Cranio-Orbito-Zygomatic Measurements from Standard CT Scans in Unoperated Treacher Collins Syndrome Patients: Comparison with Normal Controls

1995 ◽  
Vol 32 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Jeffrey C. Posnick ◽  
Mohammad M. Al-Qattan ◽  
Stephanie M. Moffat ◽  
Derek Armstrong
Keyword(s):  
Normal Values ◽  
Treacher Collins Syndrome ◽  
Ct Scans ◽  
Computed Tomographic ◽  
Cohort Group ◽  
Orbital Wall ◽  
The Mean ◽  
Medial Orbital Wall ◽  
Orbital Rim ◽  
Normal Controls

Fourteen reproducible cranio-orbito-zygomatic measurements taken from 26 standard axial computed tomographic (CT) scans of unoperated individuals with symmetric forms of Treacher Collins syndrome (TCS) were compared to age-matched controls. The interorbital measurements of the TCS patients were at the mean when compared to their cohort group (medial and lateral orbital wall separation), while the zygomatic measurements were significantly less than normal confirming the extent of malar hypoplasia. The congenitally deficient lateral aspect of the orbits in TCS patients was confirmed by the greater than normal values measured for globe protrusion and medial orbital wall protrusion in conjunction with the diminished lateral orbital wall lengths, all of which use the lateral orbital rim as a reference point. The abnormal shape of the anterior cranial vault in patients with TCS was documented as a diminished intercoronal distance (width) and decreased cephalic length when compared to normal age-matched controls.

Cranio-Orbito-Zygomatic Measurements from Standard CT Scans in Unoperated Crouzon and Apert Infants: Comparison with Normal Controls

1992 ◽  
Vol 29 (2) ◽  
pp. 129-136 ◽  
Author(s):  
Michele Carr ◽  
Jeffrey C. Posnick ◽  
Gaylene Pron ◽  
Derek Armstrong
Keyword(s):  
Normal Population ◽  
Correlation Coefficients ◽  
Apert Syndrome ◽  
Ct Scans ◽  
Wall Angle ◽  
Observer Error ◽  
Computed Tomographic ◽  
Orbital Wall ◽  
Facial Differences ◽  
Normal Controls

Cranio-orbito-zygomatic measurements taken from standard axial computed tomographic (CT) scans of unoperated patients with Crouzon syndrome (6 males, 14 females) and Apert syndrome (6 males, 10 females) under 1 year of age were compared to each other and to normal controls (40 males, 35 females). Fifteen cranio-orbito-zygomatic variables were measured and repeated. Means and standard deviations were computed for each sex, and means were pooled since they were not significantly different. Correlation coefficients for repeat measures (intra-observer error) of each variable showed good reproducibility. Only the lateral orbital wall angle differed between the syndromes (p = .034), suggesting that upper facial differences (as measured by these variables) do not manifest themselves at this young age. All measurements for both syndromes, except one, were outside the 95 percent confidence range for age-matched controls. Measurements taken from standard CT scans provide an objective comparison between specific syndromes and the normal population.

scholarly journals Ethnic variation in medial orbital wall anatomy and its implications for decompression surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Minhui Amy Chan ◽  
Farah Ibrahim ◽  
Arjunan Kumaran ◽  
Kailing Yong ◽  
Anita Sook Yee Chan ◽  
...  
Keyword(s):  
Relative Position ◽  
Ethmoid Sinus ◽  
Decompression Surgery ◽  
Ethnic Variation ◽  
Sinus Wall ◽  
Orbital Wall ◽  
Mean Width ◽  
Significant Difference ◽  
The Mean ◽  
Medial Orbital Wall

Abstract Background To describe the inter-ethnic variation in medial orbital wall anatomy between Chinese, Malay, Indian and Caucasian subjects. Methods Single-centre, retrospective, Computed Tomography (CT)-based observational study. 20 subjects of each ethnicity, were matched for gender and laterality. We excluded subjects younger than 16 years and those with orbital pathology. OsiriX version 8.5.1 (Pixmeo., Switzerland) and DICOM image viewing software CARESTREAM Vue PACS (Carestream Health Inc., USA) were used to measure the ethmoidal sinus length, width and volume, medial orbital wall and floor angle and the relative position of the posterior ethmoid sinus to the posterior maxillary wall. Statistical analyses were performed using Statistical Package for Social Sciences version 25.0 (IBM, USA). Results There were 12 males (60 %) in each group, with no significant difference in age (p = 0.334–0.994). The mean ethmoid sinus length in Chinese, Malay, Indian and Caucasian subjects, using the Chinese as reference, were 37.2, 36.9, 38.0 and 37.4mm, the mean width was 11.6, 10.5, 11.4 and 10.0mm (p = 0.020) and the mean ethmoid sinus volume were 3362, 3652, 3349 and 3898mm3 respectively. The mean medial orbital wall and floor angle was 135.0, 131.4, 131.0 and 136.8 degrees and the mean relative position of posterior ethmoid sinus to posterior maxillary wall were − 2.0, -0.2, -1.5 and 1.6mm (p = 0.003) respectively. Conclusions No inter-ethnic variation was found in decompressible ethmoid sinus volume. Caucasians had their posterior maxillary sinus wall anterior to their posterior ethmoidal walls unlike the Chinese, Malay and Indians. Awareness of ethnic variation is essential for safe orbital decompression.

Frontonasal and Craniofrontonasal Dysplasia: Preoperative Quantitative Description of the Cranio-Orbito-Zygomatic Region Based on Computed and Conventional Tomography

1994 ◽  
Vol 31 (2) ◽  
pp. 97-105 ◽  
Author(s):  
Stephanie M Moffat ◽  
Jeffrey C. Posnick ◽  
Gaylene E. Pron ◽  
Derek C. Armstrong
Keyword(s):  
Computed Tomography ◽  
Clinical Presentation ◽  
Matched Control ◽  
Quantitative Description ◽  
Frontonasal Dysplasia ◽  
Orbital Wall ◽  
Computed Tomography Scans ◽  
Conventional Tomography ◽  
The Mean ◽  
Medial Orbital Wall

The unoperated cranio-orbito-zygomatic complex of 18 children (mean 4.7 years) with frontonasal dysplasia (FND) and 12 children (mean 1.1 years) with craniofrontonasal dysplasia (CFND) was quantified by 15 standard measurements performed on either computed tomography scans or facial tomograms. The results were compared with age-matched control values. In the FND group, the mean anterior interorbital and mid-interorbital distances were significantly increased at 148% and 118% of normal, and in the CFND patients, at 177% and 140% of normal. Excessive medial orbital wall protrusion (mean, 145% of normal in FND and 177% in CFND), shortened zygomatic arch lengths (mean, 94% of normal In FND and 91% in CFND), and reduced cephalic lengths (mean, 96% of normal in FND and 83% in CFND) were all observed. An expanded interzygomatic buttress distance was documented only in the CFND group, at 111% of normal. The clinical presentation of craniofacial deformities such as FND and CFND can be objectively described by a numerical analysis of the bony pathology.

Nasal and Nasoethmoidal-Orbital Fractures: A Continuum of Injury

2000 ◽  
Vol 8 (2) ◽  
pp. 73-77
Author(s):  
Mohammed M Elahi ◽  
Bernard L Markowitz
Keyword(s):  
Open Reduction Internal Fixation ◽  
Successful Outcome ◽  
Orbital Fractures ◽  
Computed Tomographic ◽  
Fracture Failure ◽  
Orbital Wall ◽  
Functional Consequences ◽  
High Index Of Suspicion ◽  
Medial Orbital Wall ◽  
Nasal Fractures

The unilateral nasoethmoid orbital (NOE) fracture is frequently misdiagnosed. This fracture is independent of the clinically obvious NOE fracture and has alternately been referred to as complex nasal, minimally displaced, occult or greenstick NOE fracture. Failure to identify and treat these injuries at initial presentation results in undesirable aesthetic and functional consequences that are difficult to repair secondarily. Three patients who presented with nasal fractures complicated by minimally displaced fractures of the medial orbital wall were reviewed retrospectively. These injuries were successfully diagnosed and treated after their examining physicians failed to appreciate the injury on the initial evaluation. Complex nasal injuries with fracture extensions to the NOE are often missed by the examining physician. These injuries should benefit from a high index of suspicion and be evaluated with axial and coronal computed tomographic imaging. Acute treatment with appropriate exposure, open reduction, internal fixation and bone grafting is most compatible with a successful outcome.

Postoperative Computed Tomographic Evaluation of Patients with Large Pituitary Tumors Treated with Operative Decompression and Radiation Therapy

Neurosurgery ◽  
1991 ◽  
Vol 28 (2) ◽  
pp. 238-241 ◽  
Author(s):  
Paul B. Nelson ◽  
Alan G. Robinson ◽  
William Hirsch
Keyword(s):  
Radiation Therapy ◽  
Pituitary Tumors ◽  
Residual Tumor ◽  
Early Postoperative Period ◽  
Ct Scans ◽  
Computed Tomographic ◽  
Ct Evaluation ◽  
Serial Ct ◽  
The Mean ◽  
Operative Decompression

Abstract Thirty consecutive patients who underwent operative decompression and radiation therapy for large sellar and suprasellar pituitary tumors (⩾2 cm) were studied in terms of the serial computed tomographic (CT) changes. There were 23 men and 7 women. The mean age was 49.6 ± 2.5 years, and the mean follow-up was 45.3 ± 3.9 months. Twenty-eight of the 30 patients had transsphenoidal surgery, and 27 had hormonally inactive tumors. Radiation therapy was begun within 1 month of surgery with a mean dose of 4855 ± 70 cGy. Postoperative CT scans were obtained within 1 month of surgery and at 6- to 12-month intervals thereafter. Fourteen patients (45%) had no suprasellar tumor visualized in either the early postoperative CT scans or on subsequent scans. Eleven patients (35%) had a persistent suprasellar mass during the early postoperative period that resolved on serial CT evaluation. The mean time for resolution was 10.4 ± 1.2 months. Six patients (20%) had a persistent suprasellar mass on serial CT evaluation. A persistent postoperative mass that subsequently resolved in many of the patients was thought to be caused by the gradual retraction of the postoperative packing and hematoma, as well as the effect of radiation on any residual tumor.

Endoscopic treatment of combined metopic-sagittal craniosynostosis

2020 ◽  
Vol 26 (2) ◽  
pp. 113-121
Author(s):  
Ema Zubovic ◽  
Gary B. Skolnick ◽  
Sybill D. Naidoo ◽  
Mark Bellanger ◽  
Matthew D. Smyth ◽  
...  
Keyword(s):  
Endoscopic Treatment ◽  
Ct Scans ◽  
Sagittal Synostosis ◽  
Sagittal Craniosynostosis ◽  
Cranial Index ◽  
Helmet Therapy ◽  
The Mean ◽  
Normal Controls ◽  
Cranial Vault Remodeling

OBJECTIVECombined metopic-sagittal craniosynostosis is traditionally treated with open cranial vault remodeling and fronto-orbital advancement, sometimes in multiple operations. Endoscopic treatment of this multisuture synostosis presents a complex challenge for the surgeon and orthotist.METHODSThe authors retrospectively analyzed the preoperative and 1-year postoperative CT scans of 3 patients with combined metopic-sagittal synostosis, all of whom were treated with simultaneous endoscope-assisted craniectomy of the metopic and sagittal sutures followed by helmet therapy. Established anthropometric measurements were applied to assess pre- and postoperative morphology, including cranial index and interfrontal divergence angle (IFDA). Patients’ measurements were compared to those obtained in 18 normal controls.RESULTSTwo boys and one girl underwent endoscope-assisted craniectomy at a mean age of 81 days. The mean preoperative cranial index was 0.70 (vs control mean of 0.82, p = 0.009), corrected postoperatively to a mean of 0.82 (vs control mean of 0.80, p = 0.606). The mean preoperative IFDA was 110.4° (vs control mean of 152.6°, p = 0.017), corrected postoperatively to a mean of 139.1° (vs control mean of 140.3°, p = 0.348). The mean blood loss was 100 mL and the mean length of stay was 1.7 days. No patient underwent reoperation. The mean clinical follow-up was 3.4 years.CONCLUSIONSEndoscope-assisted craniectomy with helmet therapy is a viable single-stage treatment option for combined metopic-sagittal synostosis, providing correction of the stigmata of trigonoscaphocephaly, with normalization of the cranial index and IFDA.

Medial orbital protrusion - a potentially hazardous anomaly during endoscopic sinus surgery

1999 ◽  
Vol 113 (8) ◽  
pp. 754-755 ◽  
Author(s):  
J. C. Lim ◽  
P. J. Hadfield ◽  
S. Ghiacy ◽  
N. R. Bleach
Keyword(s):  
Computed Tomography ◽  
High Risk ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Developmental Anomaly ◽  
Sinus Surgery ◽  
Ct Scans ◽  
Orbital Wall ◽  
Medial Orbital Wall

AbstractWe report the case of a 57-year-old patient with a presumed developmental anomaly of the medial orbital wall. The resultant protrusion of orbital contents into the ethmoidal complex was clearly demonstrated on coronal computed tomography (CT) scans of the paranasal sinuses. This anomaly presents a high risk of iatrogenic injury to the medial rectus and orbit during functional endoscopic sinus surgery and has not previously been described.

Resources: Internet Resources for the Independent Medical Evaluator – 2007

2007 ◽  
Vol 12 (4) ◽  
pp. 4-7
Author(s):  
Christopher R. Brigham ◽  
Jenny Walker
Keyword(s):  
Head Trauma ◽  
Clonic Seizure ◽  
Acute Subdural Hematoma ◽  
Orbital Fracture ◽  
Orbital Wall ◽  
First Occurrence ◽  
One Year ◽  
The One ◽  
Neurological Injuries ◽  
Medial Orbital Wall

Abstract Rating patients with head trauma and multiple neurological injuries can be challenging. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, Section 13.2, Criteria for Rating Impairment Due to Central Nervous System Disorders, outlines the process to rate impairment due to head trauma. This article summarizes the case of a 57-year-old male security guard who presents with headache, decreased sensation on the left cheek, loss of sense of smell, and problems with memory, among other symptoms. One year ago the patient was assaulted while on the job: his Glasgow Coma Score was 14; he had left periorbital ecchymosis and a 2.5 cm laceration over the left eyelid; a small right temporoparietal acute subdural hematoma; left inferior and medial orbital wall fractures; and, four hours after admission to the hospital, he experienced a generalized tonic-clonic seizure. This patient's impairment must include the following components: single seizure, orbital fracture, infraorbital neuropathy, anosmia, headache, and memory complaints. The article shows how the ratable impairments are combined using the Combining Impairment Ratings section. Because this patient has not experienced any seizures since the first occurrence, according to the AMA Guides he is not experiencing the “episodic neurological impairments” required for disability. Complex cases such as the one presented here highlight the need to use the criteria and estimates that are located in several sections of the AMA Guides.

Age does not necessarily influence latency of event-related potentials

2014 ◽  
Vol 33 (10) ◽  
pp. 723-727
Author(s):  
M. Westermann ◽  
I. W. Husstedt ◽  
A. Okegwo ◽  
S. Evers
Keyword(s):  
Normal Values ◽  
Rank Correlation ◽  
Event Related Potentials ◽  
Intrinsic Property ◽  
Total Sample ◽  
Oddball Paradigm ◽  
Age Dependent ◽  
Related Potentials ◽  
The Mean ◽  
P3 Component

SummaryEvent-related potentials (ERP) are regarded as age dependent. However, it is not known whether this is an intrinsic property of ERP or an extrinsic factor. We designed a setting in which ERP were evoked using a modified oddball paradigm with highly differentiable and detectable target and non-target stimuli. A total of 98 probands were enrolled in this study. We evaluated the latency and amplitude of the P3 component of visually evoked ERP. The mean P3 latency was 294 ± 28 ms and was not related to age (r = –0.089; p = 0.382; Spearman-rank-correlation). The P3 amplitude was related to age in the total sample (r = –0.323; p = 0.001; Spearmanrank-correlation) but not in the probands under the age of 60 years. There were no significant differences regarding sex. Our findings suggest that ERP are not age dependent if highly differentiable and detectable stimuli are used. This should be considered when normal values of ERP are created for clinical use.

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