This article provides a comprehensive review of the pathophysiology, evaluation, and management of enophthalmos. This 2nd edition of Orbital Surgery is actually three books in one. In this retrospective study, the authors compare the outcomes of two different approaches to the orbital floor: the classic subciliary versus the transconjunctival plus lateral canthotomy swinging eyelid. Of 12 eyelids of 7 cadavers, dissected and macroscopically evaluated, a fat-pad was identified in the post-aponeurotic space of all eyelids. Surgery for highly vascular orbital lesions is an additional situation where maintaining an adequate surgical field is often challenging but paramount.
Methods: Thirty cadaveric orbits from Caucasians were dissected. The superomedial lid crease approach to the medial intraconal space has a number of advantages over the medial transconjunctival and lateral orbital approaches, including ease of dissection, incision-to-nerve distance, and angle of approach to the optic nerve. Most ophthalmologists' surgical approach is oculocentric. Basic surgical principles of exposure, hemostasis, and atraumatic dissection are also highlighted. Our findings show the advantages of the swinging eyelid: better aesthetic results, the same or greater exposure of the orbital floor and the caudal part of the lateral and medial walls, shorter surgical time sutureless and a less extended scar.
A young patient presented with visual disturbances reduction of color discrimination, central scotoma and mild exophthalmos owing to the presence of a right orbital apex cavernous haemangioma with superior orbital fissure invasion. All 4 of the latter category appeared multi-lobular. Through the text and vivid illustrations, a virtual road map of incision sites and surgical approaches is introduced to the reader. It can also be used to accurately analyze the result of intervention, which is an important component of the simulator for training and treatment planning. Pathologies included amyloidosis 1 , lymphoma 4 , metastatic adenocarcinoma within the optic nerve 1 , idiopathic lateral rectus muscle mysositis 4 , meningothelial meningioma of the optic nerve 1 , intraconal orbital meningioma 1 , reactive lymphoid hyperplasia 1 , optic nerve glioma 3 , optic nerve meningioma 1 , and cavernous haemangioma 1. No patient required detachment of the lower lid, the technique leaving both upper and lower 'arms' of the lateral canthal tendon attached to Whitnall's tubercle.
The illustrations are super and text contains so important summaries. The mean decrease in proptosis 3 months postoperatively was 3. The lesion was radically resected minimizing the surgical morbidity and hospitalization time for the patient and with encouraging functional and cosmetic outcomes. We describe three different techniques, namely supraorbital, transorbital and transorbitectomy approach. Objective: It is still controversial whether lymphangiomas are a true entity or a combination of congenital venous and lymphatic malformations. Even physicians who do not perform orbital surgery should find this book a useful addition to their collection, for it facilitates a greater understanding of applied orbital anatomy. An interactive image-based geometrical modeling tool is developed to generate a finite element model of the orbit.
Underdocumented vasculature was found traversing these foramina. Persistent trigeminal paresthesia was noted in one patient 2. This 2nd edition of Orbital Surgery is actually three books in one. The salient points of the anatomy of the superior orbit are also detailed. We conducted a cadaver dissection to document its presence, measure its location, and evaluate it histopathologically. This marvelous textbook and work of art should be owned by all physicians interested in the treatment of diseases of the orbit.
This 2nd edition of Orbital Surgery is actually three books in one. The management of surgical decompression of the orbit for acute blindness is essential when treatment of a midfacial fracture is intended. Acute orbital compartment syndrome can effectively be relieved by lateral canthotomy and cantholysis and administration of high doses of corticosteroids. It's an overview on orbital diseases, an anatomical atlas, and a surgical atlas. Emphasis throughout is on the dynamic nature of the surgical decision-making process and the reasoning the skillful surgeon uses to adapt surgical techniques to the problem at hand.
Data on proptosis reduction effect, new-onset diplopia and other complications of lateral wall decompression were analyzed. However, orbital tumors, like many other rare diseases, are optimally managed by those with the greatest expertise. Preoperatively, 12 patients 30% had a diplopia in the primary position of the gaze and 26 patients 65% had a diplopia within 30 degrees of the gaze. Inside is in perfect, unused condition. One hundred and forty-six orbits were studied.
This approach is also flexible, permitting the clinician to increase exposure to the orbit peroperatively by swinging the lower lid if required. The options of possible orbital interventions i. In all cases, exposure of dura was planned and did not present as a surprise. Technical feasibility and safety, early and late complications, length of hospitalization time and follow-up data were collected and analyzed. Patients and methodsRetrospective, non-interventional descriptive case series for patients who underwent a lateral canthotomy to access pathology within the lateral orbit. The average reduction in proptosis in the simple deep lateral decompression group was 5.