0000000000323136

AUTHOR

W. Lieb

Orbital Decompression for Endocrine Ophthalmopathy: The Endonasal Approach

A surgical endonasal procedure is described to perform orbital decompression in patients suffering from ophthalmopathy in Grave's disease. The decompression technique employs removal of the lamina papyracea as an exclusive modality or in conjunction with a transmaxillary or lateral decompression approach. This present series contain 23 patients who underwent decompression over a 3-year period and were followed for at least 6 months postoperative. The results of decompression were assessed by measuring reduction in proptosis and visual acuity. All patients demonstrated improved visual acuity. Measuring retroplacement of the globe, the endonasal approach proved to equal the results obtained …

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Echographic patterns of an orbital myxoma and schwannoma

A case of intramuscular orbital myxoma and of a schwannoma of the orbit were studied with B-scan and standardized A-scan echography as described by Ossoinig. The myxoma appeared as a well outlined process with medium internal reflectivity and areas of low internal reflectivity. Postoperatively the incompletely excised tumour was followed with echography as well as CT and MRI. The second tumour, a schwannoma had a very sharply defined shape, with a thick low to medium reflective outer wall and low internal reflectivity. This corresponds to the Antoni A and Antoni B patterns of the excised tumour.

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Ciamexone in endocrine orbitopathy. A randomized double-blind, placebo-controlled study.

Abstract The influence of ciamexone on the activity and course of endocrine orbitopathy was investigated. Fifty-one patients with active orbitopathy classes II-VI were allocated randomly to two groups: over a period of six months, 26 patients received 300 mg/day ciamexone and 25 patients received placebo tablets. In both groups, prednisolone was administered in addition in the first four weeks. Ophthalmological investigations and clinical tests as well as orbit sonography were carried out before as well as one, three and six months after the beginning of therapy. Before and after treatment, computer tomography of the orbit was performed. Symptoms and signs did not show any significant impro…

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Farbduplexsonographische Messung der Lymphknotenperfusion: Ein Beitrag zur Diagnostik der zervikalen Metastasierung*

The objective of this study was to find additional sonomorphological criteria for determining the status of enlarged lymph nodes. By using colour-coded duplex sonography the perfusion of 63 lymph nodes in the neck was analysed. The status was confirmed either histologically or clinically (29 metastases from squamous cell carcinomas and 34 acute or chronic inflammatory nodal diseases). A quantitative evaluation of the pulsatility measured in 51 lymph nodes by computing the Pourcelot-Ratio and the Mean Pulsatility Index yielded significant differences between the two groups. By definition of a limiting value of the Pourcelot-Ratio (0.75) for the prediction of benignity, the specificity and th…

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Photoreactive flow changes in the posterior cerebral artery in control subjects and patients with occipital lobe infarction.

Background and Purpose Photoreactive flow changes of the posterior cerebral artery (PCA) in control subjects and patients with unilateral occipital lobe infarction were investigated to study the hypothesis that occipital lobe infarction of varying extent leads to a reduced visually activated flow increase in the ipsilateral PCA. Methods Maximum mean flow velocity (MFV) of the PCA was investigated by transcranial Doppler sonography after photic stimulation of the retina. Results In 25 control subjects MFV was increased by 30.6±9.7%. In 13 patients with unilateral occipital lobe infarction the ipsilateral MFV increase was significantly lower than in control subjects. Nine patients with homon…

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Role of Octreoscan and Correlation with MR Imaging in Graves' Ophthalmopathy

Since the identification of somatostatin receptors on lymphocytes, orbital infiltration with mononuclear cells in Graves' ophthalmopathy has provided a rationale for receptor imaging with the radiolabeled somatostatin analog Octreotide. In 40 patients with Graves' ophthalmopathy and 10 controls, 110 MBq indium-Octreotide were administered i.v., and scans were performed at 4 and 24 h after injection. An uptake ratio between the orbits and the brain was determined. In 20 ophthalmophathy patients, magnetic resonance imaging (MRI) of the orbits was performed and the T2 relaxation time was measured within the rectus muscles. Compared to controls (4 h Octreotide uptake: median 6.0 counts/pixel/MB…

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