2011-2012 Basic and Clinical Science Course, Section 7: by John Bryan Holds MD

By John Bryan Holds MD

Info the anatomy of the orbit and adnexa, and emphasizes a pragmatic method of the assessment and administration of orbital and eyelid problems, together with malpositions and involutional adjustments. Updates present details on congenital, inflammatory, infectious, neoplastic and nerve-racking stipulations of the orbit and accent buildings. Covers key elements of orbital, eyelid and facial surgical procedure. comprises a variety of new colour photographs. significant revision 2011-2012.

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Extra info for 2011-2012 Basic and Clinical Science Course, Section 7: Orbit, Eyelids, and Lacrimal System (Basic & Clinical Science Course)

Sample text

Alth ough preseptal cellulitis in adults is usually due to penetrating cutaneous trauma or dacryocystitis, in chi ldren the most co ml11on cause is unde rl ying sinusitis. Histori cali y. preseptal cellulitis in infants and children yo unger than 5 years was often associated with bacte re mia, sept ice mi a, and menin gitis ca used by Ha emophilus inJIuenzae. However, the introduction of the H influenzae B ( Hib) vacci ne has virtuall y el imi nated thi s etiology. Now. most pediatric cases are th e res ult of gram -positive cocci infec tion.

However, a superimposed aberrant growth usually follows the original arrest, and the resulting deformity does not represent any previous normal stage of development. An example of this latter condition is formation of an orbital cyst following incomplete closure of the fetal fissure. As a rule, the more gross the abnormality, the earlier in development it occurred. The examination of the child with an ocular or craniofacial malformation should focus on carefully defining the severity of the defect and ruling out associated changes.

Areas of edema can sometimes be used to discern the degree of disease activity. Locali zat ion of foreign bodies is possible with ultrasonography. Doppler ultrasonography can prOVide specific information regarding blood flow (eg, th e velOCity and direction of blood flow in patients with occlusive vascular disease o r vascu lar abnorma li ties associ ated with increased blood flow). However, ultrasound analys is of orbi tal tissues and diseases requires speciali zed equipment and experienced personnel, and office-based equ ip ment is generally not suitable for this purpose.

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