Subject(s)
Humans , Orbital Diseases/surgery , Orbital Implants , Printing, Three-Dimensional , Prosthesis Design , Deep LearningABSTRACT
SUMMARY: Late orbital reconstruction is a complex and challenge for surgeons. The aim of this article is to present complex orbital reconstruction using patient specific implant (PSI) strategy and polyetheretherketone (PEEK). A literature review and a cases series of sequelae after complex orbital trauma are presented; cases with great middle third deformities showing defect in the maxilla, nasal area, body of the zygoma and zygomatic arch were included; in both cases the sequelae was for more than 10 years. Virtual planning and PEEK implants were manufacture using a puzzle (two or three parts) by 3D print or injection. Patients were treated and their surgeries carried out without complications, using a minimal surgical approach. No infections were observed, and after 12 months follow-up they were stable showing normal function. PSI based-PEEK for orbital reconstruction are safe, efficient, effective and to obtain orbital morphology with low complications.
RESUMEN: La reconstrucción tardía de la órbita es un desafío complejo para cirujanos. El objetivo de este artículo fue presentar la reconstrucción orbitaria compleja utilizando implante paciente específico (PSI) y polietereterketona (PEEK). Son presentados una revisión de literatura y una serie de casos con secuelas posteriores a un trauma orbitario complejo; además, son presentados casos con gran deformidad del tercio medio del rostro mostrando defectos en maxila, área nasal, cuerpo del hueso cigomático y arco cigomático; ambos casos de secuela fueron por más de 10 años. Planificación virtual e implantes en PEEK fueron creados usando una estrategia de puzzle (dos o tres partes) por inyección o impresión 3D. Los pacientes fueron tratados y sus cirugías realizadas sin complicaciones usando accesos quirúrgicos reducidos. No se observaron infecciones y después de 12 meses de seguimiento permanecieron estables mostrando función normal. Los PSI para reconstrucción orbitaria son seguros, eficientes, efectivos y recuperan morfología de órbita con bajas complicaciones.
Subject(s)
Humans , Male , Female , Middle Aged , Orbital Diseases/surgery , Plastic Surgery Procedures/methods , Printing, Three-Dimensional , Orbit/injuries , Orbital Diseases/complications , Polymers/chemistry , Benzophenones/chemistry , Biocompatible Materials/chemistry , Treatment Outcome , Orbital ImplantsABSTRACT
RESUMO Objetivo: Conheça as características demográficas e clínicas da Órbita Associada da Tiroide (OAT), bem como a taxa de exigência da cirurgia orbital em pacientes do Centro Médico Nacional do Oeste. Métodos. Estudo observacional, transversal, descritivo e retrospetivo realizado analisando os registos de pacientes diagnosticados com OAT tratados num centro de cuidados de terceiro nível de janeiro de 2005 a julho de 2016. Os resultados. Um total de 236 órbitas de 118 pacientes foram avaliados, com uma idade média de 47,3 (13,2 anos, 74,6% eram do sexo feminino e 25,4% masculinos. 4,2% dos doentes foram tratados com hipotiroidismo, 94,1% com hipertireoidismo e 1,7% com goiter tóxico difuso. 44,9% dos doentes estudados com restrição de movimento ocular,10,2% com queratopatia de exposição e 51,7% com hipertensão intraocular. 34,7% dos doentes avaliados no serviço necessitaram de descompressão orbital, 16,1% de cirurgia palpebral e 8,5% de correção do hatrabisma. Na gestão conservadora destes doentes, 48,3% exigiam o uso de lubrificantes tópicos dos olhos, enquanto 52,5% dos pacientes necessitavam do uso de hipotensivos oculares em número variável. As conclusões. A OAT foi associada principalmente ao hipertiroidismo, sendo mais comum em pacientes do sexo feminino entre os 40 e os 59 anos; mais de 50% dos pacientes necessitaram do uso de hipotensivos oculares. Da mesma forma, a gestão cirúrgica foi realizada em mais de 50% dos pacientes, sendo a descompressão orbital a intervenção mais frequente.
ABSTRACT Objective. To know the demographic and clinical characteristics of Thyroid Associated Orbitopathy (TAO), as well as the requirement rate of orbital surgery in patients of the Orbit Service in the National Medical Center of the West, IMSS. Methods. Observational, cross-cutting, descriptive and retrospective study carried out analyzing the records of patients diagnosed with TAO and treated at a third-level care center from January 2005 to July 2016. Results. A total of 236 orbits of 118 patients were valued, with an average age of 47.3 ± 13.2 years, 74.6% were female and 25.4% male. 4.2% of patients were treated with hypothyroidism, 94.1% with hyperthyroidism and 1.7% with diffuse toxic goiter. 44.9% of patients studied had eye movement restriction,10.2% exposure keratopathy and 51.7% intraocular hypertension. 34.7% of patients valued in the service required orbital decompression, 16.1% palpebral surgery and 8.5% strabism correction. In the conservative management of these patients 48.3% required the use of topical eye lubricants, while 52.5% required the use of eye hypotensives in variable numbers. Conclusions. TAO was mainly associated with hyperthyroidism, being more common in female patients between the age of 40 and 59; more than 50% of patients required the use of eye hypotensives. Likewise, surgical management was performed in more than 50% of patients, with orbital decompression being the most frequent intervention.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Orbital Diseases/surgery , Orbital Diseases/etiology , Ophthalmologic Surgical Procedures/statistics & numerical data , Thyroid Diseases/complications , Exophthalmos/surgery , Exophthalmos/etiology , Orbit/surgery , Exophthalmos/diagnosis , Graves Disease/complications , Cross-Sectional Studies , Retrospective Studies , Decompression, Surgical/methods , Intraocular PressureABSTRACT
RESUMEN Los tumores quísticos primarios de la órbita, causados por infestaciones parasitarias como el Equinococcus granulosus son raros. Al ser el Perú zona endémica para este parásito, presentamos el caso de una niña de 10 años de edad, proveniente de una zona rural de Huancavelica, con proptosis axial irreductible del globo ocular derecho, de curso progresivo, con pérdida de la agudeza visual e imágenes tomográficas de la órbita en relación a masa tumoral de apariencia quística. Los exámenes serológicos fueron negativos, la paciente fue sometida a resección quirúrgica con resultado histopatológico de membranas anhistas correspondientes a quiste hidatídico. Al año de seguimiento no se evidencia recurrencia local ni sistémica. En conclusión, ante una tumoración orbitaria quística en pacientes pediátricos, se debe de considerar como diagnóstico diferencial la hidatidosis orbitaria, sobre todo si proceden de zonas endémicas.
ABSTRACT Primary orbital cystic tumors caused by Echinococcus granulosus are rare. As this parasite is endemic in Peru, we report the case of a 10-year-old girl from a rural area of Huancavelica, who presented with progressive and irreducible axial proptosis of the right eye and loss of vision. Orbital tomographic images demonstrated a tumor mass with a cystic appearance. Serologic tests were negative. The patient underwent surgical resection, and histopathologic analysis revealed anhistic membranes, corresponding to hydatid cysts. During one year of follow-up, no evidence of local or systemic recurrence was observed. In conclusion, orbital hydatidosis should be considered in the differential diagnosis of a cystic orbital tumor in pediatric patients, especially if the patient is from an endemic area.
Subject(s)
Child , Female , Humans , Orbital Diseases/parasitology , Echinococcosis , Orbital Diseases/surgery , Orbital Diseases/diagnosis , Echinococcosis/surgery , Echinococcosis/diagnosisABSTRACT
RESUMO A rinossinusite aguda é uma das afecções mais prevalentes das vias aéreas superiores. Fatores anatômicos presentes em crianças e jovens propiciam o aparecimento de complicações orbitárias. Embora mais raras, as complicações intracranianas das rinossinusites perfazem um grau alto de letalidade, são mais comuns em pacientes acima de sete anos, e devem ser tratadas por uma equipe multidisciplinar.
ABSTRACT Acute rhinosinusitis is one of the most prevalent diseases of the upper airways. Anatomical factors present in children and young people allow for the onset of orbital complications. Although rare, intracranial complications of sinusitis account for a high degree of lethality, are more common in patients over the age of seven, and should be treated by a multidisciplinary team.
Subject(s)
Humans , Female , Child , Orbital Diseases/etiology , Orbital Diseases/diagnostic imaging , Sinusitis/complications , Epidural Abscess/etiology , Epidural Abscess/diagnostic imaging , Orbital Diseases/surgery , Periosteum/pathology , Sinusitis/diagnostic imaging , Tomography, X-Ray Computed , Drainage/methods , Acute Disease , Epidural Abscess/surgery , Abscess/surgery , Abscess/etiology , Abscess/diagnostic imagingABSTRACT
La rinosinusitis aguda, puede presentar una serie de complicaciones conocidas, un grupo de ellas son las complicaciones orbitarias. Se presenta la historia de un paciente que consultó por proptosis ocular, siendo diagnosticado un absceso subperióstico retroorbitario secundario a una rinosinusitis aguda. Se trató con técnica endoscópica, evoluciona con un hematoma retroorbitario que tuvo que ser drenado con un abordaje mixto, endoscópico y abierto, con buena evolución. Actualmente las complicaciones orbitarias de la rinosinusitis aguda tienen una baja prevalencia, y así, las complicaciones del drenaje endoscópico son aún menos frecuentes. Se destaca la importancia del conocimiento del manejo tanto endoscópico como abierto.
Among acute rhinosinusitis complications, the ones with orbital involvement are relevant. We present a case report of a patient who presented proptosis and was initially diagnosed with a retro ocular abscess as a complication to an acute rhinosinusitis. The abscess was drained with an endoscopic sinus surgery. On the fourth post-surgery day a retro ocular hematoma was diagnosed. The hematoma was treated with a combined open and endoscopic approach with a favorable outcome. In conclusion, even though orbital complications of rhinosinusitis nowadays have low prevalence, and orbital complications of their endoscopic management are even rarer, it is important for the otorhinolaryngologist to be familiar with their open, endoscopic, or combined surgical treatment.
Subject(s)
Humans , Male , Adolescent , Abscess/surgery , Drainage , Endoscopy/methods , Orbital Diseases/surgery , Rhinitis/complications , Sinusitis/complications , Abscess/etiology , Acute Disease , Orbital Diseases/etiology , Exophthalmos/etiology , Hematoma/etiology , Periosteum/surgery , Paranasal Sinuses , Tomography, X-Ray ComputedABSTRACT
Apresentamos um caso no qual foi realizada orbitotomia de urgência em paciente com granuloma de células de Langerhans intraorbitário o qual apresentava comprometimento anatômico e funcional da função visual devido à hipertensão intraorbitária. Paciente masculino, 2 anos, apresentou exoftalmia, proptose conjuntival, olho vermelho, oftalmoplegia completa com midríase não fotorreativa e ptose palpebral direita. À fundoscopia apresentava engurgitamento venoso com edema de papila à direita. Foi realizada abordagem cirúrgica com orbitotomia via intracraniana sendo removida a lesão com remissão total da clínica tanto anatômica quanto funcionalmente. O manejo do granuloma de células de Langerhans pode variar desde a abordagem cirúrgica primária, passando pela terapia com esteróides até quimioterapia e radioterapia. No caso, a cirurgia foi a primeira opção devido ao e iminente risco de perda da função visual.
We present a case in which a patient with intraorbital Langerhans' cell granuloma, with anatomical and functional skills compromised by intraorbital hypertension, which was treated with urgency orbitotomy by cranial approach. Male, two years-old, presented conjuntival proptosis, red eye, complete ophthalmoplegy, exophthalmos, with non-fotoreactive mydriasis and blepharoptosis of the right eye. Fundoscopy presented venous enlargement with optic disc edema. A cranial approach with orbitotomy was carried out, removed the lesion with total remission of clinical presentation and anatomic appearance as well. The handling of Langerhans' cell granuloma can vary from primary surgical approach as corticotherapy to chemotherapy and radiotherapy. In this case, the surgery was the first option due to the imminent risk of loss of visual function.
Subject(s)
Child, Preschool , Humans , Male , Eosinophilic Granuloma/surgery , Orbital Diseases/surgery , Eosinophilic Granuloma/pathology , Histiocytosis, Langerhans-Cell/pathology , Histiocytosis, Langerhans-Cell/surgery , Ophthalmologic Surgical Procedures/methods , Orbital Diseases/pathology , Visual Acuity/physiologyABSTRACT
This paper reports a rare case of acute severe orbital abscess manifested 2 days after a facial trauma without bone fracture in a 20-year-old Afro-American female. The symptoms worsened within the 24 h prior to hospital admission resulting in visual disturbances such as diplopia and photophobia. The clinical findings at the first consultation included fever, periorbital swelling and redness, ptosis, proptosis and limitation of ocular movements upwards, downwards, to the right and to the left. Computed tomography scan showed proptosis with considerable soft tissue swelling on the left side and no fracture was evidenced in the facial skeleton, including the zygomatic-orbital complex. After hospital admission and antibiotic therapy intravenously the patient was conducted to the operation room and submitted to incision and drainage under general anesthesia. The orbit was approached thorough both eyelids and the maxillary sinus was reached only through the Caldwell-Luc approach. The postoperative period was uneventful and the rapid improvement of symptoms was remarkable. Visual acuity and ocular motility returned to the normal ranges within 2 days after the surgical intervention. After 12 postoperative days, the patient presented with significative improvement in the ptosis and proptosis, and acceptable scars.
Este artigo apresenta um caso de abscesso agudo em cavidade orbitária, após 2 dias de trauma facial, sem a presença de fratura óssea, ocorrido em uma mulher da raça negra com 20 anos de idade. Os sintomas se intensificaram nas últimas 24 h com o desenvolvimento de distúrbios visuais do tipo diplopia e fotofobia. Durante exame clínico foi constatado a presença de febre, edema e eritema periorbitário, ptose, proptose e limitação de movimentação ocular para cima, baixo, lado direto e esquerdo. A tomografia computadorizada evidenciava proptose associada a edema considerável, dos tecidos moles no lado esquerdo da face, sem fratura do complexo zigomático-orbitário. A internação hospitalar e o início da antibioticoterapia endovenosa foram realizados, e o tratamento cirúrgico de incisão e drenagem do abscesso sob anestesia geral foi conduzido, sendo realizado por meio de incisão na pálpebra superior e inferior para acesso a cavidade orbitária e por acesso de Caldwell-Luc para o seio maxilar. No pós-operatório imediato foi observada rápida melhora dos sintomas inicialmente relatados pela paciente. Após 2 dias da intervenção cirúrgica foi observado melhora na movimentação ocular e na acuidade visual, retornando ao normal. No décimo segundo dia pós-operatório, a paciente apresentou melhora significativa com relação à ptose palpebral e a proptose, com adequado processo de cicatrização.
Subject(s)
Female , Humans , Young Adult , Abscess/etiology , Facial Injuries/complications , Orbital Diseases/etiology , Acute Disease , Abscess/drug therapy , Abscess/surgery , Anti-Bacterial Agents/therapeutic use , Drainage , Emergency Treatment , Maxillary Sinusitis/complications , Maxillary Sinusitis/drug therapy , Orbital Diseases/drug therapy , Orbital Diseases/surgery , Treatment Outcome , Young AdultABSTRACT
We report the case of an 11-year-old girl with sickle cell disease who presented to the emergency room after being hit by a mud pie in the left frontal region. Examination evidenced left eye proptosis, eyelid swelling, reduced visual acuity and afferent pupillary defect, without any inflammatory signs such as fever, hyperemia or tenderness. Computed tomography of the orbits showed a large superomedial subperiosteal hematoma in the left orbit. The patient was treated with canthotomy, cantholysis and surgical draining of the hematoma. Two days after drainage she persisted with a subperiosteal hematoma and low visual acuity. A wide exploration of the orbital roof through a lid crease approach disclosed a thickened superior orbital rim with multiple bone defects along the roof and with continuous bleeding. Hemostasis was accomplished with bone wax. Orbital compression was resolved and the patient recovered her previous normal visual acuity.
Relatamos o caso de uma menina de 11 anos com doença falciforme, trazida à sala de emergência após ser atingida por um bloco de barro na região frontal esquerda. Apresentava ao exame proptose do olho esquerdo, edema palpebral, diminuição da acuidade visual e defeito pupilar aferente, sem quaisquer sinais inflamatórios como febre, hiperemia ou aumento de sensibilidade. A tomografia computadorizada de órbitas demonstrou um extenso hematoma subperiósteo superomedial na órbita esquerda. A paciente foi tratada com cantotomia, cantólise e drenagem cirúrgica do hematoma. Dois dias após a drenagem, ela permaneceu com um hematoma subperiósteo e a acuidade visual diminuída. Uma ampla exploração através de incisão no sulco palpebral superior revelou um rebordo orbitário superior espessado, e múltiplos defeitos ósseos ao longo do teto da órbita com sangramento persistente. Foi realizada hemostasia com cera óssea. A compressão orbitária foi resolvida, e a paciente recuperou a acuidade visual normal prévia.
Subject(s)
Child , Female , Humans , Anemia, Sickle Cell/complications , Craniocerebral Trauma/complications , Hematoma/etiology , Nerve Compression Syndromes/etiology , Orbital Diseases/etiology , Periosteum/injuries , Decompression, Surgical , Drainage , Drug Combinations , Hemostasis, Surgical , Hematoma , Hematoma/surgery , Hemostatics/therapeutic use , Nerve Compression Syndromes , Nerve Compression Syndromes/surgery , Orbital Diseases , Orbital Diseases/surgery , Palmitates/therapeutic use , Visual Acuity/physiology , Waxes/therapeutic useABSTRACT
OBJETIVO: Avaliar as características dos portadores de cavidades anoftálmicas que desenvolveram extrusão do implante. MÉTODOS: Estudo retrospectivo, observacional, tendo sido avaliados 37 portadores de cavidade anoftálmica que tiveram extrusão do implante de cavidade, na Faculdade de Medicina de Botucatu-UNESP. RESULTADOS: As extrusões ocorreram em cavidades enucleadas ou evisceradas, a maioria delas submetidas a cirurgia em decorrência de phthisis bulbi ou trauma, em geral de 1 a 2 anos após a cirurgia inicial. A deiscência precedeu a extrusão em todos os casos, tendo a extrusão ocorrido com todos os tipos de implantes empregados. CONCLUSÃO: Após a colocação de implantes de cavidade podem ocorrer complicações. A deiscência e extrusão das esferas são possibilidades que podem requerer nova intervenção cirúrgica, para a qual o paciente e o oftalmologista devem estar preparados.
PURPOSE: To evaluate the characteristics of patients with anophthalmic cavity who developed sphere extrusion. METHODS: A retrospective observational study was done evaluating 37 patients with anophthalmic cavity and sphere extrusion at the "Faculdade de Medicina de Botucatu-UNESP". RESULTS: Extrusion was observed in enucleated and eviscerated cavities. The majority of the patients had the eye removed because of phthisis bulbi or trauma and the extrusion happened 1 or 2 years after the surgery. Extrusion was preceded by conjunctival dehiscence and exposure of the sphere and occurred with all used implants. CONCLUSION: Complications after orbital implant placement are a possibility. Dehiscence and sphere extrusion may happen and another surgery would be necessary. The patient and the ophthalmologist have to be prepared for this.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Eye Enucleation , Eye Evisceration , Foreign-Body Migration/etiology , Orbital Implants/adverse effects , Eye Enucleation/statistics & numerical data , Eye Evisceration/statistics & numerical data , Eye Injuries/surgery , Orbital Diseases/surgery , Polymers , Retrospective Studies , Reoperation/statistics & numerical data , Surgical Wound Dehiscence/complications , Time FactorsABSTRACT
Descrevemos um paciente de 16 anos que após traumatismo crânio-encefálico leve evoluiu com dor ocular, hematoma palpebral unilateral e proptose do olho esquerdo. Tomografia computadorizada de órbitas evidenciou hematoma subperiosteal em órbita esquerda. Foi realizada drenagem cirúrgica da coleção. O hematoma subperiosteal de órbita, apesar de raro, deve ser incluído como etiologia de proptose ocular e seu diagnóstico deve ser precoce a fim de evitar a morbidade associada.
We describe a sixteen years old male patient that suffered a craniocerebral trauma and presented at the emergency room, with ocular pain, palpebral hematoma and left eye proptosis. Orbital computed tomography showed left subperiosteal orbital hematoma. A surgical drainage was performed. Subperiosteal hematoma of the orbit is a rare cause of proptosis; its early diagnosis must be made in order to avoid possible complications.
Subject(s)
Adolescent , Humans , Male , Craniocerebral Trauma/complications , Hematoma/etiology , Orbital Diseases/etiology , Periosteum/injuries , Exophthalmos/etiology , Hematoma/diagnosis , Hematoma/surgery , Orbital Diseases/diagnosis , Orbital Diseases/surgery , Tomography, X-Ray ComputedABSTRACT
AIMS: To establish a correct method of evaluation and management of contracted sockets RESULTS: Anopthalmic socket were frequently seen in orbit and Oculoplasty clinic of Aravind Eye Hospital, Madurai, South India. Prospective evaluation of Anophthalmic Sockets was done in this study. Anophthalmic Socket which can not support prosthetic eye is called contracted socket.4,5,14. These sockets were graded as congenital and acquired, which were managed using single, combined and multiple procedures. Surgical outcome of each case were analyzed.
Subject(s)
Adolescent , Adult , Aged , Anophthalmos/pathology , Child , Child, Preschool , Contracture/surgery , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Orbital Diseases/surgery , Orbital Implants , Prospective Studies , Treatment OutcomeABSTRACT
We report the successful removal of a retrobulbar foreign body using a transcranial approach in a 63-year-old patient with a penetrating injury to the left eye. Initial ocular examination revealed a corneoscleral laceration, hyphema, a traumatic cataract, and vitreous hemorrhage. Visual acuity consisted only of the perception of hand motion. Computed tomography demonstrated an orbital foreign body in the retrobulbar area. Emergency corneoscleral suturing, phacoemulsification of the cataract, and vitrectomy with posterior vitreous detachment were performed. Fifteen days after the emergency operation, we successfully removed the orbital foreign body using a transcranial approach, although the foreign body was very close to the optic nerve. On fundus examination 6 months later, a white, fibrous lesion was seen inferior to the optic disc, and the corrected visual acuity was 20/30. These positive results may be due to the complete vitrectomy at the correct time performed by a retina specialist and the minimal pressure on the eyeball while removing the foreign body, which resulted from the use of a transcranial approach.
Subject(s)
Middle Aged , Male , Humans , Wounds, Penetrating/etiology , Orbital Diseases/surgery , Foreign Bodies/surgery , Fluorescein Angiography , Accidents, OccupationalABSTRACT
O prolapso de gordura orbitária é entidade benigna incomum que pode causar defeitos estéticos. Os autores apresentam uma paciente de 63 anos com prolapso de gordura orbitária temporal bilateral associado a pterígio medial bilateral, ressaltando aspectos clínicos e cirúrgicos. Discute-se a importância do diagnóstico clínico e de imagem, além da comprovação histopatológica da lesão.
Subject(s)
Humans , Female , Middle Aged , Adipose Tissue/surgery , Orbital Diseases/complications , Pterygium/complications , Orbital Diseases/diagnosis , Orbital Diseases/surgery , Prolapse , Pterygium/diagnosis , Pterygium/surgery , Treatment OutcomeABSTRACT
O cisto de inclusão conjuntival gigante (CICG) pode causar sérios defeitos estéticos além de incompleto fechamento palpebral. Os autores apresentam paciente de 57 anos com cisto de inclusão conjuntival gigante em olho direito associado a pterígio. Discute-se sobre os aspectos fisiopatológicos da formação do cisto de inclusão e sobre as possíveis técnicas cirúrgicas.
Subject(s)
Humans , Female , Middle Aged , Cysts/surgery , Cysts/physiopathology , Conjunctiva/pathology , Orbital Diseases/surgery , Pterygium/surgeryABSTRACT
Extradural hematoma (EDH) is a frequent lesion, with an incidence varying from 0.2 to 6 percent in patients admitted to hospital due to traumatic head injury. The higher incidence is found in patients with more severe injuries. The association of EDH with subperiosteal intraorbital hematomas is rarely reported, and we were not able to find in the literature any report of traumatic bilateral intraorbital hematomas and EDH. We report this case of a 32 year-old man with bilateral intraorbital (subperiosteal) hematoma associated with unilateral EDH. The lesions were treated surgically, but unfortunately with an unfavorable outcome
Subject(s)
Humans , Male , Adult , Hematoma, Epidural, Cranial , Orbital Diseases/diagnosis , Craniocerebral Trauma/complications , Craniotomy/adverse effects , Frontal Bone/surgery , Hematoma, Epidural, Cranial , Orbital Diseases/etiology , Orbital Diseases/surgery , Periosteum/pathology , Periosteum/surgery , Tomography, X-Ray ComputedABSTRACT
Objetivo: Descrever a apresentação clínica e os achados diagnósticos aos exames de imagem de um caso incomum de cisto hemático intraconal espontâneo da órbita. Métodos: O paciente foi submetido a exame clínico e oftalmológico completos, tomografia computadorizada, ultra-sonografia orbitária, imagem por ressonância magnética e abordagem cirúrgica da lesão. Resultados: Observou-se proptose intensa com sinais congestivos e baixa visual. A tomografia computadorizada mostrou massa homogênea de limites bem definidos na órbita, comprimindo o globo ocular anteriormente. A ultra-sonografia mostrou lesão com baixa refletividade no seu interior. A imagem por ressonância magnética revelou lesão arredondada que nos cortes enfatizando T1 apresentava sinal isointenso em seu interior associado a halo de hipersinal periférico e possuía hipersinal nos cortes enfatizando T2, achados estes indicativos de lesão com sangue no seu interior. A abordagem cirúrgica confirmou a presença de cisto hemático da órbita que foi drenado com excelente recuperação funcional. Conclusões: Cisto hemático intraconal deve ser incluído no diagnóstico diferencial das lesões bem delimitadas e de evolução aguda ou subaguda da órbita que apresentem hipersinal em T1 e em T2 à imagem por ressonância magnética. O tratamento deve ser feito em caráter de urgência, nos casos em que há proptose intensa ou risco de comprometimento visual.
Subject(s)
Humans , Male , Adult , Cysts , Orbital Diseases/diagnosis , Cysts , Orbital Diseases/surgery , Orbital Diseases , Magnetic Resonance Imaging/methods , Tomography, X-Ray ComputedABSTRACT
Tecido cerebral na órbita, tendo continuidade com o conteúdo intracraniano, é relativamente incomum. Tecido cerebral isolado na órbita, entretanto, é muito mais raro. No presente trabalho säo apresentados dois casos de tecido cerebral ectópico na órbita, com cisto ependimal. Säo analisadas as similaridades e diferenças com outros casos da literatura, bem como as dificuldades no diagnóstico desta malformaçäo. Näo conhecemos nenhum caso descrito na literatura nacional.
Subject(s)
Humans , Male , Female , Infant , Choristoma/physiopathology , Orbital Diseases/surgery , Ependyma/physiopathology , Coloboma , Skull/abnormalities , Orbit/abnormalities , Radiography , Tomography, X-Ray ComputedABSTRACT
Las complicaciones a partir de infecciones en los senos paranasales, aunque raras veces, pueden provocar lesiones oculares. Clásicamente estas afecciones eran abordadas por técnicas abiertas con las siguientes secuelas y defectos estéticos. La evolución endoscópica nasal permite hoy día un manejo de una forma eficaz y segura sin los inconvenientes de las técnicas abiertas. Presentamos 11 pacientes con complicaciones orbitarias provocadas en 6 casos por sinusitis complicadas y 5 por mucoceles de senos paranasales que provocan una clínica ocular (exoftalmos, diplopia, disminución de la agudeza visual) y que fueron tratados por cirugía endoscópica nasal bajo anestesia general. En todos los casos la evolución fue satisfactoria
Subject(s)
Cystoscopy , Mucocele/complications , Orbital Diseases/surgery , Sinusitis/complicationsABSTRACT
El histiocitoma fibroso es un tumor poco frecuente, cuyas manifestaciones oculares generalmente involucran la órbita; se presenta como una lesión aislada con un curso benigno o maligno. Histiológicamente se caracteriza por la presencia de dos tipos celulares, histiocitos y fibroblastos, dispuestos estos últimos en forma arremolinada. Se presenta el caso de un paciente masculino de 54 años de edad quien inició con proptosis de ojo derecho de evolución lenta y progresiva durante año y medio. Se realizó orbitomía lateral tipo Kronlein modificada y mediante el estudio histopatológico se establecio el diagnóstico de histiocitoma fibroso benigno