scholarly journals TRAUMATIC SUPERIOR ORBITAL FISSURE SYNDROME - A CASE REPORT

2020 ◽  
Vol 1 (1) ◽  
pp. 20-24
Author(s):  
Daniela Vrînceanu ◽  
B. Bănică ◽  
Adriana Nica ◽  
Alina Popa-Cherecheanu
Keyword(s):  
Ct Scan ◽  
Clinical Symptoms ◽  
High Dose ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Superior Orbital Fissure ◽  
Male Victim ◽  
Therapeutic Algorithm ◽  
And Function ◽  
Early Restoration

The superior orbital apex syndrome is a relatively uncommon complication of midface maxillofacial trauma. The clinical symptoms consist in ophthalmoplegia, palpebral ptosis, exophthalmia, fixed mydriasis, retrobulbar pain and supraorbital nerve hypoesthesia by involvement of the third (oculomotor nerve), fourth (trochlear), fifth (trigeminal) and sixth nerve (abducens). If there is involvement of the optical nerve, the syndrome is termed - orbital apex syndrome. In this article, we will present the case of a 33-years old male, victim of human aggression with traumatic superior orbital apex syndrome. We discuss details of diagnosis and surgical treatment. We will make, also, a review of literature on this subject. Even if the actual therapeutic algorithm is currently a matter of controversy, the generally accepted therapy plane initiated with a high dose of corticosteroids. Fine slice CT scan examination is mandatory for the correct planning. If the CT scan reveals a highly displaced maxillo-zygomatic complex fracture with or without orbital blow-out fracture, we recommend early surgical intervention after the resolving of the periorbital hematoma within 5 to 10 days ideally if concomitant intracranial injury or other conditions permit it. The early restoration of the orbital anatomy and volume will create the basis for cranial nerve decompression and function at the level of superior orbital fissure.

scholarly journals Orbital apex disorders: Imaging findings and management

2018 ◽  
Vol 31 (2) ◽  
pp. 104-125 ◽  
Author(s):  
Pradeep Goyal ◽  
Steven Lee ◽  
Nishant Gupta ◽  
Yogesh Kumar ◽  
Manisha Mangla ◽  
...  
Keyword(s):  
Management Strategies ◽  
Disease Process ◽  
Current Status ◽  
Imaging Findings ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Superior Orbital Fissure ◽  
Cavernous Sinus Syndrome ◽  
The Past ◽  
Superior Orbital Fissure Syndrome

Orbital apex disorders include orbital apex syndrome, superior orbital fissure syndrome and cavernous sinus syndrome. These disorders result from various etiologies, including trauma, neoplastic, developmental, infectious, inflammatory as well as vascular causes. In the past, these have been described separately based on anatomical locations of disease process; however, these three disorders share similar causes, diagnostic evaluation and management strategies. The etiology is diverse and management is directed to the causative process. This imaging review summarizes the pertinent anatomy of the orbital apex and illustrates representative pathological processes that may affect this region. The purpose of this review is to provide an update on the current status of diagnostic imaging and management of patients with orbital apex disorders.

scholarly journals Bilateral Orbital Apex Syndrome Related to Sphenoid Fungal Sinusitis

2021 ◽  
pp. 014556132110247
Author(s):  
Dong Hyun Kim ◽  
Jin Uk Jeong ◽  
Seul Kim ◽  
Seon Tae Kim ◽  
Gyu Cheol Han
Keyword(s):  
Optic Nerve ◽  
Bone Tissue ◽  
Cavernous Sinus ◽  
Rare Case ◽  
Rare Condition ◽  
Fungal Sinusitis ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Superior Orbital Fissure ◽  
Surrounding Bone

Orbital apex syndrome (OAS) is a rare condition that usually occurs due to damage to surrounding inner and surrounding bone tissue. Orbital apex syndrome may result from a variety of conditions that cause damage to the superior orbital fissure and to the optic canal leading to optic nerve (II) dysfunction. We recently experienced a rare case of sphenoidal Aspergillosis, which damaged the adjacent cavernous sinus structures and led to the definite symptom of bilateral OAS in a 77-year-old male. We present this rare case with a brief review of these disease’s entities.

scholarly journals Traumatic Orbital Apex Syndrome: An Uncommon Sequela of Facial Trauma

2019 ◽  
Vol 98 (10) ◽  
pp. 609-612 ◽  
Author(s):  
Tom Shokri ◽  
Brad E. Zacharia ◽  
Jessyka G. Lighthall
Keyword(s):  
Facial Trauma ◽  
Direct Compression ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Superior Orbital Fissure ◽  
Superior Orbital Fissure Syndrome ◽  
Craniomaxillofacial Trauma ◽  
Direct Nerve ◽  
Displaced Fracture ◽  
Superior Orbit

Orbital apex syndrome (OAS) is a rare ocular complication following craniomaxillofacial trauma. This traumatic syndrome is a combination of features seen in both superior orbital fissure syndrome and traumatic orbital neuropathy due to nerve impingement. Due in part to the rarity of this disorder, the optimal treatment of traumatic OAS has yet to be determined. We present a case in which traumatic OAS was caused by direct compression due to a displaced fracture segment from the superior orbit. The patient was successfully treated with a combination of emergent decompression and urgent reconstruction suggesting that this may be an effective strategy in OAS resulting from direct nerve compression as a result of craniomaxillofacial fracture.

Superior orbital fissure and orbital apex syndrome as rare complications of herpes zoster

2017 ◽  
Vol 117 (4) ◽  
pp. 943-946 ◽  
Author(s):  
Mansoureh Jamshidian Tehrani ◽  
Bahram Eshraghi ◽  
Alireza Zamzam ◽  
Golshan Latifi ◽  
Samira Yadegari
Keyword(s):  
Herpes Zoster ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Superior Orbital Fissure

Orbital apex syndrome secondary to nasopharyngeal carcinoma

2015 ◽  
Vol 4 (2) ◽  
pp. 177
Author(s):  
CS Sandhya ◽  
DMurali Krishna ◽  
C Jagannath ◽  
G Srinivas ◽  
K Radhika
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Orbital Apex ◽  
Orbital Apex Syndrome

scholarly journals Orbital apex syndrome in COVID-19 patient, a case report

2021 ◽  
pp. 101006
Author(s):  
Masood Bagheri ◽  
Ahad Jafari ◽  
Sasan Jafari
Keyword(s):  
Case Report ◽  
Orbital Apex ◽  
Orbital Apex Syndrome

scholarly journals Granulomatosis with Polyangiitis Presenting with Bilateral Orbital Apex Syndrome

2021 ◽  
pp. 32-40
Author(s):  
Yusuke Murai ◽  
Takuji Kurimoto ◽  
Sotaro Mori ◽  
Kaori Ueda ◽  
Mari Sakamoto ◽  
...  
Keyword(s):  
Visual Field ◽  
Eye Movement ◽  
Endoscopic Sinus Surgery ◽  
Granulomatosis With Polyangiitis ◽  
Field Tests ◽  
Sinus Surgery ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Initial Examination ◽  
Steroid Pulse

We report a rare case of granulomatosis with polyangiitis (GPA) presenting with bilateral orbital apex syndrome (OAS). A 73-year-old woman with a history of endoscopic sinus surgery for ethmoidal sinusitis experienced a sudden decrease in visual acuity (VA) of both eyes. At the initial examination, her VA had decreased to 0.01 in the right eye and 0.03 in the left eye, and eye movement in both eyes was mildly limited in all directions. Visual field tests of both eyes showed a large central scotoma. Laboratory tests revealed an elevation of myeloperoxidase-anti-neutrophil cytoplasmic antibody. Facial computed tomography demonstrated a thickened mucosal membrane in the entire ethmoidal sinus, and the posterosuperior walls of Onodi cells filled with infiltrative lesions had thinned. Orbital magnetic resonance imaging showed severe inflammation in the orbital apex. From these clinical findings, the patient was diagnosed with GPA presenting with OAS associated with ethmoid sinusitis. Emergent endoscopic sinus surgery was performed for biopsy and debridement of the ethmoidal and sphenoid sinusitis to decompress the optic nerve. One day after endoscopic sinus surgery, the patient’s VA and visual field were improved, and steroid pulse therapy was commenced postoperatively. Four days later, VA had recovered to 1.0 in both eyes, and eye movement and visual field had were improved. Although OAS is a rare manifestation, early surgical treatment should be considered when the orbital lesion presents as risk of rapid deterioration of visual function in patients with GPA.

scholarly journals Orbital apex syndrome without MRI lesion caused by ANCA-associated vasculitis

2014 ◽  
Vol 54 (2) ◽  
pp. 158-161
Author(s):  
Hiroaki Iwanami ◽  
Hirotaka Katoh ◽  
Youhei Ohnaka ◽  
Masashi Nakajima ◽  
Mitsuru Kawamura
Keyword(s):  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Anca Associated Vasculitis

scholarly journals Dose dependence of efficacy but not of safety in sublingual immunotherapy

2016 ◽  
Vol 65 (1) ◽  
Author(s):  
F. Frati ◽  
C. Incorvaia ◽  
F. Marcucci ◽  
L. Sensi ◽  
G. Di Cara ◽  
...  
Keyword(s):  
Sublingual Immunotherapy ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Dose Dependence ◽  
Subcutaneous Immunotherapy ◽  
High Dose ◽  
Systemic Reactions ◽  
Significant Difference

Sublingual immunotherapy (SLIT) currently represents, as indicated by meta-analysis of its efficacy and safety, a valid option to the generally used traditional subcutaneous immunotherapy (SCIT) for treating respiratory allergy. Regarding efficacy, recent studies demonstrated that, similar to what has already been observed in SCIT as well as in experimental and clinical studies about the magnitudo of allergen exposure, the effectiveness on both clinical symptoms and immunologic changes depends on the amount of allergen administered during treatment. In addition, in vitro studies addressed with the role of dendritic cells, currently considered to be of pivotal importance in orienting toward tolerance the immune response to allergens, showed that the internalisation of allergen molecules, which is followed by tolerogenic presentation to T cells, depends on the amount of allergen. However, such dose dependence is not apparent concerning the safety. In fact, the comparison of studies respectively conducted with high and low allergen doses did not show differences in the rate of systemic reactions, which in any case never had the presentation of anaphylaxis, and instead a significant difference in the rate of local reactions, following the oral and gastrointestinal contact with the allergen extract, in favour of high dose studies.

Long-Term Follow-up and Prognosis of Orbital Apex Syndrome Resulting From Nasopharyngeal Rhabdomyosarcoma

2005 ◽  
Vol 140 (2) ◽  
pp. 236.e1-236.e8 ◽  
Author(s):  
Kenneth S. Shindler ◽  
Grant T. Liu ◽  
Richard B. Womer
Keyword(s):  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
Long Term Follow Up
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