• 제목/요약/키워드: Orbital disease

검색결과 61건 처리시간 0.034초

A diagnostic dilemma in pediatric osteomyelitis: a case report

  • Mandrekar, Pooja Narendra;Gavhane, Sanket;Fernandes, Trishala Bhadauria;Dhupar, Vikas;Dhupar, Anita
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제48권2호
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    • pp.117-121
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    • 2022
  • Infantile osteomyelitis is a rare disease that is infective in nature and may rapidly turn fatal, as the disease is often misdiagnosed due to its varied presenting signs. Early diagnosis may help in avoiding systemic involvement and permanent deformity. The disease presents with signs of orbital involvement, nasal congestion, and emesis, as well as other standard hallmarks of infection. Furthermore, the maxilla is a highly vascular and porous bone and the occurrence of osteomyelitis in an infant maxilla is highly uncommon. In addition, routine blood work is not suggestive of the presence of this disease. Thus, prompt diagnosis of this condition poses a challenge to surgeons due to the confusing array of symptoms combined with the rarity of the disease. One such case of osteomyelitis of the maxilla in a young child is presented. The dilemma encountered by the surgeon during the diagnosis and treatment of the disease is discussed.

흉벽에 발생한 Sparganosis;1례 보고 (A Case of Sparganosis in the Chest Wall)

  • 김상익
    • Journal of Chest Surgery
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    • 제25권11호
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    • pp.1240-1244
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    • 1992
  • Human sparganosis caused by Sparganum mansoni, the larval plerocercoid worm of the genus Spirometra, is not uncommon in Korea and is mostly found in subcutaneous or adipose tissue of the abdominal, thoracic wall and inguinal region, but is rarely found in the orbital cavity, brain and breast. It, at present, is a surgical disease because its diagnosis depends almost on the demonstration of the larva[e] from lesion or finding the worm section in surgical pathology specimens. We experienced a case of human sparganosis from a 48 years old woman who had a history of eating a raw frog. We report the case and review the related literatures.

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정혈(井穴) 자락요법(刺絡療法)에 관(關)한 문헌고찰(文獻考察) (The Literature Study on Jung point venesection therapy)

  • 김윤희;이현;이병렬
    • 혜화의학회지
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    • 제10권1호
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    • pp.237-245
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    • 2001
  • I have come to next conclusions in consequnce of documentary study about medical books of many generations regarding Jung point venesection therapy. 1. Jung point is significant as the beginning of pulse energy flow on meridian, the origin of all meridional pulse energy being located at extrimity terminal, confluence of three yin and three yang, and emergent treatment point. 2. Jung point venesection therapy was much used for the first-aid treatment for acute and thermic disease, and that is the combination of the meaning as of restoration from death and emergent treatment of Jung point and function of openning of orifice, leakage of fever, circulation of blood, remove of edema of venesection therapy. 3. It is very much used for emergency case, five sensory organ disease and CVA, heating shock and so on. Besides that digestive disease, cough, fever with cold, childhood disease, cardiac ache, thoracic disease, numbness of digitus terminal, mental disorder follow that in order. 4. Sosang, Jung point of Arm Greater Yin Lung meridian, is very much used for five sensory organ disease. Sosang is for orbital disease, sangyang for auditory disease, sosang for nasal disease, and sosnag for introitus-throat disease. 5. Ten Jung point is most used for first-aid diseases of CVA, heating shock. 6. Ten Jung point is most used for digestive disease of stomach ache, vomiting, diarrhea, intestinal convulsion. 7. Ten Jung point is most used for cold disease of cough, fever, malaria. 8. Ten Jung point, sosang, kwanchung are much used for childhood disease of acute convulsion and fever. 9. Among Jung point, sosang is most used, 34 times. Next there are Ten Jung point, kwanchung, sangyang, sotaek, jungchung, unbaek, taedon in order. In the order of frequency in use, arm channel is more used than leg channel.

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Clinical and Radiological Features of Diffuse Lacrimal Gland Enlargement: Comparisons among Various Etiologies in 91 Biopsy-Confirmed Patients

  • Sae Rom Chung;Gye Jung Kim;Young Jun Choi;Kyung-Ja Cho;Chong Hyun Suh;Soo Chin Kim;Jung Hwan Baek;Jeong Hyun Lee;Min Kyu Yang;Ho-Seok Sa
    • Korean Journal of Radiology
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    • 제23권10호
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    • pp.976-985
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    • 2022
  • Objective: To compare the clinical and radiological features of various etiologies of chronic diffuse lacrimal gland enlargement. Materials and Methods: We retrospectively reviewed 91 consecutive patients who underwent surgical biopsy for chronic diffuse lacrimal gland enlargement and were diagnosed with non-specific dacryoadenitis (DA) (n = 42), immunoglobulin G4-related dacryoadenitis (IgG4-RD) (n = 33), and lymphoma (n = 16). Data on patient demographics, clinical presentation, and CT imaging findings (n = 73) and MRI (n = 43) were collected. The following radiologic features of lacrimal gland enlargement were evaluated: size, unilaterality, wedge sign, angle with the orbital wall, heterogeneity, signal intensity, degree of enhancement, patterns of dynamic contrast-enhanced, and apparent diffusion coefficient value. Radiological features outside the lacrimal glands, such as extra-lacrimal orbital involvement and extra-orbital head and neck involvement, were also evaluated. The clinical and radiological findings were compared among the three diseases. Results: Compared to the DA and IgG4-RD groups, the lymphoma group was significantly older (mean 59.9 vs. 46.0 and 49.4 years, respectively; p = 0.001) and had a higher frequency of unilateral involvement (62.5% vs. 31.0% and 15.2%, respectively; p = 0.004). Compared to the IgG4-RD and lymphoma groups, the DA group had significantly smaller lacrimal glands (2.3 vs. 2.8 and 3.3 cm, respectively; p < 0.001) and a lower proportion of cases with a wedge sign (54.8% vs. 84.8% and 87.5%, respectively; p = 0.005). The IgG4-RD group showed more frequent involvement of the extra-orbital head and neck structures, including the infraorbital nerve (36.4%), paranasal sinus (72.7%), and salivary gland (58.6%) compared to the DA and lymphoma groups (4.8%-28.6%) (all p < 0.005). Conclusion: Patient age, unilaterality, lacrimal gland size, wedge sign, and extra-orbital head and neck involvement differed significantly different between lymphoma, DA, and IgG4-RD. Our results will be useful for the differential diagnosis and proper management of chronic lacrimal gland enlargement.

Quantitative Assessment of Orbital Volume and Intraocular Pressure after Two-Wall Decompression in Thyroid Ophthalmopathy

  • Park, Sang Min;Nam, Su Bong;Lee, Jae Woo;Song, Kyeong Ho;Choi, Soo Jong;Bae, Yong Chan
    • 대한두개안면성형외과학회지
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    • 제16권2호
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    • pp.53-57
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    • 2015
  • Background: Surgical outcomes after orbital wall decompression have focused on the degree of exophthalmos and intraocular pressure. The aim of this research was to evaluate intraorbital volume using computed tomography (CT) images following two-wall decompression using a combined subcilliary and endoscopic approaches. Methods: A retrospective review was performed for all patients who had undergone the two-wall decompression method. The pre/postoperative CT images were used to evaluate changes in intraocular volume. Intraocular pressure was evaluated using applanation tonometry. Surgical details are discussed within the body of text. Results: Two-wall decompression thru the medial wall and floor was associated with an average intraorbital volume change of $7.3cm^3$, with maximal accommodation up to $13cm^3$. Changes in intraocular pressures were not statistically significant. Conclusion: Two-wall decompression was effective in accommodation of up to $13cm^3$ of soft tissue herniation. There was no statistically significant association between changes in volume to pressure.

백색광 간섭계를 이용한 안구 돌출 측정 장치 설계 및 제작 (Design and manufacture of eyeball protrusion measuring device using white light scanning interferometer)

  • 장중수;김영길
    • 한국정보통신학회논문지
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    • 제23권1호
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    • pp.63-69
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    • 2019
  • 안와 내에서 안구의 상대적 위치는 여러 병적인 상태를 짐작할 수 있는 하나의 기준이 될 수 있다. 특히 안와골절, 갑상선 안질환, 안와 종양 등의 진단과 이에 약물 및 수술적 치료의 결과를 판단하는데 유용하다. 현재 안구 돌출 값을 측정하기 위해 주로 사용되는 대표적 측정 기기인 Hertel과 Naugle 안구돌출계 등은 검사자가 다를 경우, 같은 검사자가 반복적으로 측정하더라도 검사할 때마다 안와의 고정부위가 달라지는 현상, 또한 동일한 안구돌출계라고 하더라도 제조 회사가 다르다면 안와의 고정부위 디자인이 달라 검사자에 의한 측정 오차 발생이 필연적이다. 본 논문에서는 백색광 간섭계를 이용한 안구 돌출 측정 장치를 설계 및 제작하고 실제 사람의 안구 돌출을 측정하여 수동식 측정 방법에 비해 정밀도 및 반복 정도가 크게 높아진 것을 확인하였다.

Mucormycosis Management in COVID-19 Era: Is Immediate Surgical Debridement and Reconstruction the Answer?

  • Gupta, Samarth;Goil, Pradeep;Mohammad, Arbab;Escandon, Joseph M.
    • Archives of Plastic Surgery
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    • 제49권3호
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    • pp.397-404
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    • 2022
  • Background Excessive use of corticosteroids therapy along with gross immunocompromised conditions in the novel coronavirus disease 2019 (COVID-19) pandemic has raised the risks of contracting opportunistic fungal infections. Here, we describe our experience with the implementation of a surgical protocol to treat and reconstruct rhino-orbital-cerebral mucormycosis. Methods A retrospective review of our prospectively maintained database was conducted on consecutive patients diagnosed with mucormycosis undergoing immediate reconstruction utilizing our "Mucormycosis Management Protocol." All patients included in this study underwent reconstruction after recovering from COVID-19. Wide local excision was performed in all cases removing all suspected and edematous tissue. Reconstruction was done primarily after clear margins were achieved on clinical assessment under a cover of injectable liposomal amphotericin B. Results Fourteen patients were included. The average age was 43.6 years and follow-up was 24.3 days. Thirteen patients had been admitted for inpatient care of COVID-19. Steroid therapy was implemented for 2 weeks in 11 patients and for 3 weeks in 3 patients. Eight patients (57.1%) had a maxillectomy and mucosal lining resection with/without skin excision, and six patients (42.8%) underwent maxillectomy and wide tissue excision (maxillectomy and partial zygomatic resection, orbital exenteration, orbital floor resection, nose debridement, or skull base debridement). Anterolateral thigh (ALT) flaps were used to cover defects in all patients. All flaps survived. No major or minor complications occurred. No recurrence of mucormycosis was noted. Conclusion The approach presented in this study indicates that immediate reconstruction is safe and reliable in cases when appropriate tissue resection is accomplished. Further studies are required to verify the external validity of these findings.

Skull Base Invasion of Adenoid Cystic Carcinoma of the Lacrimal Gland : A Case Report

  • Lee, Jae-Il;Kim, Young-Zoon;Lee, Eun-Hee;Kim, Kyu-Hong
    • Journal of Korean Neurosurgical Society
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    • 제44권4호
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    • pp.273-276
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    • 2008
  • Although adenoid cystic carcinoma (ACC) of the lacrimal gland is a rarely encountered orbital tumor, it invades intracranially more frequently than carcinomas of other glands in the head and neck. A 52-year-old man underwent orbital exenteration and resection of intracranially extended tumor via a fronto-orbito-zygomatic approach in combination with a transfacial approach. Histopathologically, the tumor showed perineural, vascular, and lymphatic invasion. Additionally, he received radiotherapy (60 Gy) and adjuvant systemic cisplatin and 5-fluorouracil chemotherapy due to residual tumor in the orbit and systemic metastases (lung, ribs, and spines). He was free of progression and recurrence at 6 months after treatment. The authors report a case of skull base invasion by an ACC of the lacrimal gland to remind neurosurgeons planning intervention that this disease shows a tendency to invade intracranially.

소아에서 발생한 Tolosa-Hunt 증후군 1례 (A case of Tolosa-Hunt syndrome)

  • 김도균;김영옥;우영종
    • Clinical and Experimental Pediatrics
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    • 제49권6호
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    • pp.696-699
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    • 2006
  • 소아에서 드물게 보고되는 토로사-헌트 증후군은 둔하면서 지속적인 안와 주위의 통증과 안구운동 장애 및 해면동 주위의 뇌신경 침범을 특징으로 하는 질환으로 비특이적 염증조직에 기인한 것으로 알려져 있다. 이는 자연 치유도 가능하나 대개 스테로이드가 증상의 회복에 효과적이며 신속한 호전을 유도한다. 토로사-헌트 증후군은 그 예후가 양호하다고 알려져 있으나 일부는 치료 후에 재발하기도 한다. 우리는 토로사-헌트 증후군으로 진단받고 스테로이드 치료 후 특별한 휴우증 없이 회복되었다가 스테로이드를 감량 중 잦은 두통과 안와 주위 통증의 재발을 호소하여 장기간 저용량 스테로이드를 투여 받고 있는 여아 1례를 경험하였기에 이를 보고하는 바이다.

Management of the Intractable Huge Intracranial Osteoma Based on the 3D Printing Model

  • Choi, Jong-Woo
    • Journal of International Society for Simulation Surgery
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    • 제3권2호
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    • pp.77-79
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    • 2016
  • Osteoma is one of the benign tumor that occurs on the bones all over the body. Mostly the simple excision is known to be enough. However, sometimes we encounter the troublesome situation where the osteoma is located in very challenging area, which results in the recurrence. 26 year female presented with the intractable intracranial osteoma. Given the disease entity of the osteoma, the simple excision would be enough or conservative management. But this osteoma turned out to be huge and recurrent in spite of the endoscopic resections, which causes the facial disappearance accompanied by the orbital vertical dystopia. Moreover, the patient's main concern was the pain. We performed the intracranial resection of the whole lesion and reconstructed the skull base and frontal bone as well as the part of the orbital wall. In order to restore the original bony anatomy, the 3D printing model was used based on the titanium mesh. I report this unusual case of the intractable intracranial huge osteoma. This report may be helpful for the other surgeons to make a decision on their similar cases in the future.