Displaying publications 1 - 20 of 75 in total

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  1. Abdul Satar H, Yaakub A, Md Shukri N, Ahmad Tajudin LS
    Cureus, 2021 Apr 09;13(4):e14392.
    PMID: 33981511 DOI: 10.7759/cureus.14392
    Paediatric orbital cellulitis is a potential sight- and life-threatening condition. It is a serious infection in children that can result in significant complications, including blindness, cavernous sinus thrombosis, cerebral venous sinus thrombosis, meningitis, subdural empyema, and brain abscess. Of the patients with orbital cellulitis, 17% died from meningitis, and 20% of the survivors had permanent loss of vision. Therefore, the potential for sight- and life-threatening complications makes prompt diagnosis and early treatment very important. We report here a case of a two-year-old girl who presented with a three-day history of left periorbital swelling, preceded by left upper perioral swelling that extended upward to the left cheek and left lower lid and was associated with low-grade fever. The patient had been admitted and was treated as having left preseptal with facial cellulitis; the patient was started on intravenous amoxicillin/clavulanic acid (200 mg three times per day dose), and chloramphenicol ointment was applied to the periorbital area. On day 3, the condition worsened, and dental examination showed multiple dental caries, upper gum swelling and abscess, and mobility of teeth 61 and 62 (two baby teeth). Contrast-enhanced computed tomography (CECT) of the orbit, paranasal, and brain showed a left periosteal abscess collection extending to the inferomedial region of the orbit. Examination and tooth extraction were performed under general anesthesia. The intraoperative results showed the presence of a left upper gum abscess, which was possibly the primary source of infection. Clinical improvement was observed postoperatively. Orbital cellulitis can be a complication of a dental abscess. This case emphasizes the importance of primary tooth care in children. A lack of care can result in fatal complications.
    Matched MeSH terms: Orbit; Orbital Cellulitis
  2. Chew C, Wan Hitam WH, Ahmad Tajudin LS
    Cureus, 2021 Mar 31;13(3):e14200.
    PMID: 33936906 DOI: 10.7759/cureus.14200
    Leptomeningeal carcinomatosis (LC) and optic nerve metastasis are uncommon occurrences in breast cancer. We report a rare case of LC with optic nerve infiltration secondary to breast cancer. A 45-year-old lady who was a known case of treated right breast carcinoma six years ago presented with a blurring of vision in both eyes, floaters, and diplopia for one month. She also had recurrent attacks of seizure-like episodes, headache, and vomiting. Examination revealed high blood pressure with tachycardia. Her right eye visual acuity was counting fingers at two feet and 6/36 in the left eye. She had right abducens nerve palsy. Fundoscopy showed bilateral optic disc swelling with pre-retinal, flame-shaped haemorrhages and macular oedema. CT scan of brain and orbit was normal. She was admitted for further investigations. While in the ward, her vision deteriorated further. Her visual acuity in both eyes was at the level of no perception to light. She also developed bilateral abducens nerve palsy and right facial nerve palsy. Subsequently, she started having bilateral hearing loss. There were few episodes of fluctuations in conscious awareness. MRI brain showed mild hydrocephalus. Both optic nerves were thickened and enhanced on T1-weighted and post-gadolinium. Lumbar puncture was performed. There was high opening pressure. Cerebrospinal fluid cytology showed the presence of malignant cells. Family members opted for palliative care in view of poor prognosis. Unfortunately, she succumbed after a month's stay in hospital. Diagnosis of LC and optic nerve infiltration presents a formidable challenge to clinicians especially in the early stages where neuroimaging appears normal and lumbar puncture has high false negatives. Multiple high-volume taps are advised if clinical suspicion of LC is high.
    Matched MeSH terms: Orbit
  3. Razali NR, Choo YM
    Malays Fam Physician, 2021 Mar 25;16(1):136-138.
    PMID: 33948155 DOI: 10.51866/cr1010
    Acute ptosis due to preseptal cellulitis requires urgent medical attention, as the infection can extend posteriorly into the orbit, leading to significant visual and cerebral complications. We report a case of a 58-year-old woman with uncontrolled diabetes mellitus presenting with acute ptosis due to preseptal cellulitis. After initial resolution of fever with intravenous amoxicillin-clavulanate, she experienced a seizure due to cerebral abscess a week later and was treated with intravenous ceftriaxone. Preseptal cellulitis is usually treated on an outpatient basis with oral antibiotics, as it rarely extends posteriorly to cause cerebral complications. We wish to highlight the importance of admitting patients with preseptal cellulitis in patients with uncontrolled diabetes for intravenous antibiotics due to the potential for visual and cerebral complications.
    Matched MeSH terms: Orbit
  4. Wahab Z, Tai E, Wan Hitam WH, Sonny Teo KS
    Cureus, 2021 Mar 06;13(3):e13735.
    PMID: 33842113 DOI: 10.7759/cureus.13735
    INTRODUCTION: Nasopharyngeal carcinoma (NPC) is a tumor arising from the epithelial cells of the nasopharynx. NPC can spread and invade the base of skull, nasal cavity, paranasal sinuses, pterygopalatine fossa, and apex of the orbit. However, the involvement of the optic nerve in NPC is rare. The purpose of this case report is to report the efficacy of corticosteroid therapy in optic neuropathy secondary to NPC.

    CLINICAL CASE: A 56-year-old Chinese woman, an active smoker, presented with a hearing deficit, persistent tinnitus and nasal congestion. Examination and investigations revealed the presence of a mass in the nasopharynx. Tissue biopsy revealed nasopharyngeal carcinoma. However, the Epstein-Barr virus was not tested. She was counseled for chemotherapy, but refused and was subsequently lost to follow up. She presented one year later with right eye ptosis associated with progressive worsening of diplopia and blurring of vision. Examination revealed multiple (second, third, fourth and sixth) cranial nerve involvement. Systemic examination and investigations revealed cervical lymphadenopathy and liver metastasis. Repeated imaging showed that the mass had invaded the base of the skull, cavernous sinus and orbital apices. Pulse dosing of corticosteroid therapy was commenced, resulting in dramatic improvement of vision.

    CONCLUSION: Optic neuropathy may be the presenting sign of NPC. Corticosteroid therapy can offer immediate visual improvement.

    Matched MeSH terms: Orbit
  5. Ng YS, Gan YK, Tupang L
    Turk J Ophthalmol, 2021 Feb 25;51(1):62-65.
    PMID: 33631919 DOI: 10.4274/tjo.galenos.2020.00225
    An 88-year-old woman was brought to the hospital immediately after her neighbours noticed that she was bleeding from her right eye. On examination, her right eye was phthisic with maggot infestation of her right orbit. Over a hundred live maggots were extracted using forceps. Computed tomography scan revealed the infestation was confined to the right orbit. The patient underwent exenteration of the right orbit under general anaesthesia. The species was identified by an entomologist as Chrysomya bezziana, which has aggressive larvae that eat living tissue. This case report demonstrates that orbital myiasis caused by C. bezziana poses a very real risk of intracranial invasion as they feed on living tissues. Adjacent tissue destruction can be very rapid and definitive treatment involves urgent removal of its larvae via surgical debridement. To our knowledge, we are reporting the first case of orbital myiasis from a patient in Malaysia. Therefore, our case report may be helpful in the management of similar case of orbital myiasis.
    Matched MeSH terms: Orbit
  6. Saad AZM, Nordin NR, Sulaiman WAW, Jamayet N, Johar SFNM, Hussein A
    Arch Plast Surg, 2021 Jan;48(1):80-83.
    PMID: 33503749 DOI: 10.5999/aps.2020.00206
    Eye socket contracture is a well-known late complication of enucleation surgery, and the additional insult of radiotherapy at an early age causes even further fibrosis and scarring of the socket. Management of the contracted socket is challenging, and several methods have been proposed. We report a case of eye socket contracture after enucleation and radiotherapy in which multiple reconstructive procedures failed. The recurrent contracture caused difficulty in housing and retaining the eye prosthesis. We reconstructed the lower eyelid with a facial artery myomucosal flap and nasolabial flap, and the upper eyelid with a Fricke flap following reconstruction of the orbital rims (supraorbital and infraorbital rims with a calvarial bone graft, and further augmentation of the infraorbital rim with a rib bone graft). Cosmesis post-reconstruction was acceptable and the prosthesis was retained very well.
    Matched MeSH terms: Orbit
  7. Chua AW, Kumar CM, Chua MJ, Harrisberg BP
    Anaesth Intensive Care, 2020 Nov;48(6):430-438.
    PMID: 33198476 DOI: 10.1177/0310057X20957018
    Thyroid eye disease is an autoimmune inflammatory disorder of the orbit in adults. It causes inflammation, expansion and fibrosis of orbital fat, muscles and the lacrimal gland, leading to facial disfigurement, functional disability and, in severe cases, blindness. Overall, approximately 20% of affected patients need some form of surgical intervention requiring anaesthesia. This narrative review explores the background of thyroid eye disease, surgical procedures performed and their implications for anaesthesia. General anaesthesia is used for orbital decompression procedures, strabismus correction surgery and complex oculoplastic procedures. Local anaesthetic infiltration or regional anaesthesia under monitored anaesthesia care are the techniques most commonly employed for eyelid retraction surgery. It is important to limit the volume of local anaesthetic agent used during infiltration and continuously monitor the orbital volume and ocular pressure with a ballottement technique. In addition, the contralateral eye should be checked and, if necessary, protected against corneal exposure. Retrobulbar, peribulbar and sub-Tenon's blocks are best avoided. Topical anaesthesia has been used for some strabismus correction surgery but its use is limited to motivated and cooperative patients only.
    Matched MeSH terms: Orbit
  8. Sadacharan CM, Packirisamy V
    J Craniofac Surg, 2020 Jul 14.
    PMID: 32675767 DOI: 10.1097/SCS.0000000000006757
    In cosmetic surgery, knowledge of the average dimensions of periorbital features based on gender and ethnicity is essential to improve the patient appearance and maintain the ethnicity. The aim the study was to establish gender-specific periorbital anthropometric and anthroposcopic data for Indian Americans (IA) and to assess the statistically ethnic differences by comparing with published data of Malaysian Indians (MI). Evaluation of periorbital features was done on the standardized frontal photographs of 400 IA, aged 18 to 26 years. The measured values were evaluated by an independent t-test. Sexual dimorphism was found in all 15 measurements. The eyebrow height, combined height of the orbit and eyebrow, eyebrow apex inclination, apex to lateral canthus distance, medial end of brow to medial canthus distance, lateral end of brow to lateral canthus distance; pretarsal skin height, palpebral fissure height, palpebral fissure inclination (PFI), and medial canthus tilt were significantly greater in female than the males. In males, eyebrow apex hairline distance, apex to lateral limbus distance, eyebrow apex angle (EAA), lower eyelid height, and interpupillary distance was significantly greater than the females. Significant ethnic difference was found between IA and MI for eyebrow height, apex to lateral limbus distance, EAA, palpebral fissure height, and PFI in male group. In female group, EAA, medial canthus tilt, and PFI were significantly greater in MI. Four types of epicanthus were observed and the brow apex between lateral limbus and lateral canthus was the most common position. The generated normative data may be useful during diagnosis and treatment planning.
    Matched MeSH terms: Orbit
  9. Ting XW, Sothiraghagan S, W Md Kasim WM, Muhammed J
    Cureus, 2020 May 24;12(5):e8259.
    PMID: 32596077 DOI: 10.7759/cureus.8259
    Objective To describe the patient demographics, clinical findings, investigations, surgical outcomes, and histopathological findings of seven cases of orbital solitary fibrous tumours. Method This was a retrospective review of seven cases of orbital solitary fibrous tumour, which were followed up in Hospital Serdang, a national oculoplastic centre, from years 2008-2017. Results This study included seven patients with ages between 21 and 35 years old; two were males and five were females. All seven patients presented with painless chronic unilateral proptosis. Radiological imaging of the orbit showed a localized contrast enhancing intraorbital mass. All patients underwent orbitotomy and excisional biopsy. Intraoperative findings showed a well-encapsulated and vascularized mass. Histological findings of spindle-shaped cells were noted. All cases had positive staining for cluster of differentiation (CD) 34, five were positive for CD 99, four were positive for B-cell lymphoma (BCL-2), and five patients had positive staining for S-100. Three of the patients did not have clear margins during the primary operation and subsequently had a recurrence within two years. Conclusion A solitary fibrous tumour is a rare mesenchymal tumour with a pleural origin. The orbit is the most common extrapleural site of the tumour and they are usually benign. Immunohistochemistry is important to differentiate it from other, more aggressive forms of orbital tumours. Regular follow-up is important to monitor for recurrence.
    Matched MeSH terms: Orbit; Orbital Neoplasms
  10. Yi Wen L, Singh S, Mohamad NFB, Toh YF, Khalil AAK
    Ophthalmic Plast Reconstr Surg, 2020 5 20;37(1):e23-e25.
    PMID: 32427737 DOI: 10.1097/IOP.0000000000001713
    Simple bone cyst is a benign osteolytic lesion, found primarily in the mandible, occasionally in the maxilla, and rarely in the zygoma. A 17-year-old male patient with 6-month history of left facial mass presented with worsening proptosis and displacement of left eyeball associated with reduced OS vision. The lesion was painless to start with, but with time, he reported OS pain. There was no history of any trauma. CT scan and MRI of orbit performed revealed cystic bony lesion involving greater wing of sphenoid. He subsequently had excision of the left facial mass with exenteration of OS due to poor visual prognosis, followed by reconstruction with osteomyocutaneous flap from left scapular region. The histopathologic features were consistent with a diagnosis of simple bone cyst of zygomatic arch.
    Matched MeSH terms: Orbit
  11. Mohammad Razali A, Mohd Zain A, Bt Wan Abdul Halim WH, Md Din N
    Cureus, 2020 Apr 18;12(4):e7732.
    PMID: 32440379 DOI: 10.7759/cureus.7732
    Most patients with sinonasal carcinoma present to the otorhinolaryngologist with nasal symptoms. It is however uncommon for them to present with acute visual loss at first presentation. We report a case of compressive optic neuropathy secondary to sinonasal carcinoma, which presented acutely with right eye blurring of vision upon waking up. Computed tomography (CT) of the brain and orbit with contrast showed a locally invasive nasopharyngeal mass extending into the right orbit and cranial fossa. Histopathological examination revealed squamous cell sinonasal carcinoma. Her visual acuity improved with a three-day course of pulsed intravenous methylprednisolone 1 g per day, followed by a gradual tapering dose of oral prednisolone (1 mg/kg/day).
    Matched MeSH terms: Orbit
  12. Chee, Yik Chang
    MyJurnal
    A 24-year-old female complained of a 2-week history of fever and right-eye swelling. There was no ocular pain, blurring of vision, or history of prior trauma to the affected eye. On examination, she was febrile and not in respiratory distress. The right lower eyelid appeared swollen with skin erythema (Figure 1), while the visual acuity was normal. The white cell count was 14.8 × 103/μL (normal range = 4 – 10 × 103/μL). Her liver and renal function tests were within the normal range. The abdominal ultrasonography revealed multiple splenic microabscesses, while chest radiograph was normal. Contrast-enhanced computed tomography of the orbit showed a right lower eyelid abscess with extension into the right nasolacrimal duct (Figure 2). Incision and drainage of the eyelid abscess were performed and the culture of the pus, as well as the blood, yielded Burkholderia pseudomallei. She received intravenous ceftazidime 2 g every 8 hours for 4 weeks, followed by oral trimethoprim-sulfamethoxazole for 20 weeks’ duration. The right eyelid abscess and splenic microabscesses resolved completely post-treatment. Please interpret the figures and suggest the provisional diagnosis.
    Matched MeSH terms: Orbit
  13. Patricia Ann John, Sylves Patrick, Mohtar Ibrahim, Adil Hussein
    MyJurnal
    A 64-year-old Malay gentleman alleged occupational injury when a malfunctioned metal hydraulic door hit on his face while unloading sand from his tipper-truck. Post-trauma, he complained of right eye (RE) pain and total loss of vision. On examination, noted RE visual acuity was unable to be assessed and left eye (LE) was 6/24 with pinhole 6/9. No eyeball could be seen in the right socket with superior orbital rim step deformity and left periorbital haema- toma. Computed tomography scan of the brain and orbit confirmed displaced right eye globe into the right anterior cranial fossa with right and left multiple orbital wall fractures. He then underwent successful right eye globe reposi- tioning. Traumatic orbital roof fracture is a rare condition. Repositioning of the eye globe was done to salvage the eye globe for a cosmetic reason and to avoid localised inflammatory reaction at the anterior cranial fossa.
    Matched MeSH terms: Orbit; Orbital Diseases; Orbital Fractures
  14. Nazimi, A.J., Nuraudi Zafirah, A.R., Nur Syaira, I., Izhar, A.A., Muhd Fazlynizam, R.
    Medicine & Health, 2020;15(1):237-249.
    MyJurnal
    Tujuan kajian ini adalah untuk menerokai kaedah pembantu penanda permukaan terhadap implan orbital untuk pembedahan tulang orbit. Enam tengkorak manusia dewasa kering telah digunakan dalam kajian ini. Implan orbital aluminium yang disediakan secara individu, dengan ketebalan 0.4 mm disediakan untuk lantai orbit secara bilateral. Empat penanda permukaan implan fizikal dari aspek anterior dan posterior implan yang disediakan dan diimbas secara optik. Pemeriksaan pra-pembedahan tomografi berkomputer ‘cone-beam’ (CBCT) diperolehi untuk semua lantai orbit. Data 'Digital Imaging and Communications in Medicine' (DICOM) tengkorak diambil, diimport dan direka bentuk dengan format data stereolithografi (STL) implan orbital masing-masing menggunakan iPlan CMF (Versi 3.0, BrainLab, Jerman). Teknik gabungan imej dilakukan untuk setiap tengkorak selepas pembinaan semula dengan pengambilan pos-pembedahan CBCT. Pengukuran berasaskan daripada data tomografi terhadap posisi implant kemudian dinilai di antara kedudukan implan yang direncanakan dan yang direalisasikan dalam satah sagittal dan coronal. Analisa statistik dijalankan menggunakan Statistik Statistik PASW® 18. Hasil kajian menunjukkan bahawa 38 daripada 48 penanda permukaan yang dinilai menunjukkan peningkatan ketinggian kedudukan dalam skala kecil pasca-pembedahan berbanding dengan kedudukan implan orbital maya. Semakan metrik Euclidean menunjukkan perbezaan yang kurang daripada 1.00 mm dalam semua penanda permukaan kecuali pada kawasan lej posterior dan anterior dalam penilaian satah sagittal. Kajian ini menunjukkan bahawa penempatan penanda permukaan terhadap implant orbit dalam pembedahan navigasi orbit menyumbang kepada kedudukan implan orbital secara konsisten.
    Matched MeSH terms: Orbit; Orbital Implants
  15. El Rassi E, Adappa ND, Battaglia P, Castelnuovo P, Dallan I, Freitag SK, et al.
    Int Forum Allergy Rhinol, 2019 07;9(7):804-812.
    PMID: 30809970 DOI: 10.1002/alr.22316
    BACKGROUND: Orbital cavernous hemangiomas (OCH) are the most common adult orbital tumor and represent an ideal index lesion for endonasal orbital tumor surgery. In order to standardize outcomes reporting, an anatomic-based staging system was developed.

    METHODS: An international, multidisciplinary panel of 23 experts in orbital tumor surgery was formed. A modified Delphi method was used to develop the cavernous hemangioma exclusively endonasal resection (CHEER) staging system with a total of 2 rounds being completed.

    RESULTS: Tumors medial to a plane along the long axis of the optic nerve may be considered amenable for an exclusively endonasal resection. In select cases, tumors may extend inferolaterally if the tumor remains below a plane from the contralateral naris through the long axis of the optic nerve (ie, plane of resectability [POR]). This definition reached consensus with 91.3% of panelists in agreement. Five stages were designed based on increasing technical resection difficulty and potential for morbidity. Stages were based on the relationship of the tumor to the extraocular muscles, the inferomedial muscular trunk of the ophthalmic artery (IMT), and orbital foramina. Staging by anatomic location also reached consensus with 87.0% of panelists in agreement. Size was not included in the staging system due to the lack of agreement on the contribution of size to resection difficulty.

    CONCLUSION: Endoscopic orbital tumor surgery is a nascent field with a growing, yet heterogeneous, body of literature. The CHEER staging system is designed to facilitate international, high-quality, standardized studies establishing the safety, efficacy, and outcomes of endonasal resection of OCH.

    Matched MeSH terms: Orbit; Orbital Neoplasms
  16. Kumaran A, Chan A, Yong K, Shen S
    Orbit, 2019 Apr;38(2):95-102.
    PMID: 29482415 DOI: 10.1080/01676830.2018.1441316
    AIM: To describe differences in the deep lateral orbital wall (specifically, trigone) between Chinese, Malay, Indian and Caucasian subjects Methods: Single-centre retrospective Computed Tomogram (CT)-based study; 20 subjects of each ethnicity were used from existing databases, matched for gender, average age and laterality. Subjects below 16 years of age were excluded. DICOM image viewing software CARESTREAM Vue PACS (Carestream Health Inc., USA) and OsiriX version 7.5 (Pixmeo., Switzerland) were used to measure deep lateral wall length, thickness and volume, as well as orbital depth and statistical analyses performed using Statistical Package for Social Sciences version 21 (IBM, USA).

    RESULTS: In each group, there were 12 males (60%) and average age was not significantly different (p = 0.682-0.987). Using Chinese subjects as a reference, in Chinese, Malay, Indian and Caucasian subjects, mean trigone thickness was 13.68, 14.02, 11.60 (p orbital depth was 27.54, 24.97, 22.12 (p = 0.001) and 25.93 mm and diagonal orbital depth was 34.19, 33.27, 29.48 (p = 0.01) and 34.63 mm respectively.

    CONCLUSIONS: Indian and, to a lesser extent, Caucasian subjects have smaller trigones compared to their Chinese and Malay counterparts. Indian subjects also have shallower orbits and due care should be taken during decompression surgery.

    Matched MeSH terms: Orbit/anatomy & histology*; Orbit/surgery
  17. Alam T, Islam MT, Cho M
    Sci Rep, 2019 Mar 05;9(1):3441.
    PMID: 30837629 DOI: 10.1038/s41598-019-40207-3
    Epsilon-and-mu-near-zero (EMNZ) metamaterial structure inspired UHF antenna for nanosatellite has been proposed in this paper. The antenna consists of 3 × 2-unit cell array on the ground plane and a meander line radiating patch. Coaxial probe feeding technique has been obtained to excite the antenna. The meander line enables the antenna to resonate at lower UHF band and the metamaterial array is used to make the resonant frequency stable by reducing the coupling effect with metallic nanosatellite structure. The metamaterial structure exhibits EMNZ characteristics from 385 MHz to 488.5 MHz, which facilitates stable resonant frequency and higher antenna efficiency when embedded with nanosatellite structure. The proposed EMNZ inspired antenna has achieved measured impedance bandwidth (S11 orbit nanosatellite communications.
    Matched MeSH terms: Orbit
  18. Jamayet NB, Rahman AM, Nizami MMUI, Johari Y, Husein A
    Indian J Dent Res, 2018 12 28;29(6):840-843.
    PMID: 30589017 DOI: 10.4103/ijdr.IJDR_20_17
    Exenteration surgery greatly affects a person in terms of function, esthetics, and psychological trauma. In such cases, restoration by silicone orbital prosthesis is a well-accepted treatment option. However, this is a difficult task, necessitating personalized design of method for each patient. This case report describes the technique for fabrication of a silicone orbital prosthesis for a male patient with left orbital defect due to exenteration of a Grade 3 squamous cell carcinoma of the left eye and surrounding tissues. The patient was delivered with a satisfactory silicone orbital prosthesis having good retention and finish. Multidisciplinary management and team approach are crucial in providing precise and effective rehabilitation for improving the patient's quality of life and help them return to their normal social life.
    Matched MeSH terms: Orbit; Orbital Implants
  19. Khoo KW, Arman Zaharil MS, Mohd Ali MZ
    Med J Malaysia, 2018 12;73(6):423-424.
    PMID: 30647221
    Craniosynostosis is a premature pathologic fusion of one or more cranial vault sutures leading to abnormally-shaped skull. It can occur in isolated event (non-syndromic), or it can occur in conjunction with other anomalies in welldefined patterns (syndromic). The diagnosis rests on clinical examination and confirmation is generally on the computed tomography scan. The need for surgery is both for cosmetic and functional reasons. Here we describe a case of nonsyndromic craniosynostosis that was treated with frontal orbital advancement (FOA). The potential benefits of FOA need to be carefully weighed against the potential complications when deciding for any surgical intervention.
    Matched MeSH terms: Orbit/surgery*
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