[Lacrimal canalicular transposition for lower canaliculus repair: About four cases]. / Reconstruction du canalicule inférieur par transposition canaliculaire : à propos de quatre cas.

The main function of the eyelids is to support and protect the globe. The lower eyelid and medial canthus are often the location of malignant tumors that can be locally aggressive and require disfiguring surgeries. Chronic epiphora often appears in cases of inadequate reconstruction in this location and can require secondary procedures. We report four cases of medial canthus repair after tumor removal with loss of the inferior canaliculus. The ipsilateral superior canaliculus was removed before being transposed into the lower eyelid. This simple method allows for complete canalicular reconstruction. It obviates the need for artificial material and its potential associated complications. It has the advantage of a one-step eyelid and canalicular reconstruction and prevents epiphora after tumor resection.

[Clinical features and management of acute myositis in idiopathic orbital inflammation]. / Présentation clinique et prise en charge des myosites aiguës dans les inflammations orbitaires non spécifiques.

Acute myositis is the second most common component of non-specific orbital inflammation. We will describe its clinical features and natural history. This is a retrospective study of 10 cases. The diagnosis of acute myositis was based on clinical and imaging criteria. Our study includes five men and five women. The average age was 35.8 years (17-59 years). Clinical symptoms were: pain increased on eye movement (10/10), diplopia (4/10), proptosis (6/10), visual loss (3/10), lid edema (6/10), conjunctival hyperemia (7/10), anterior scleritis (2/10), episcleritis (2/10), chemosis (4/10), upper lid retraction (1/10), limitation of eye movement (3/10), fundus abnormalities (2/10). Imaging showed thickening of one or more extraocular muscles (10/10). Recovery was complete with anti-inflammatory therapy in six patients. Three patients experienced recurrence, and one patient had a clinical rebound upon tapering the treatment. Acute myositis can be defined by pain on eye movement, signs of inflammation, and extraocular muscle thickening on imaging. If the clinical presentation is typical, histopathological analysis can be deferred but remains necessary in cases of poor response to treatment, chronic duration or suspicion of tumor infiltration. The diagnosis of acute myositis may be suspected in the presence of consistent, well-defined clinical signs. Contiguous inflammation is often associated. Treatment is based on steroids or non-steroidal treatment anti-inflammatory therapy, administered alone or consecutively. Recurrences are frequent but do not alter the final prognosis.

Optic Nerve Sheath Meningocele: A Case Report.

Isolated optic nerve sheath meningocele is a rare affection defined as the cystic enlargement of the optic nerve sheath filled with cerebrospinal fluid. We report the case of a 39-year-old woman presenting with bilateral meningocele uncovered during a routine examination for headache complaints. A 5-year follow-up validated the lesion's clinical and imaging stability. Magnetic resonance imaging (MRI) is an essential tool in the diagnosis of this pathology, alongside characteristic symptoms indicating that the meningocele might have progressively expanded into the orbit. In this case we present a therapeutic approach based on pathophysiological hypotheses and review of the literature.

Surgical and prosthetic treatment for microphthalmia syndromes.

Our aim was to evaluate the long-term outcomes of prosthetic treatment and orbital expansion in the management of microphthalmia syndromes. We did a retrospective single-centre study of all cases of microphthalmia treated between 1989 and 2010. The patients were divided into three groups: isolated microphthalmia, microphthalmia associated with micro-orbitism, and complex microphthalmia syndrome. To evaluate the results a score was computed for each patient by assessing the length of the palpebral fissure, the depth of the conjunctival fornix, and local complications together with an evaluation of the satisfaction of patients and their families. Forty-four children were included (27 boys and 17 girls). Twenty-seven had unilateral microphthalmia (61%) and 17 bilateral microphthalmia (39%). Twelve patients were lost to follow up. The mean duration of follow-up was 12 years (range 4-21). Management involved an ocular conformer in only 31 patients (71%). The treatment was deemed satisfactory in all except 10 children. Surgical treatment with orbital expansion permitted good symmetry of the orbital cavities with a final mean difference of 9% (range 3-17) compared with the initial 16.8% (range 13.6-20.3). The prosthetic treatment gives satisfactory results. Despite limited indications and difficult follow-up, our experience emphasises the value of surgical treatment for severe micro-orbitism.

[Histologic risk factors of basal cell carcinoma of the face, about 184 cases]. / Facteurs de risques histologiques des carcinomes basocellulaires de la face : à propos d'une série de 184 cas.

BACKGROUND: Basal cell carcinoma is the most common type of skin cancer in humans. OBJECTIVES: The aim of our study was to determine the histologic risk factors involved in recurrence of basal cell carcinomas of the face. PATIENTS AND METHODS: We conducted a retrospective study of patients with primary basal cell carcinoma (BCC) of the face treated between March 2003 and December 2005. We analyzed the size of lateral and deep margins of tumor, histologic subtype, perineural invasion, and ulcerations. Clinical follow-up was observed until June 2011. RESULTS: We note that 184 cases of BCC were included. Eleven recurrences occurred during the follow-up, i.e. 6%. The population was divided into two groups according to histologic safety margins (1 mm for all basal cell carcinomas, 0.8 mm for nodular and 2 mm for aggressive-growth (AG-BCC) subtypes). There was a significant difference between groups in regards to cancer recurrence. Tumor size above 2 cm and presence of perineural invasion increased the risk of recurrence. DISCUSSION: Low histological safety margins appear to be critical on tumor recurrence. Depending on the tumor characteristics, and the patient, we advocate a re-excision in cases of histological safety margins inferior to 0.8 mm for the nodular subtypes and 2 mm for aggressive subtypes. Tumor size, and perineural invasion should be taken into consideration so as to make a well-informed decision between re-excision and a watching strategy in critical cases.