2011-2012 Basic and Clinical Science Course, Section 7: by John Bryan Holds MD

By John Bryan Holds MD

Information the anatomy of the orbit and adnexa, and emphasizes a realistic method of the review and administration of orbital and eyelid problems, together with malpositions and involutional adjustments. Updates present details on congenital, inflammatory, infectious, neoplastic and nerve-racking stipulations of the orbit and accent constructions. Covers key elements of orbital, eyelid and facial surgical procedure. contains quite a few new colour pictures. significant revision 2011-2012.

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Additional resources for 2011-2012 Basic and Clinical Science Course, Section 7: Orbit, Eyelids, and Lacrimal System (Basic & Clinical Science Course)

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T hey may be freely mobile or they may be fixed to periosteulll at the underl ying suture. If the dermoid occu rs more posteriorly, in the temporal fossa, computed tomography (CT) is often indicated to mle o ut dumbbell expansion through the suture into the under lying orbit. Medial lesions in the infant should be distinguished from congenital encephaloceles and dacryoceles. Dermoid cysts that do not present until adulthood often are not palpable because they are situated posteriorly in the orbit, usuall y in the superior and temporal portions adjacent to the bony sutures.

Khalil M, Lindley S, Matouk E. Tuberculosis of the orbit. Ophthallllology. 1985;92(1 I): \624-\627. Zygomycosis Zygo mycosis (also know n as phycomycosis or muconnycosis) is the most common and th e most vir ul ent fu ngal disease involving the orbit. The specific fungal ge nus involved is usually kIucor or Rhizopus. These fungi, belonging to the class Zygomyce tes, almost always extend into the orbit from an adjacent sinus or the nasal cavity.

Acco rding to the guidelines set forth by Garcia and Harris, manageme nt may consist of careful observation unless any of the following criteria are present: patient 9 years or older presence of frontal sinusitis non medial location of su bperiosteal abscess (SPA) large SPA suspicion of anaerobic infection (presence of gas in abscess on CT) recurrence of SPA after prior drainage evidence of chro nic sinusitis (eg, nasal polyps) acute optic nerve or retinal compromise infection of dental ori gin (anaerobic infection more likely) Surgical drainage cou pled with appropriate antibiotic therapy is recommended in older patients or those with more severe presentation and usually leads to dramatic clinical improvement within 24-48 hours.

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