBC count, high blood glucose, and a high CRP level. For the risk factors of orbital complications in IFS patients, posterior ethmoid sinus involvement, sphenoid sinus involvement, facial pain, blurred vision, and periorbital swelling were recognized as predictors. Among IFS patients, a history of organ or hematopoietic cell transplantation was a risk factor for poor survival, while, conversely, surgical intervention and high Hb and albumin levels were related to improved survival. As predictors of orbital complications in IFS patients, posterior ethmoid sinus involvement, sphenoid sinus involvement, facial pain, blurred vision, and periorbital swelling upon the first visit should raise attention, with close monitoring.
PubMed: 36547572
DOI: 10.3390/jof8121239 -
Cureus Jan 2022Herpes zoster infection is more frequent and severe in the immunocompromised population. Its incidence is significantly higher in this population when compared to...
Herpes zoster infection is more frequent and severe in the immunocompromised population. Its incidence is significantly higher in this population when compared to immunocompetent individuals. The authors present a case of an 88-year-old man with a history of arterial hypertension and myelodysplastic syndrome. The patient was evaluated in the emergency department (ED) for edema of the frontal facial region with left periorbital involvement and multiple purulent vesicles. He was diagnosed with viral infection by herpes zoster and was prescribed valaciclovir and deflazacort. He returned two days later due to an increase in the lesions affecting the left hemi-cranium, with decreased visual acuity and painless purulent drainage in the ipsilateral eye. The ophthalmological evaluation revealed exuberant edema with associated chemosis and involvement of the cornea of the affected eye. He was hospitalized and began antiviral therapy with intravenous acyclovir and chloramphenicol with topical ganciclovir. There was a progressive resolution of the skin lesions but no reversal of the loss of vision in the affected eye. Herpes zoster infection is more frequent and severe in the immunocompromised population. The clinical presentation is often similar to that of the immunocompetent population; however, it can have exuberant manifestations. The authors emphasize the need for close clinical monitoring of the immunocompromised patient with herpes zoster infection and review the role of corticosteroids when treating this particular population.
PubMed: 35004077
DOI: 10.7759/cureus.20908 -
Cureus Aug 2020Introduction Orbital infection is an ophthalmological emergency as it can lead to blindness and intracranial spread. Imaging is needed to determine the extent of the...
Introduction Orbital infection is an ophthalmological emergency as it can lead to blindness and intracranial spread. Imaging is needed to determine the extent of the infection, to localize an abscess, and for surgical planning. The role of magnetic resonance imaging (MRI) is well established in the evaluation of orbital pathologies, including orbital cellulitis and abscess, mainly due to its ability to evaluate early intracranial involvement. The objective of the study was to highlight the spectrum of MR imaging findings and the pattern of spread in fifteen patients with orbital cellulitis. Methods A prospective study was conducted in a tertiary care hospital. Fifteen patients of all age groups, of either sex, presenting with clinical findings suggestive of orbital cellulitis, referred for MRI of orbits, were included in the study. Written informed consent was obtained prior to the study. Patients' demographic data such as age and gender, associated co-morbidities, complications, and the pattern of spread of disease on MRI were recorded and evaluated. Descriptive statistics were used. Results Orbital/periorbital abscess was found to be the most common complication of orbital cellulitis (eight cases, 53.3%), followed by optic neuritis/perineuritis (four cases, 26.67%), intracranial involvement (four cases, 26.67%), dacryoadenitis (three cases, 20%) and cavernous sinus thrombophlebitis (three cases, 20%). Seven cases (46.67%) had right orbital involvement. Sinusitis was found to be the most common predisposing factor. Amongst the cases associated with sinusitis, the commonest inflamed paranasal sinus was found to be the ethmoid sinus (twelve cases). Amongst the fifteen cases of orbital/periorbital cellulitis, there were only two cases of isolated preseptal cellulitis (13.33%), five cases of postseptal cellulitis (33.33%) and eight cases of both preseptal and postseptal orbital cellulitis (53.33%). Conclusion MRI is the imaging modality of choice in the evaluation of orbital cellulitis because of its superior soft tissue and contrast resolution. It is vital to evaluate the extent of the orbital infection, underlying paranasal sinus involvement, as well as detect complications of orbital cellulitis, especially intracranial spread.
PubMed: 32923259
DOI: 10.7759/cureus.9663