眼眶瘘管临床分析

临床上眼眶瘘管较少见，大多数是由于对原发病的诊断和处理不当所造成的，本文总结了我院1979年至1993年共收治的10例眼眶层管，现分析报告如下。临床资料1．一般资料：本组共10例，男性8例，女性2例；年龄最大47岁，最小10岁；病程最长18年，最短4个月；9例经彻底手术后治愈，l例因故未手术。1例手术多达8次。2．瘘营位置及长度：眶外上线处5例，眶内下缘3例，眶内上缘2例。渗管最长5cm，最短4mm。3．瘘管原因：①外伤异物6例（植物性异物4例，金属异物1例，玻璃1例）。②鼻窦炎2例。③皮样囊肿2例。4．并发眼症：①脸闭合不全3例，脸外翻1…     

眼眶瘘管并发颅内脓肿2例

眼眶瘘管是一种少见病,眼眶瘘管引发颅内脓肿尚未见报道。本文报告2例,1例死亡,1例治愈。例1,廖XX,男,20岁,农民,1970年10月第1次住入五官科.主诉：4月前做过左眼外侧囊肿摘除术,1月前该处出现小孔不断渗液,左眼球逐渐突出,间有头痛。诊断：左眼外眦瘘管。施行瘘管切除术。术后不久复发,眼突出及头痛加重。1972年3月第2次住院,诊断：左眶骨炎。应用苯甲异恶哩青霉素控制病情,头痛消失出院。1972年7月4日因头痛加剧第3次住院,住院号2064体查：左耳前及左颈侧各有一个蚕豆和花生米大之淋巴结,质软,前者有压痛,后者无压痛;…     

眼眶内植物性异物致眼眶瘘管一例

1病例 患者男,55岁。因右眼被芦苇刺伤后红肿6个月于我院就诊。患者于2013年11月不慎被芦苇刺伤右眼上睑,伤后患侧眼睑红肿,并出现少量流血,不伴明显眼红,眼胀或眼痛等症状,未作特殊处理。2014年5月9日自觉右眼眼睑肿胀加重,局部可触及小硬结,来我院就诊,门诊MRI示右眼眶内异物,遂以“右眼眶内异物”收住入院。     

眼眶植物性异物的诊断和治疗

目的：通过对眼眶植物性异物的临床分析，该病最好的诊断和治疗方法。方法：复习我院收治的眼眶植物性异物21例,分析其各项检查及治疗方法。结果：眼眶瘘管形成占眼眶植物性异物的57．14％；B型超声检查异常者占64．70％，可提示异物存在者占41．18％；CT扫描异常者94．12％，可提示异物存在者占41．18％；2例行MRI检查均清晰地显示出异物影像，21例患者均手术取出异物，证实术前诊断。结论：眼眶植物性异物影像学检查显示率较低，对于显示异物，MRI优于超声和CT。正确诊断必须结合病史和眼部体征，尤其是眼眶瘘管的存在，手术摘出异物的同时需将瘘管一同切除，以求彻底治愈。     

眼眶蜂窝组织炎26例临床分析

眼眶蜂窝组织炎２６例临床分析苏州市吴县红十字医院眼科陆盘根眼Ｄｂｅ窝组织炎（Ｏｒｂｉｔａｋｅｌｉｖｌｉｔｉ）是眼眶内软组织的急性化脓性炎症．延误诊断或治疗，不仅可严重损害视力，导致失明，还可引起一系列严重的并发症，如眼球自发性破裂”ｔ，颅内感染、海绵...     

眼眶及眶周疼痛的病因分析

目的 分析引起眼及眶周疼痛的病因。方法 对１９９３－１９９６年间以眼眶及眶周疼痛为主诉我院就诊的１３８例病例进行分析。结果 引起眼眶及眶周疼痛的眼现可大致分为：血管畸形,炎症,肿瘤,海绵窦－眶上裂平凡为。结论病因分析结果对医师诊断和鉴别诊断与眶周疼痛有关的疾病具有重要的参考价值。     

眼眶肌炎4例

眼眶肌炎是一组具有典型临床急、慢性发病特征的非特异性眼眶炎症 ,近年来引起人们在诊断上的重视。此病归类于眼眶炎性假瘤的一个临床亚型还是 /或作为一种独立的眼外肌疾病 ,值得探讨。现报告近年来我院收治的 4例眼眶肌炎例 1　女　 30岁　住院号 1 97380　于 1 999年 3月因左眼反复间歇性疼痛伴头痛、呕吐 ,历时近 2年。入院后 ,全身一般情况良好 ,右眼视力 1 .0 ,左眼视力 0 .9。眼球突出度 :右眼1 1 mm,左眼 1 1 mm,眼位正常 ,眼球运动自如。右眼眼压1 4.5 7mm Hg,左眼眼压 1 8.86 mm Hg。眼前节正常 ,眼底无异常发现。眼眶触诊 ,左…     

眼眶巨大骨瘤一例

患者男 ,2 0岁。发现左眼突出 4ｄ ,于 2 0 0 0年 2月 18日就诊。患者既往体健 ,无外伤及遗传病史。眼部检查 :右眼裸眼视力 0 3,左眼 0 5 ;双眼矫正视力 1 2。双眼前节未见异常。右眼正常。左眼球向前下方突出 ,眼球运动自如 ,上眶缘内侧可扪及花生米大小骨性包块 ,触痛明显 ,边界欠清。眼底未见异常。眼球突出度 :右眼 17ｍｍ ,左眼 2 2ｍｍ ,眶距112ｍｍ。ＣＴ检查 :左眼眶内上方见一 2 0ｃｍ× 2 1ｃｍ大小片状致密影 ,ＣＴ值为 15 41 2Ｈｕ ,眼球受压 ,向左下方移位(图 1)。诊断 :左眼眶骨瘤。于同月 2 1日在全麻下行前路开眶术 (…     

外伤性颈内动脉—海绵瘘的DSA血管内治疗

目的：探讨数字减影血管造影（Digital subtraction angiography,DSA)及血管内治疗对外伤性颈内动脉-海绵瘘（Traumatic carotid-cavernous fistula,TCCF)的诊断及治疗价值。方法：对9例以搏动性突眼为主要症状的海绵窦瘘患者行DSA检查及行可脱性球囊血管内栓塞治疗总结分析。结果：9例患者均成功栓塞瘘口且保留载瘤动脉通畅。结论：DSA检查和血管内栓塞治疗是TCCF理想的诊断与治疗方法。     

A Case of Erdheim—Chester Disease with Bilateral Orbital Involvement

Purpose: To describe a case of Erdheim-Chester disease with bilateral orbital involvement.Methods: A 43-year-old female with bilateral proptosis was presented. Its clinical features, image findings, pathological character and therapeutic effect were evaluated. Results: CT demonstrated bilateral, diffuse orbital mass. Histopathologic assessment revealed a diffuse xanthogranulomatous process with clusters of lipidladen histocytes. Numerous Touton giant cells were scattered throughout the lesion.Renal and heart failure happened during a 6-year follow-up period. Long bones roentgenogram demonstrated diffuse symmetrical sclerosis with extensive, lytic lesions. Systemic administration of corticosteroids, chemotherapy, immunoglobulin and traditional Chinese medicine showed good therapeutic result.Conclusions: An administration of systemic corticosteroids, chemotherapy, immuno-globin and traditional Chinese medicine can control Erdheim-Chester disease. Further exploration of its pathogenesis     

Orbital Compartment Syndrome Following Transvenous Embolization of Carotid-Cavernous Fistula

Abstract

Superior ophthalmic vein (SOV) thrombosis is a rare complication of carotid-cavernous fistula (CCF) embolization and is usually associated with a paradoxical worsening of signs followed by subsequent spontaneous resolution. We report a case in a 69-year-old female who developed orbital compartment syndrome due to SOV thrombosis following transvenous embolization of an indirect CCF. The patient was treated with an urgent lateral canthotomy and cantholysis and had good recovery. This report demonstrates that the paradoxical worsening due to SOV thrombosis in CCF may result in orbital compartment syndrome and require early recognition and prompt decompressive measures to avoid permanent visual sequelae.     

Features Associated with Recurrence of Idiopathic Orbital Inflammatory Pseudotumor

Purpose: To explore factors which lead to recurrence of idiopathic orbital inflam-matory pseudotumor (IOIP). Methods: Idiopathic orbital inflammatory pseudotumor in 209 cases between Jan 1, 1978 and Dec 31, 1999 in our hospital was evaluated retrospectively. The comparison of clinical and pathological parameters between patients with at least one episode of recurrence and those with no recurrence at all was performed and analyzed using logistic regression method. Results: Follow-up results (with a mean follow-up time of 3.4 years, ranging from 0.5 year to 21.0 years) showed that the recurrence rate of IOIP was 41%. Sex and proptosis were associated with the recurrence of IOIP. Male gender was more likely to relapse than female counterparts, with the male being 52% and female being 25%. The severer the proptosis is, the higher the rate of recurrence. Among the clinical subtypes of IOIP, the rate of recurrence (17%) in cases with dacryoadinitis was the lowest, followed by anterior local orbital mass (44%), posterior orbital mass (54%), myositis (75%) and diffuse subtype (100%). However, the clinical subtypes did not show significant relationship with the recurrence of IOIP. Conclusions: Male gender and severe proptosis are associated with a higher recurrent rate in patients with IOIP.     

Dural Arteriovenous Fistula of the Optic Nerve Sheath

Dural arterial-venous fistulas (dAVf) are acquired vascular lesions that can give a variety of symptoms, depending on anatomical localization and venous drainage pattern. We present a very unusual case of a dAVf localized at the level of the optic nerve sheath including discussion of the vascular anatomy and treatment options.     

Orbital alveolar soft part sarcoma: Histopathologic report of two cases

Alveolar soft part sarcoma is considered as a distinct histopathological entity with rare cases reported from the orbit area. Two cases of alveolar soft part sarcomas occurring in the orbit of two patients along with their histopathologic findings are reported herewith. In both cases, the patients presented with eyelid swelling and proptosis. The diagnosis was made by incisional biopsies and histopathology. The literature is reviewed regarding occurrence of this tumor, its diagnosis and management.     

Direct Orbital Puncture of the Cavernous Sinus for the Treatment of a Carotid-Cavernous Dural AV Fistula with a Concomitant Venous/Lymphatic Malformation

Abstract

A 37- year old male with a long history of a left orbital venous/lympathic malformation presented with ocular injection, increased proptosis and reduced left vision. Angiography demonstrated a carotid cavernous dural AV fistula combined with a concomitant venous/lymphatic malformation. After attempts at transvenous embolization, a direct uncomplicated transorbital puncture of the cavernous sinus via a lateral orbitotomy was performed with complete resolution of ocular symptoms.     

角膜移植联合抗青光眼术治疗角膜瘘（附22例病例分析）

应用角膜移植联合抗青光眼术治疗角膜瘘共22例（22只眼），术后效果较好，在穿透角膜移植的13例中，术后全部达到封瘘目的，11例术后植片透明，8例术后视力提高；板层角膜移植9例，术后也全部达到封瘘目的，并有4例植片透明，5例术后视力提高，手术主要合并症是持续性上皮缺损和虹膜前粘连，并就手术适应症、手术方式的选择及技术操作等方面进行了讨论。     

眼眶恶性黑色素瘤的诊断与治疗

目的 探讨眼眶恶性黑色素瘤的发病情况、临床表现、影像学特征、病理特点及其治疗.方法 回顾分析1999年1月至2006年12月就诊的眼眶恶性黑色素瘤患者.结果 眼眶恶性黑色素瘤最常见的症状为眼球突出及眼睑皮下肿物伴眼睑肿胀;最常见的体征为眼球突出、眼球运动受限及眶压升高,其次为眼睑肿胀和扪及皮下肿物;除脉络膜恶性黑色素瘤侵及眼眶者外,患侧眼底多无明显改变.彩色多普勒血流显像示病变区均可见较丰富的血流信号核磁共振检查示,病变区显示特征性的短T1,短T2信号影.病理检查见瘤细胞为圆形、椭圆形、上皮样多角形和梭形等,胞浆内有黑色素沉着;免疫组化示黑色素相关抗原(HMB45)和S-100蛋白均呈阳性.全部病例均手术治疗,经随访0.5～6年,半数无复发及转移.结论 眶内恶性黑色素瘤较少见,多由脉络膜、结膜或眼睑蔓延而来,原发者甚为罕见.核磁共振检查的影像特点可做为重要的诊断依据,治疗以手术切除为主.     

Transverse and Sigmoid Sinus Dural Arteriovenous Fistula Mimicking Idiopathic Intracranial Hypertension and Carotid Cavernous Fistula

Intracranial dural arteriovenous fistulas (dAVFs) can produce a variety of symptoms depending on fistula location, size, and venous drainage. Although cavernous sinus fistulas (CCFs) classically present with symptoms of orbital venous congestion due to retrograde venous drainage into the superior ophthalmic vein (i.e. an arterialised “red eye”) (Miller NR. Neurosurg Focus 2007;23:1--15), dAVFs not localised to the cavernous sinus rarely present with a “red eye” and instead produce increased intracranial pressure, which can mimic idiopathic intracranial hypertension (IIH). The authors present a unique case of an intracranial dAVF with clinical features suggestive of both CCF and IIH. Clinicians should be aware of this possibility to avoid delayed diagnosis of the intracranial dAVF.