Congenital Cyst and Fistula of the Dorsum of the Nose: A Case Report and Literature Review

Congenital cyst and fistula of the dorsum of the nose is a rare congenital entity. We report a new case of dorsum nasal fistula in a 5 years old male patient that communicates the frontal region with the subcutaneous surface. Radiologic imaging showed a median 5mm defect, in the projection of the metopic suture that leads to a communication between the frontal region and the skin figure. Complete resection was performed by an external approach with vertical incision of the cyst. The histological diagnosis was consistent with a dermoid fistulized cyst. The follow-up displayed unremarkable finding, the patient did not present any diplopia nor decreased visual acuity, or any signs of meningitis or cerebrospinal fluid rhinorrhoea, or saddle nose.

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Good visual rehabilitation in a patient without traumatic cataract surgery after removal of a ferrous intravitreal foreign body by external magnetic extraction through a pars plana incision: A case report

10.21203/rs.2.319/v1 ◽

2019 ◽

Author(s):

Zhitao Su ◽

Panpan Ye ◽

Jijian Lin ◽

Xiaodan Huang ◽

Xiaoyun Fang

Keyword(s):

Visual Acuity ◽

Foreign Body ◽

Foreign Bodies ◽

External Approach ◽

Traumatic Cataract ◽

Visual Axis ◽

Visual Rehabilitation ◽

Pars Plana ◽

Magnetic Extraction

Abstract Background: There is an increasing trend toward performing pars plana vitrectomy and simultaneous cataract extraction in the management of patients with intraocular foreign bodies and traumatic cataracts. Herein, we describe a case of good visual rehabilitation in a patient without traumatic cataract surgery after removal of a ferrous intravitreal foreign body (IVFB) using an external approach. Case presentation: A 44-year-old man presented to our ophthalmology department because of decreased visual acuity after a penetrating trauma to the left eye 2 days earlier. Best-corrected visual acuity (BCVA) was 20/200. An examination revealed a midperipheral self-sealing corneal penetrating wound at the 5 o’clock position, in addition to a mild inflammatory reaction in the anterior chamber. Pupil dilation revealed peripheral anterior and posterior capsular violations, with subcapsular opacity involving the visual axis. A small metallic-like foreign body suspended in the vitreous was confirmed by B-scan ultrasonography and orbital computed tomography. This IVFB was successfully removed by external magnetic extraction through a pars plana incision. At the 2-week follow-up, the traumatic cataract was partially resolved, and BCVA improved to 20/125. At the 3-month follow-up, the traumatic cataract was mostly resolved, the visual axis was clear under a normal pupil, and BCVA improved to 20/20. Peripheral localized lens opacity was found after pupil dilation, and a fundus examination revealed no obvious abnormality. Conclusions: The size and location of an intraocular foreign body and the location and extent of lenticular involvement and associated injuries should be considered in patients with intraocular foreign bodies and traumatic cataracts. In selected patients with a small ferrous IVFB and a localized traumatic cataract, a good visual outcome may be achieved with minimal surgery. Keywords: Intravitreal foreign body, Traumatic cataract, External approach, Case report.

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Good visual rehabilitation in a patient without traumatic cataract surgery after removal of a ferrous intravitreal foreign body by external magnetic extraction through a pars plana incision: A case report

10.21203/rs.2.319/v2 ◽

2019 ◽

Author(s):

Zhitao Su ◽

Panpan Ye ◽

Jijian Lin ◽

Xiaodan Huang ◽

Xiaoyun Fang

Keyword(s):

Visual Acuity ◽

Foreign Body ◽

Foreign Bodies ◽

External Approach ◽

Traumatic Cataract ◽

Visual Axis ◽

Visual Rehabilitation ◽

Pars Plana ◽

Magnetic Extraction

Abstract Background: There is an increasing trend toward performing pars plana vitrectomy and simultaneous cataract extraction in the management of patients with intraocular foreign bodies and traumatic cataracts. Herein, we describe a case of good visual rehabilitation in a patient without traumatic cataract surgery after removal of a ferrous intravitreal foreign body (IVFB) using an external approach. Case presentation: A 44-year-old man presented to our ophthalmology department because of decreased visual acuity after a penetrating trauma to the left eye 2 days earlier. Best-corrected visual acuity (BCVA) was 20/200. An examination revealed a midperipheral self-sealing corneal penetrating wound at the 5 o’clock position, in addition to a mild inflammatory reaction in the anterior chamber. Pupil dilation revealed peripheral anterior and posterior capsular violations, with subcapsular opacity involving the visual axis. A small metallic-like foreign body suspended in the vitreous was confirmed by B-scan ultrasonography and orbital computed tomography. Retinal injury and vitreous hemorrhage were excluded by B-scan ultrasonography and binocular indirect ophthalmoscopy. This IVFB was successfully removed by external magnetic extraction through a pars plana incision. At the 2-week follow-up, the traumatic cataract was partially resolved, and BCVA improved to 20/125. At the 3-month follow-up, the traumatic cataract was mostly resolved, the visual axis was clear under a normal pupil, and BCVA improved to 20/20. Peripheral localized lens opacity was found after pupil dilation, and a fundus examination revealed no obvious abnormality. Conclusions: The size and location of an intraocular foreign body and the location and extent of lenticular involvement and associated injuries should be considered in patients with intraocular foreign bodies and traumatic cataracts. In selected patients with a small ferrous IVFB and a localized traumatic cataract, a good visual outcome may be achieved with minimal surgery. Keywords: Intravitreal foreign body, Traumatic cataract, External approach, Case report.

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Microsurgical resection of foramen magnum meningioma through a transcondylar approach: three-dimensional operative video

Neurosurgical Focus: Video ◽

10.3171/2019.10.focusvid.19465 ◽

2019 ◽

Vol 1 (2) ◽

pp. V3

Author(s):

Guilherme H. W. Ceccato ◽

Rodolfo F. M. da Rocha ◽

Duarte N. C. Cândido ◽

Wladimir O. Melo ◽

Marcio S. Rassi ◽

...

Keyword(s):

Nerve Palsy ◽

Three Dimensional ◽

Foramen Magnum ◽

Complete Resection ◽

Neurophysiological Monitoring ◽

Cervical Instability ◽

Transcondylar Approach ◽

Postoperative Mri ◽

Microsurgical Resection

Foramen magnum (FM) meningiomas are challenging lesions. We present the case of a 38-year-old female with neck pain, dysphonia, and slight twelfth nerve palsy. Imaging workup was highly suggestive of an FM meningioma, and microsurgical resection with the aid of intraoperative neurophysiological monitoring was indicated. A transcondylar approach was employed, the vertebral artery was mobilized, and the tumor was completely removed. Postoperative MRI demonstrated complete resection. There were no signs of cervical instability. The patient presented with improvement of her symptoms and no new neurological deficit on follow-up. FM meningiomas can be successfully resected using a transcondylar approach, since it increases the exposure of the ventral FM, allowing the surgeon to work parallel to the skull base and flush with the tumor’s attachment. Informed consent was obtained from the patient for publication of this operative video.The video can be found here: https://youtu.be/itfUOB-6zM0.

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Ophthalmological findings in children with non-syndromic craniosynostosis: preoperatively and postoperatively up to 12 months after surgery

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2020-000677 ◽

2021 ◽

Vol 6 (1) ◽

pp. e000677

Author(s):

Evangelia Ntoula ◽

Daniel Nowinski ◽

Gerd Holmstrom ◽

Eva Larsson

Keyword(s):

Visual Acuity ◽

University Hospital ◽

Cranial Sutures ◽

Sagittal Craniosynostosis ◽

Syndromic Craniosynostosis ◽

Disc Oedema ◽

Before And After ◽

Congenital Condition ◽

Skull Deformity

AimsCraniosynostosis is a congenital condition characterised by premature fusion of one or more cranial sutures. The aim of this study was to analyse ophthalmic function before and after cranial surgery, in children with various types of non-syndromic craniosynostosis.MethodsChildren referred to Uppsala University Hospital for surgery of non-syndromic craniosynostosis were examined preoperatively. Visual acuity was measured with Preferential Looking tests or observation of fixation and following. Strabismus and eye motility were noted. Refraction was measured in cycloplegia and funduscopy was performed. Follow-up examinations were performed 6–12 months postoperatively at the children’s local hospitals.ResultsOne hundred twenty-two children with mean age 6.2 months were examined preoperatively. Refractive values were similar between the different subtypes of craniosynostosis, except for astigmatism anisometropia which was more common in unicoronal craniosynostosis. Strabismus was found in seven children, of which four had unicoronal craniosynostosis.Postoperatively, 113 children were examined, at mean age 15.9 months. The refractive values decreased, except for astigmatism and anisometropia in unicoronal craniosynostosis. Strabismus remained in unicoronal craniosynostosis. Two new cases with strabismus developed in unicoronal craniosynostosis and one in metopic, all operated with fronto-orbital techniques. No child had disc oedema or pale discs preoperatively or postoperatively.ConclusionOphthalmic dysfunctions were not frequent in children with sagittal craniosynostosis and preoperative ophthalmological evaluation may not be imperative. Children with unicoronal craniosynostosis had the highest prevalence of strabismus and anisometropia. Fronto-orbital techniques used to address skull deformity may be related to a higher prevalence of strabismus postoperatively.

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Surgical correction of severe congenital ptosis using a modified frontalis muscle advancement technique: A single-arm trial

European Journal of Ophthalmology ◽

10.1177/1120672121995754 ◽

2021 ◽

pp. 112067212199575

Author(s):

Lei Zhang ◽

Mingyu Ren ◽

Yuqing Yan ◽

Wenjuan Zhai ◽

Lihong Yang ◽

...

Keyword(s):

Success Rate ◽

Advancement Flap ◽

Orbicularis Muscle ◽

Congenital Ptosis ◽

Inferior Margin ◽

Field Of Vision ◽

Vertical Incision ◽

Registration Number ◽

The Mean

Purpose: To describe our experience with a modified frontal muscle advancement flap to treat patients with severe congenital ptosis. Methods: Analysis of the clinical charts of 154 patients who underwent a modified frontal muscle advancement flap. The FM was exposed by a crease incision. The FM flap was created by deep dissection between the orbicularis muscle and orbital septum from the skin crease incision to the supraorbital margin and subcutaneous dissection from the inferior margin of the eyebrow to 0.5 cm above the eyebrow. No vertical incision was made on the FM flap to ensure an intact flap wide enough to cover the entire upper tarsal plate. Contour, symmetry of height, marginal reflex distance (MRD1), and complications were assessed. Mean follow-up was 10 months. Results: The mean patient age was 7.6 ± 5.6 (range, 2–18) years. The mean MRD1 was 3.2 ± 1.3 mm after the operation. All bilateral cases achieved symmetry and optimal lid contour; 17 unilateral cases were under corrected, with a success rate of 89.0%. Complications such as entropion, exposure keratitis, FM paralysis, frontal hypoesthesia, severe haematoma, and entropion were not observed in our series. Conclusion: A modified frontal muscle advancement flap produced a high success rate with a clear field of vision, mild trauma, and few complications. This technique is relatively simple and should be considered for correcting severe congenital ptosis. Date of registration: 29-03-2020 Trial registration number: ChiCTR2000031364 Registration site: http://www.chictr.org/

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Long term follow-up of visual acuity and incidence of subretinal neovascularization in Mactel Type 2 in 82 Eyes

Seminars in Ophthalmology ◽

10.1080/08820538.2021.1929347 ◽

2021 ◽

pp. 1-6

Author(s):

Kerul Marsonia ◽

Kedarisetti Kiran Chandra ◽

M. Hasnat Ali ◽

Jay Chhablani ◽

Raja Narayanan

Keyword(s):

Visual Acuity ◽

Subretinal Neovascularization ◽

Long Term Follow Up

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Safety and efficacy of repeated crosslinking assisted by transepithelial double-cycle iontophoresis in keratoconus progression after primary corneal crosslinking

Eye ◽

10.1038/s41433-020-01365-1 ◽

2021 ◽

Author(s):

Huping Wu ◽

Lan Li ◽

Shunrong Luo ◽

Xie Fang ◽

Xumin Shang ◽

...

Keyword(s):

Visual Acuity ◽

Corneal Thickness ◽

Good Alternative ◽

Persistent Epithelial Defect ◽

Safety And Efficacy ◽

Corneal Epithelial ◽

Epithelial Damage ◽

Corneal Confocal Microscopy

Abstract Objectives To evaluate the safety and efficacy of repeated corneal collagen crosslinking assisted by transepithelial double-cycle iontophoresis (DI-CXL) in the management of keratoconus progression after primary CXL. Methods A retrospective analysis was conducted in the patients who underwent repeated CXL between 2016 and 2018. These patients were treated with DI-CXL if keratoconus progression was confirmed after primary CXL. Scoring of ocular pain and corneal epithelial damage, visual acuity, corneal tomography, in vivo corneal confocal microscopy (IVCM) was performed before and at 3, 6, 12, and 24 months after DI-CXL. Results Overall, 21 eyes of 12 patients (mean age 17.3 ± 1.9 years) were included in this study. Before DI-CXL, an average increase of 4.26 D in Kmax was detected in these patients with a mean follow-up interval of (23.0 ± 13.7) months. After DI-CXL, corneal epithelial damage rapidly recovered within days. Visual acuity remained unchanged with follow-up of 24 months. When compared to baseline, significant decreases were observed in Kmax (at 3 months) and K2 (at 3 and 6 months) after DI-CXL. Corneal thickness of thinnest point significantly decreased at 3 months postoperatively. When compared to baseline, no significant differences were found in any of the refractive or tomographic parameters at 12 and 24 months. IVCM revealed trabecular patterned hyperdense tissues after DI-CXL in the anterior stroma at the depth of 200 μm or more. No corneal infiltration or persistent epithelial defect was recorded after DI-CXL. Conclusion DI-CXL is safe and effective as a good alternative in stabilizing keratoconus progression after primary CXL.

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Stereotactic radiosurgery for treating meningiomas eligible for complete resection

Radiation Oncology ◽

10.1186/s13014-021-01748-y ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Maximilian I. Ruge ◽

Juman Tutunji ◽

Daniel Rueß ◽

Eren Celik ◽

Christian Baues ◽

...

Keyword(s):

Adverse Events ◽

Stereotactic Radiosurgery ◽

Medical Condition ◽

Local Tumor Control ◽

Complete Resection ◽

Neurological Deficits ◽

Tumor Control ◽

Recurrence Rates ◽

Treatment Volume

Abstract Background For meningiomas, complete resection is recommended as first-line treatment while stereotactic radiosurgery (SRS) is established for meningiomas of smaller size considered inoperable. If the patient´s medical condition or preference excludes surgery, SRS remains a treatment option. We evaluated the efficacy and safety of SRS in a cohort comprising these cases. Methods In this retrospective single-centre analysis we included patients receiving single fraction SRS either by modified LINAC or robotic guidance by Cyberknife for potentially resectable intracranial meningiomas. Treatment-related adverse events as well as local and regional control rates were determined from follow-up imaging and estimated by the Kaplan–Meier method. Results We analyzed 188 patients with 218 meningiomas. The median radiological, and clinical follow-up periods were 51.4 (6.2–289.6) and 55.8 (6.2–300.9) months. The median tumor volume was 4.2 ml (0.1–22), and the mean marginal radiation dose was 13.0 ± 3.1 Gy, with reference to the 80.0 ± 11.2% isodose level. Local recurrence was observed in one case (0.5%) after 239 months. The estimated 2-, 5-, 10- and 15-year regional recurrence rates were 1.5%, 3.0%, 6.6% and 6.6%, respectively. Early adverse events (≤ 6 months after SRS) occurred in 11.2% (CTCEA grade 1–2) and resolved during follow-up in 7.4% of patients, while late adverse events were documented in 14.4% (grade 1–2; one case grade 3). Adverse effects (early and late) were associated with the presence of symptoms or neurological deficits prior to SRS (p < 0.03) and correlated with the treatment volume (p < 0.02). Conclusion In this analysis SRS appears to be an effective treatment for patients with meningiomas eligible for complete resection and provides reliable long-term local tumor control with low rates of mild morbidity.

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Incremental Role of 18F-FDG PET with contrast enhanced CT (PET-CECT) in detection of recurrence of carcinoma cervix

10.1055/s-0039-1685260 ◽

2016 ◽

Author(s):

S. Dash ◽

A. Goel ◽

S. Sogani

Keyword(s):

Fdg Pet ◽

Carcinoma Cervix ◽

Histopathological Correlation ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Radiologic Imaging ◽

18F Fdg

Purpose: To evaluate the role of 18F-FDG PET with contrast enhanced CT (PET-CECT) in early detection of recurrence in follow up patients of carcinoma cervix. Methods: Patients with histopathologically proven carcinoma cervix who underwent chemotherapy, radiotherapy and/or surgery and on follow up were recruited in the study. Fifty-two patients underwent 18F-FDG PET-CECT for detection of recurrence. The median age was 51.5 (average = 53.4) years. PET-CECT studies were evaluated and analyzed separately by an experienced nuclear medicine physician and a radiologist independently. The physicians were blinded for the patient history. PET-CECT results were validated with histopathological correlation, conventional radiologic imaging/follow up PET-CECT study and clinical follow up. Results: Out of 52 patients, 34 patients were reported as positive for recurrence, 17 of these were having active local recurrence and 31 patients had regional lymph nodal metastases, 14 patients had distant metastases (out of them 6 patients had distant lymph node metastases, 6 had pulmonary metastases, 4 had skeletal metastases and two had liver metastases). Remaining 18 patients were reported as negative for recurrence. The lung was the most common site for distant metastasis. Patient were then further evaluated based on histopathological correlation, conventional radiologic imaging and follow up PET-CECT scan and five were found to be false positive and one patient was identified as false negative. The sensitivity, specificity, positive and negative predictive value were derived to be 96.7%, 77.3%, 85.3% and 94.4%, respectively. Accuracy was calculated to be 88.5%. Conclusions: 18F-FDG PET-CECT is a very useful non-invasive modality for the early detection of recurrence and metastatic workup in patients with carcinoma cervix with a very high sensitivity and negative predictive value. It is also useful in targeting biopsy sites in suspected cases of recurrence.

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Retinal Vasculitis Associated With Dermatomyositis Treated With Intravenous Steroids

Journal of VitreoRetinal Diseases ◽

10.1177/24741264211018960 ◽

2021 ◽

pp. 247412642110189

Author(s):

Austen N. Knapp ◽

Jawad I. Arshad ◽

Daniel F. Martin ◽

Rula Hajj-Ali ◽

Kimberly Baynes ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Retinal Vasculitis ◽

Subretinal Fluid ◽

Retrospective Case ◽

Hand Motion ◽

Frosted Branch Angiitis ◽

Intravenous Steroids

Purpose: This work aims to present treatment and long-term follow-up of a 31-year-old woman with dermatomyositis who presented with hemorrhagic retinal vasculitis and macular edema. Methods: A retrospective case report is presented. Results: A 31-year-old woman with dermatomyositis treated with systemic immunosuppression was evaluated for acute, reduced vision. Best-corrected visual acuity was hand motion in the right eye and 20/200 in the left eye. Fundus examination revealed diffuse intraretinal hemorrhages, cotton-wool spots, and vascular sheathing with a frosted branch angiitis–like appearance. Optical coherence tomography revealed significant macular edema and subretinal fluid that quickly resolved after admission and treatment with intravenous steroids. Multimodal imaging at 7-year follow-up disclosed long-term sequelae including peripheral nonperfusion and retinal neovascularization. Conclusions: When vasculitis associated with dermatomyositis is treated aggressively with intravenous steroids at initial presentation, good visual acuity outcomes can be achieved, but long-term consequences of retinal nonperfusion and neovascularization persist.

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