Colobomatous cysts of optic nerve

2016 ◽  
Vol 7 (4) ◽  
pp. 153-158
Author(s):  
Nataliia N Sadovnikova ◽  
Vlidimir A Shereshevsky ◽  
Natalia V Prisich ◽  
Vladimir V Brzesky ◽  
Dmitriy Yu Li

Objectives of publication:presentation of a rare clinical observation from our own practice.Key points:colobomatous orbital cyst with microphthalmos — rare anomaly of an embryonal development of an eyeball, it is formed owing to “filling” of an optic nerve with the intraocular liquid coming to him from a vitreous chamber through сoloboma of disk because of violation of hydrodynamics in a forward segment of an eye. Usually this anomaly is combined with microphthalmic eye, though cases of a colobomatous cyst with a normal size of an eyeball, and also with other anomalies of development of an eye (inferior uveoretinal coloboma, prepupillary membrane, corneal opacity) are described.Сlinical observation:during 2015 in our department there were two children to whom after the carried-out inspection the diagnosis of a colobomatous cysts of optic nerve has been exposed. Concerning the first child waiting tactics has been recognized expedient, at repeated surveys in 1 and 4 months of any dynamics in the ophthalmologic status it hasn’t been revealed. To the second child because of the expressed exophthalmos with lagophthalmia, with perforation threat, surgical intervention – a puncture and drainage of a cyst of an optic nerve is performed. After operation the correct situation and mobility of an eyeball were restored, xerotic changes of a cornea and conjunctiva have decreased.Conclusions:from the pathogenetic mechanism of cystous formation of an orbit, it is more logical to specify the clinical diagnosis a mention in him an optic nerve – “сolobomatous cysts of optic nerve”. Surgical treatment depends on the sizes of cyst, degree of exophthalmos and existence of complications.

2020 ◽  
Vol 28 (4) ◽  
pp. 530-535
Author(s):  
Ivan Andreev ◽  
Alexander Kolsanov ◽  
Sergey Katorkin ◽  
Evgeniy Shestakov ◽  
Leonid Lichman

Aim. Demonstration of potentials of preoperative planning and implementation of surgical resection in patients with adrenal cysts. A clinical observation of a successful surgical treatment of a rare pathology cyst of the right adrenal is presented. The choice of surgical treatment tactics is determined by the size of tumor and clinical presentation of the disease. The surgical treatment was accomplished laparoscopically which permitted to reduce the time of recovery and rehabilitation of the patient. In this clinical observation, the benefit of using 3D-modeling of the surgical area was shown for visualization of topographic and anatomic peculiarities and facilitation of the intraoperative navigation with the help of Avtoplan program developed by Samara State Medical University. Conclusion. Preoperative 3D-modeling permits to prepare to surgical intervention taking into account individual anatomic peculiarities of a patient, and to determine the optimal volume of the operation.


2018 ◽  
pp. 22-26
Author(s):  
N. A. Buralkina ◽  
G. A. Vlasov ◽  
A. V. Veredchenko ◽  
V. V. Chursin ◽  
A. V. Asaturova ◽  
...  

The article deals with the clinical case of a patient with giant uterine myoma. It presents the features of surgical intervention and postoperative management of the patient. In the publication, the authors discuss the issues concerning the scope of the surgery in patients with large and giant uterine myomas and prognosis of reproductive outcomes in this cohort of women.


2018 ◽  
Vol 6 (4) ◽  
pp. 103-109
Author(s):  
Vladislav V. Murashko ◽  
Dmitry N. Kokushin ◽  
Sergei V. Vissarionov ◽  
Grigoriy A. Lein ◽  
Ivan V. Pavlov ◽  
...  

Introduction. New questions of indications and methods of surgical treatment of children with congenital spinal deformity are covered in detail. However, straightening deformed segment of the spine and fixing with metal construction is not sufficient, and conditions for its retention and prevention of migration must be created. The expediency of the study is relevant because of lack of systematic review of the results of orthotic support as complex treatment of this group of patients, both in Russia and abroad. The problems faced by vertebral surgeons are the following: the tendency of deformation relapse as the child grows, tendency of deformation of unfixed (lower and upper) segments of the vertebral column. Clinical case. For observation, we selected an 11-year-old patient. The diagnosis was congenital scoliosis on posterolateral hemivertebra Th4, dysplastic course of congenital spinal deformity. The surgical treatment performed was extirpation of hemivertebra Th4(S) and the correction of local congenital deformity with multicore corrective system in combination with bone grafting. We achieved complete correction of congenital local curve at the level of the posterior lateral hemivertebra and reduction of compensatory curves in the thoracic and lumbar spine. In the postoperative period, the patient was provided with corrective brace, with the aim of influencing on the compensatory curve. Discussion. This clinical observation aimed to determine the different approaches to treatment of children with congenital deformities of the thoracic spine, which consists of surgical correction of local congenital curvature curve with subsequent correction of compensatory curves by using a correcting brace. Conclusion. As a result of the surgical intervention, correction of congenital spinal deformity was achieved, and the use of a corrective brace in the postoperative period allowed the correction of compensatory curves and maintained the achieved result until the end of the patient’s growth.


Author(s):  
K.M. Saidzhamolov ◽  
◽  
E.V. Gromakina ◽  
S.K. Makhmadzoda ◽  
◽  
...  

Purpose. To assess the severity of penetrating eye trauma in children in Tajikistan. Material and methods. Retrospectively there was analyzed 277 case histories of children with a diagnosis of penetrating eye injury, admitted to the children’s department of the National Medical Centre of the Republic of Tajikistan for the provision of specialized ophthalmological care. Results. The average age of children at the time of injury to the organ of sight was 7.06 ± 3.01 years, mainly these were villagers (70%). Children under 7 years old accounted for 57.8% of those admitted to the hospital. The terms of admission to the hospital ranged from 1 to 14 days, an average of 43.02 ± 33.35 hours. The severity is caused by damage to 2 or more structures of the eyeball in 81,3%. Wounds larger than 6 mm prevailed and amounted to 63,5%. Endophthalmitis at admission was noted in 8,3% of cases. Enucleation was performed in 2 children; 244 children underwent primary surgical treatment. Visual acuity at discharge was higher than 0.1 in 72 of 275 children (26.2%), lower than 0,1 in 194 (70.7%). Conclusion. Almost every second child (43.0%) is admitted to the hospital for primary surgical treatment of an eyeball wound after 24 hours. About 2/3 of cases of eye damage are characterized by large wound sizes. Stab wounds were noted in 90.2% of cases. In 58.8% of cases, damage to the cornea was observed and in 68.6% – damage to the lens area.


2020 ◽  
Vol 57 (12) ◽  
pp. 1392-1401
Author(s):  
Mark P. Pressler ◽  
Emily L. Geisler ◽  
Rami R. Hallac ◽  
James R. Seaward ◽  
Alex A. Kane

Introduction and Objectives: Surgical treatment for trigonocephaly aims to eliminate a stigmatizing deformity, yet the severity that captures unwanted attention is unknown. Surgeons intervene at different points of severity, eliciting controversy. This study used eye tracking to investigate when deformity is perceived. Material and Methods: Three-dimensional photogrammetric images of a normal child and a child with trigonocephaly were mathematically deformed, in 10% increments, to create a spectrum of 11 images. These images were shown to participants using an eye tracker. Participants’ gaze patterns were analyzed, and participants were asked if each image looked “normal” or “abnormal.” Results: Sixty-six graduate students were recruited. Average dwell time toward pathologic areas of interest (AOIs) increased proportionally, from 0.77 ± 0.33 seconds at 0% deformity to 1.08 ± 0.75 seconds at 100% deformity ( P < .0001). A majority of participants did not agree an image looked “abnormal” until 90% deformity from any angle. Conclusion: Eye tracking can be used as a proxy for attention threshold toward orbitofrontal deformity. The amount of attention toward orbitofrontal AOIs increased proportionally with severity. Participants did not generally agree there was “abnormality” until deformity was severe. This study supports the assertion that surgical intervention may be best reserved for more severe deformity.


2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0002
Author(s):  
Brendon C. Mitchell ◽  
Matthew Y. Siow ◽  
Alyssa Carrol ◽  
Andrew T. Pennock ◽  
Eric W. Edmonds

Background: Multidirectional shoulder instability (MDI) refractory to rehabilitation can be treated with arthroscopic capsulolabral reconstruction with suture anchors. No studies have reported on outcomes or examined the risk factors that may contribute to poor outcomes in adolescent athletes. Hypothesis/Purpose: To identify risk factors for surgical failure by comparing anatomic, clinical, and demographic variables in adolescents who underwent surgical intervention for MDI. Methods: All patients undergoing arthroscopic shoulder surgery at one institution between January 2009 and April 2017 were reviewed. Patients >20 years old at presentation were excluded. Multidirectional instability was defined by positive drive-through sign on arthroscopy plus positive sulcus sign and/or multidirectional laxity on anterior and posterior drawer testing while under anesthesia. Two-year minimum follow-up was required, but those whose treatment failed earlier were included for reporting purposes. Demographics and intraoperative findings were recorded, as were Single Assessment Numeric Evaluation (SANE) scoring, Pediatric and Adolescent Shoulder Survey (PASS), and the short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) results. Results: Eighty adolescents (88 shoulders) were identified for having undergone surgical treatment of MDI. Of these 80 patients, 42 (50 shoulders; 31 female, 19 male) were available at a minimum of 2-year follow-up. Mean follow-up was 6.3 years (range, 2.8-10.2 years). Thirteen (26.0%) shoulders experienced surgical failure defined by recurrence of subluxation and instability, all of which underwent re-operation. Time to re-operation occurred at a mean of 1.9 years (range, 0.8-3.2). Our cohort had an overall survivorship of 96% at 1 year after surgery and 76% at 3 years. None of the anatomic, clinical, or demographic variables tested, or the presence of generalized ligamentous laxity, were correlated with subjective outcomes or re-operation. Number of anchors used was not different between those that failed and those that did not fail. Patients reported a mean SANE score of 83.3, PASS score of 85.0, and QuickDASH score of 6.8. Return to prior level of sport (RTS) occurred in 56% of patients. Conclusion: Multidirectional shoulder instability is a complex disorder that can be challenging to treat. Adolescent MDI that is refractory to non-surgical management appears to have long-term outcomes after surgical intervention that are comparable to adolescent patients with unidirectional instability. In patients who do experience failure of capsulorraphy, we show that failure will most likely occur within 3 years of the index surgical treatment. [Table: see text][Figure: see text]


1988 ◽  
Vol 105 (4) ◽  
pp. 441
Author(s):  
H. Stanley Thompson ◽  
JEFFREY A. NERAD

PEDIATRICS ◽  
1955 ◽  
Vol 15 (5) ◽  
pp. 595-599
Author(s):  
Niels L. Low ◽  
Erna L. Gibbs ◽  
Frederic A. Gibbs

After reviewing the literature on breath holding spells, it seemed desirable to determine whether any electroencephalographic abnormality is revealed by recordings during sleep in such cases. One hundred twenty-nine children between the ages of 7 months and 11½ years with breath holding spells were examined electroencephalographically while awake and during sleep. Seventy-seven of these children were boys and 52 were girls. All these children but one had normal electroencephalograms. One tracing taken during a breath holding spell is reproduced which shows slow wave but no seizure activity. The clinical diagnosis is discussed and it is concluded that the electroencephalogram in combination with the history and clinical observation is of value in the differential diagnosis between breath holding spells and convulsive disorders.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khaled Hamdy Abd El Megeed ◽  
Shereen Abou Bakr Saleh ◽  
Christina Alphonse Anwar ◽  
Ahmed Elkattary Mohamed Elkattary

Abstract Background Inflammatory bowel disease (IBD) is comprised of two major disorders: Ulcerative Colitis and Crohn’s disease. Ulcerative Colitis affects the colon, where as Crohn’s disease can involve any component of the gastrointestinal tract from the mouth to the perianal area. These disorders have somewhat different pathologic and clinical characteristics, but with substantial overlap; their pathogenesis remains poorly understood. Objective To determine & detect different predictors that help us to characterize patients with high probability of undergoing surgical intervention for inflammatory bowel diseases. Patients and Methods The present study was designed to detect & identify possible factors that can be used to predict surgical intervention in patients with IBD. The present study was a case control study that was conducted on 80 patients with inflammatory bowel disease (either controlled by medical treatment or needed surgical intervention as a part of disease control) who were recruited form Ain-Shams university hospitals and El Quabbary general hospital in Alexandria. In the present study, the mean age of the included patients was 36.67 ±8.5 years old and 50% of the patients were males. The mean age at the onset of the disease was 25.81 ±6.8 years old. Results In the present study, there were statistically significant differences between surgical and medical patients in terms of CDAI for CD (p &lt; 0.001) and Mayo score for UC (p &lt; 0.001). Surgical patients were more likely to have higher scores. CDAI and Mayo score were negative predictors of surgical treatment. CDAI score &gt; 287 and Mayo score &gt; 8.5 achieved high sensitivity and specificity for the detection of surgical treatment. In the present study, we found that there was statistically significant differences between surgical and medical patients in terms of Stool Calprotectin level. Surgical patients were more likely to have higher Stool Calprotectin level. Stool Calprotectin level was negative predictor of surgical treatment at a level of &gt; 341.5 microgm/gm with high sensitivity and specificity. Conclusion Surgical treatment is a common outcome in IBD. Certain clinical features and the extent of disease are risk factors for surgical intervention. Our study indicates that smoking, Chron’s disease, perianal disease, granulomas, higher severity scores, higher stool Calprotectin level, CRP, and ESR were associated with higher risks of surgical intervention. In addition, smoking, peri-anal disease, CDAI, Mayo score, Stool Calprotectin level, and CRP level were predictors of surgical treatment. The findings of our analysis have implications for practice, particularly in the promotion of preoperative individualized risk prediction. The ability to predict which patients will need surgery and target more intensive, early treatment to that group would be invaluable. Further research through large prospective cohort studies is needed to confirm our findings and conclusions.


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