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The Neuroradiology Journal Apr 2018Orbital apex disorders include orbital apex syndrome, superior orbital fissure syndrome and cavernous sinus syndrome. These disorders result from various etiologies,... (Review)
Review
Orbital apex disorders include orbital apex syndrome, superior orbital fissure syndrome and cavernous sinus syndrome. These disorders result from various etiologies, including trauma, neoplastic, developmental, infectious, inflammatory as well as vascular causes. In the past, these have been described separately based on anatomical locations of disease process; however, these three disorders share similar causes, diagnostic evaluation and management strategies. The etiology is diverse and management is directed to the causative process. This imaging review summarizes the pertinent anatomy of the orbital apex and illustrates representative pathological processes that may affect this region. The purpose of this review is to provide an update on the current status of diagnostic imaging and management of patients with orbital apex disorders.
Topics: Contrast Media; Diagnosis, Differential; Humans; Imaging, Three-Dimensional; Magnetic Resonance Imaging; Orbit; Orbital Diseases; Sensitivity and Specificity; Syndrome; Tomography, X-Ray Computed
PubMed: 29415610
DOI: 10.1177/1971400917740361 -
Magnetic Resonance Imaging Clinics of... Feb 2021Ultrahigh-field (7T) MRI provides improved contrast and a signal-to-noise gain compared with lower magnetic field strengths. Here, we demonstrate feasibility and... (Review)
Review
Ultrahigh-field (7T) MRI provides improved contrast and a signal-to-noise gain compared with lower magnetic field strengths. Here, we demonstrate feasibility and optimization of anatomic imaging of the eye and orbit using a dedicated commercial multichannel transmit and receive eye coil. Optimization of participant setup techniques and MRI sequence parameters allowed for improvements in the image resolution and contrast, and the eye and orbit coverage with minimal susceptibility and motion artifacts in a clinically feasible protocol.
Topics: Adult; Female; Humans; Magnetic Resonance Imaging; Male; Orbit; Reference Values; Young Adult
PubMed: 33237011
DOI: 10.1016/j.mric.2020.09.004 -
Folia Morphologica 2023The goal of the present study was to provide accurate data on the prevalence and morphometrical aspects of the cranio-orbital foramen (COF), which can surely be of use... (Review)
Review Meta-Analysis
BACKGROUND
The goal of the present study was to provide accurate data on the prevalence and morphometrical aspects of the cranio-orbital foramen (COF), which can surely be of use by surgeons performing procedures on the lateral orbit. Furthermore, the embryology and the clinical significance of this osseous structure were thoroughly discussed.
MATERIALS AND METHODS
Major online medical databases such as PubMed, Scopus, Embase, Web of Science, and Google Scholar were searched to find all relevant studies regarding COF.
RESULTS
Eventually, a total of 25 studies that matched the required criteria and contained complete and relevant data were included in this meta-analysis. The pooled prevalence of COF was found to be 48.37% (95% confidence interval [CI]: 41.67-55.10%). The occurrence of the COF unilaterally was set to be 71.92% (95% CI: 41.87-96.97%). The occurrence of the COF bilaterally was set at 26.08% (95% CI: 3.03-58.13%).
CONCLUSIONS
In conclusion, we believe that this is the most accurate and up-to- -date study regarding the anatomy of the COF. The COF is prevalent in 48.37% of the cases, and it is most frequently unilateral (73.92%). Furthermore, the prevalence of accessory COFs was found to be 16.72%. The presence of these foramina may represent a source of haemorrhage that ophthalmic surgeons should be aware of when performing procedures in the lateral part of the orbit.
Topics: Orbit; Humans
PubMed: 36178278
DOI: 10.5603/FM.a2022.0086 -
Acta Medica Portuguesa 1997Orbital myositis is a subgroup of the nonspecific inflammatory syndrome or orbital pseudotumor and is characterized by a primary inflammation of extraocular muscles. The... (Review)
Review
Orbital myositis is a subgroup of the nonspecific inflammatory syndrome or orbital pseudotumor and is characterized by a primary inflammation of extraocular muscles. The authors describe a 70-year-old patient with acute proptosis, ocular pain and right ophthalmoplegia, whose orbital computed tomographic scan showed enlargement of the homolateral extraocular muscles. Clinical presentation and complementary tests were compatible with the diagnosis of orbital myositis however, because of the particular aspects, which included retinal central vein occlusion, optic nerve lesion, distension of the superior ophthalmic vein and the homolateral cavernous sinus, the differential diagnosis with cavernous sinus pathology and thyroid ophthalmopathy was considered. The importance of a rapid diagnosis and treatment is stressed.
Topics: Aged; Female; Glucocorticoids; Humans; Neurologic Examination; Orbit; Orbital Pseudotumor; Prednisolone; Tomography, X-Ray Computed
PubMed: 9446484
DOI: No ID Found -
Chang Gung Medical Journal 2006Posttraumatic enophthalmos is one of the common sequelae that appears after facial injury and remains a challenge to treat for craniomaxillofacial surgeons. Several... (Review)
Review
Posttraumatic enophthalmos is one of the common sequelae that appears after facial injury and remains a challenge to treat for craniomaxillofacial surgeons. Several theories have been advocated regarding enophthalmos; however, the most well accepted concept is the enlargement of the orbital cavity after displacement due to orbital fractures. Generally, a 1 cm3 increase in orbital volume causes 0.8 mm of enophthalmos. Thorough knowledge of the orbital anatomy is fundamental and critical for the successful surgical correction of enophthalmos because most treatment failures are due to inadequate orbital dissection from fear of injuring the optic nerve and globe. A complete preoperative plan should be built on a comprehensive clinical examination of the periorbital soft tissue and bony components, detailed ophthalmic examination, and high resolution computed tomography scans in the axial, coronal and reformatted sagittal planes. Based on the anatomic deformities, there are two major fracture types including orbital blow out fractures and zygomatico-orbital fractures, resulting in posttraumatic enophthalmos. Treatment modalities and methods of approach are adapted according to the severity of the orbital deformities. Minor complications include ectropion, entropion, dystopia, diplopia, and residual enophthalmos. Rare but severe complications such as intraconal misplacement of the bone graft or retrobulbar hemorrhage with subsequent blindness may be encountered. The success of the procedures depend on adequate dissection and mobilization of the displaced soft tissue, correct repositioning of the dislocated or malunited bony orbit, and proper intra-orbital grafting.
Topics: Enophthalmos; Facial Injuries; Humans; Orbit; Orbital Fractures; Postoperative Complications
PubMed: 16924886
DOI: No ID Found -
Surgical and Radiologic Anatomy : SRA Feb 2021The orbital apex is the narrowest part of the orbit, housing the link between the intracranial cavity and orbit. Knowledge of orbital apex anatomy is crucial to...
PURPOSE
The orbital apex is the narrowest part of the orbit, housing the link between the intracranial cavity and orbit. Knowledge of orbital apex anatomy is crucial to selecting a surgical approach and reducing the risk of complications. Our purpose is to summarize current knowledge on surgical anatomy and attempt to reach a consensus on definition of the orbital apex.
METHODS
The online databases of Embase, the Cochrane library, Web of Science and PubMed (MEDLINE) were queried in a comprehensive bibliographic search on the (surgical) anatomy of the orbital apex and consisted of a combination of two subjects, using indexed terms and free text: "Orbital Apex" and "Orbital Anatomy."
RESULTS
A total of 114 relevant papers were included in this review. Numerous anatomical variations are described in the literature. Variations of the optic canal include duplication (0.64%) and keyhole anomaly (2.65%). Variations in pneumatization of the anterior clinoid process were unilateral in almost 10%, bilateral in 9%, and normal in 72%. A rare variant of the superior orbital fissure (SOF) is Warwick's foramen, which appears as if the lowest portion of the SOF was separated from the main fissure by a transverse bony bridge.
CONCLUSION
The definition of the orbital apex varies in the literature, and further research would most likely identify additional variations. A universal definition reporting these variations and pathology and imaging findings is essential for determining the optimal surgical approach to the orbital apex.
Topics: Anatomic Variation; Humans; Intraoperative Complications; Orbit
PubMed: 33128648
DOI: 10.1007/s00276-020-02573-w -
Survey of Ophthalmology 1990Congenital craniofacial abnormalities frequently require ophthalmic evaluation and surgical management. Called upon to perform as part of the craniofacial team managing... (Review)
Review
Congenital craniofacial abnormalities frequently require ophthalmic evaluation and surgical management. Called upon to perform as part of the craniofacial team managing the often severely deformed craniofacial patient, the ophthalmologist must bring a basic knowledge of craniofacial syndromes and developmental anatomy, as well as clinical acumen to help preserve or improve ocular and adnexal function. As an introduction to this area of ophthalmology, the clinical features, classification, appropriate facial embryology, assessment and surgical considerations of the various congenital craniofacial abnormalities are reviewed. The expanding availability of craniofacial surgeons and surgical teams along with improved surgical results will ultimately require an increasing involvement by many more ophthalmologists in the evaluation and management of these congenital abnormalities.
Topics: Craniofacial Dysostosis; Craniosynostoses; Eye Abnormalities; Facial Bones; Humans; Orbit; Skull; Syndrome
PubMed: 2237761
DOI: 10.1016/0039-6257(90)90067-6 -
Ceska a Slovenska Oftalmologie :... 2023The purpose is to acquaint readers with the contribution of imaging methods (IMs) of the orbit, specifically computed tomography (CT) and magnetic resonance imaging... (Review)
Review
The purpose is to acquaint readers with the contribution of imaging methods (IMs) of the orbit, specifically computed tomography (CT) and magnetic resonance imaging (MRI), in the diagnosis of thyroid-associated orbitopathy (TAO). Methods: IMs of the orbit are an indispensable accessory in the clinical and laboratory examination of TAO patients. The most frequently used and probably most accessible method is an ultrasound examination of the orbit (US), which, however, has a number of limitations. Other methods are CT and MRI. Based on the published knowledge implemented in our practice and several years of experience with the diagnosis and treatment of TAO patients, we would like to point out the benefits of CT and MRI in the given indications: visualisation of the extraocular muscles, assessment of disease activity, diagnosis of dysthyroid optic neuropathy and differential diagnosis of other pathologies in the orbit. Our recommendation for an ideal MRI protocol for disease activity evaluation is also included. Conclusion: IMs play an irreplaceable role not only in the early diagnosis of TAO, but also in the monitoring of the disease and the response to the applied treatment. When choosing a suitable IM for this diagnosis, a number of factors must always be taken into account; not only availability, cost and burden for the patient, but especially the sensitivity and specificity of the given method for the diagnosis of TAO.
Topics: Humans; Graves Ophthalmopathy; Orbit; Oculomotor Muscles; Magnetic Resonance Imaging; Tomography, X-Ray Computed
PubMed: 38086700
DOI: 10.31348/2023/10 -
Middle East African Journal of... 2015Strabismus caused by ocular or orbital trauma can be the result of localized acute soft tissue swelling or may follow orbital fractures, partial or complete loss of... (Review)
Review
Strabismus caused by ocular or orbital trauma can be the result of localized acute soft tissue swelling or may follow orbital fractures, partial or complete loss of extraocular muscle (EOM) and/or cranial nerve function, or damage to surrounding tissues causing mechanical restriction. The strabismus is frequently incomitant and can be difficult, if not impossible to completely correct. The resulting diplopia can affect the individual's ability to function at work, in sports and in common tasks of daily living like driving. The preoperative evaluation should include an assessment of the degree of limitation, muscle function and the condition of the surrounding tissue. In most cases, high resolution computed tomography and/or surface coil dynamic magnetic resonance imaging are required to determine the extent and nature of suspected bony or EOM injury, as well as muscle contractility. If the scan reveals an intact but paretic muscle or only minor muscle injury, surgical intervention is based on the degree of muscle recovery 6 months after the initial insult. If a rectus muscle has been lacerated, and the proximal stump is functional, retrieval should be attempted, either by a direct conjunctival approach if located anteriorly, or by an anterior medial orbitotomy if located deep in the orbit. If a damaged muscle cannot be found, recovered or repaired at any time, then muscle transposition should be considered. If multiple muscles are damaged or scar tissue is excessive, a tether procedure may be indicated. This paper will present an approach to some aspects of strabismus in this setting.
Topics: Diplopia; Eye Injuries; Humans; Magnetic Resonance Imaging; Oculomotor Muscles; Ophthalmologic Surgical Procedures; Orbit; Orbital Fractures; Strabismus; Tomography, X-Ray Computed
PubMed: 26180469
DOI: 10.4103/0974-9233.159732 -
British Medical Journal Apr 1947
Topics: Eye; Humans; Orbit; Surgical Flaps
PubMed: 20343505
DOI: 10.1136/bmj.1.4502.543-a