ABSTRACT
PURPOSE: To describe the clinical profile and surgical management of patients with lacrimal sac rhinosporidiosis. METHODS: This is a retrospective interventional case series. Eighteen patients, who were clinically diagnosed as isolated lacrimal sac rhinosporidiosis between October 2009 to January 2012, were included in the study. Detailed history, including whether there was exposure to stagnant bathing water, was noted. All patients underwent modified dacryocystorhinostomy (DCR) under general anaesthesia. RESULT: Out of 18 patients, 14 were male and 4 were female. Rhinosporidiosis was more prevalent in the 25 to 34 years age group. The most common clinical presentation was a doughy swelling over the lacrimal sac area, present in all cases. Twelve patients (66.67%) had a history of bathing in stagnant water. After modified DCR operation, all patients were followed for one year and only two patients had recurrence of their disease. CONCLUSION: Patients with lacrimal sac rhinosporidiosis usually present with a soft, doughy swelling in the lacrimal sac area. Bathing in stagnant water is a common risk factor. A modified DCR yields excellent outcomes.
Subject(s)
Dacryocystorhinostomy/methods , Eye Infections, Parasitic/diagnosis , Lacrimal Apparatus Diseases/diagnosis , Lacrimal Apparatus/parasitology , Rhinosporidiosis/diagnosis , Adolescent , Adult , Age Distribution , Anesthesia, General , Animals , Child , Child, Preschool , Eye Infections, Parasitic/parasitology , Eye Infections, Parasitic/surgery , Female , Humans , Lacrimal Apparatus Diseases/parasitology , Lacrimal Apparatus Diseases/surgery , Male , Middle Aged , Retrospective Studies , Rhinosporidiosis/parasitology , Rhinosporidiosis/surgery , Rhinosporidium/isolation & purification , Sex Distribution , Treatment Outcome , Young AdultABSTRACT
PURPOSE: To evaluate the outcome of surgical correction of blepharophimosis syndrome. DESIGN: A retrospective, non-randomized, interventional case series. METHODS: Ten patients undergoing surgical correction of blepharophimosis syndrome in 2 stages were reviewed. In the first stage, correction of epicanthic fold and telecanthus was done by either Y-V plasty or Roveda procedure with or without medial canthal tendon shortening. In the second stage, ptosis correction was done by bilateral frontalis sling. The preoperative and postoperative ratio of intercanthal distance (ICD) to horizontal palpebral fissure length (HPFL) was compared to assess the outcome of surgical correction of blepharophimosis. The ratio was graded as good (ratio < 1.3), suboptimal (ratio between 1.3 and 1.5), and poor (ratio > 1.5). The outcome of ptosis correction was graded as good, moderate, and poor. RESULTS: Of 10 patients, 5 (50%) underwent Y-V plasty, and 5 (50%) underwent Roveda procedure. Medial canthal tendon shortening was done in 5 patients (50%) having a preoperative ICD of 35 mm or more. After surgical correction, mean reduction in ICD was 4.8 mm (P < 0.0001), and mean improvement in HPFL was 5.45 mm (P < 0.0001). The mean ICD to HPFL ratio changed from 2.02 to 1.31 after surgery, which was statistically significant (P < 0.0001). Two patients (20%) had a ratio greater than 1.5. Nine patients (90%) had either good or moderate ptosis correction after bilateral frontalis sling with silicone rod. CONCLUSIONS: Functionally and cosmetically acceptable outcome can be achieved after surgical correction of blepharophimosis syndrome in 2 stages.
ABSTRACT
PURPOSE: Lipofibromatosis is a rare, benign, soft tissue tumor that typically involves extremities particularly in children. We report a young girl with lipofibromatosis involving the superotemporal quadrant of the left orbit. CASE REPORT: An 8-year-old girl presented with a history of a gradually expanding mass in the superotemporal quadrant of the left orbit over several years. Orbital imaging showed a soft tissue mass superolateral to the globe with possible infiltration into the lacrimal gland and lateral rectus muscle. The lesion was excised preserving adjacent structures. Histopathological examination revealed that the lesion consisted of adipose tissue with fibroblastic elements, being consistent with a diagnosis of lipofibromatosis. No recurrence of the lesion was seen in 18 months follow-up. COMMENT: Orbital involvement of lipofibromatosis as reported here is indeed a very rare entity. Diagnosis can be confirmed by histopathological analysis. As the lesion has a tendency to infiltrate into surrounding structures, surgical excision without hampering important structures is a treatment of choice.
