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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Six weeks after a traffic accident a patient presented with enophthalmos of 6 mm on the right side, a marked divergent squint, and double vision in all directions of gaze. CT scans showed a posterior medial, and inferior fracture of the orbit with tissue prolapse. In the course of surgery it became clear that an antral balloon alone would not be sufficient to push back the prolapsed tissue in the ethmoidal region. For this reason an additional, smaller (Lincoff-Kreissig) balloon was inflated in this region. The procedure was successful.
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PMID:[Support of an unusual orbital fracture by 2 balloons]. 376 95

Isolated medial blow-out fractures are rare. This report presents such a case in which blunt trauma to the orbit due to a ski accident was followed by herniation of the orbital fasciae and the nasal orbital tissue into the ethmoid and nasal cavity resulting in ptosis, enophthalmos, and total motility impairment in all directions. In particular, an incomplete abduction could be detected. To avoid recurrent infections, because of communication with the pneumatic cells of sinuses, a composite graft from the nasal septum was used for the reconstruction of the medial orbital wall.
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PMID:[Diagnosis and therapy of median blow-out fractures]. 387 43

A 62-year-old woman was seen for evaluation of an orbital tumor. Recognition of a relatively rare syndrome of pain, ptosis, and a progressively immobilized globe with enophthalmos suggested the diagnosis of metastatic carcinoma to the left orbit. In this case, this was confirmed by open breast and orbital biopsies, revealing infiltrating lobular breast carcinoma. This is the first reported case where estrogen and progesterone receptors were identified in a metastatic orbital tumor using fluorescent histochemical techniques. This technique was of value in confirming the diagnosis and providing direction for subsequent endocrinologic palliative therapy.
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PMID:Histochemical analysis of breast carcinoma metastatic to the orbit. 395 31

89 patients with fractures of the orbital floor - both in isolation (blow-out fractures) and combined with a complex fracture of the midregion of the face - were followed up for an average of 5 years. Particular attention was paid to the quantitative evaluation of binocular fusion, diplopia and enophthalmos. Comparison of operated and conservatively treated patients with blow-out fractures led to the following conclusions with regard to indications for surgery: 1. It is not justified to regard either surgery or its postponement pending developments as obligatory in all cases. 2. Surgery is indicated by clinical, orthoptic and roentgenological findings as follows: a) In case of enophthalmos or roentgenological demonstration of prolapse, surgery is indicated independent of diplopia. b) Diplopia outside the main field of view does not, in general, necessitate surgery. c) If there is diplopia within the main field of view, surgery is indicated. It is generally accepted that orbital-floor fractures associated with complex mid-face fractures require early surgical treatment. The present investigation confirms this view.
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PMID:[Operation indications of blow-out and midface fractures]. 404 89

Injuries to the inferior and lateral orbital walls are traditionally classified as either "blow-out" or trimalar fractures. This simplified system has helped considerably in the understanding of the causes of the two types of injury and methods of repair. Unfortunately, simultaneous occurrence can cause immediate and delayed problems that potentiate each other. Enophthalmos and globe ptosis, in combination with a depressed malar eminence, present a major challenge to the reconstructive surgeon's efforts to achieve satisfactory function and appearance. This paper reports the results of combined orbital floor and lateral wall injuries as an important clinical trauma syndrome. The interaction of the two fractures with regard to pathophysiology, sequelae, and methods of correction will be discussed. A review of cases will be used to describe the authors' techniques of repair, and to illustrate the preferred methods of bone grafting for correction of retrusion and depression of the globe, muscle entrapment and depression of the malar eminence.
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PMID:Evaluation and correction of combined orbital trauma syndrome. 634 76

We describe a 10-year review of 53 patients having had correction of lower eyelid ptosis using fascia lata sling suspension by the operation first described in 1973. The overall conclusion is that this continues to be a reliable procedure with a low complication rate. Four major changes relating to operative technique that create a better result are as follows: (1) the surgical correction must begin with a prosthesis that is ideal for the socket; (2) the fascial strip is narrower at 2 mm; (3) the lateral orbital rim burr hole is placed higher; and (4) the passage of the fascial strip is facilitated by the use of Wright's needle. The optimal sequence of operative procedures in the anophthalmic orbit syndrome is (1) correction of enophthalmos and superior sulcus depression, (2) correction of lower eyelid ptosis, and (3) correction of upper eyelid ptosis.
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PMID:Correction of lower eyelid ptosis in the anophthalmic orbit: a long-term follow-up. 661 50

Clinical examination and conventional radiography of the orbit following recent orbital trauma often gives an incomplete picture of the damage present. In many infra-orbital blowout injuries, damage to the medial orbital wall occurs with prolapse and sometimes incarceration of orbital contents into both the maxillary and ethmoidal air sinuses. Late enophthalmos is thought to be caused by both atrophy of orbital fat and its loss into the paranasal sinuses. Hypocycloidal tomography in an antero-posterior plane is helpful in the recognition of those defects, but it does not distinguish between the presence of blood clot and soft tissue. Computerised axial tomography (C.A.T.) and ultrasonography are currently available investigative techniques which do distinguish between the presence of air, blood clot, soft tissue and bone and, in addition, there is a significant reduction in radiation dosage when compared with tomography. A comparison of these techniques and the clinical findings is described. These investigations should indicate the necessity for surgical intervention and prevent some of the late complications, such as enophthalmos.
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PMID:Investigation and management of orbital trauma. 680 83

Thirty cases of orbital floor blow-out fractures proven by tomography were retrospectively reviewed to determine the accuracy of the plain films. Using the maximum diameter from the tomograms, the area and volume of the fractures were calculated and correlated with the presence of diplopia and enophthalmos at the time of presentation and at subsequent follow-up. Nine of the 30 cases underwent surgical repair. Orbital floor fractures were recognized in 29 of 30 cases using only the 28 degrees Caldwell and Waters views. Routine tomography is unnecessary and should be reserved as a preoperative evaluation in patients with enophthalmos to establish the presence of a significant associated medial wall prolapse.
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PMID:Another look at blow-out fractures of the orbit. 697 48

Orbital blow-out fractures were experimentally created in eight human cadavers. Each orbit underwent conventional radiographic studies, complex motion tomography, and computed tomographic examinations. A comparison of the three modalities was made. Anatomical correlation was obtained by dissecting the orbits. The significance of medial-wall fractures and enophthalmos is discussed. Limitation of inferior rectus muscle mobility is thought to be a result of muscle kinking associated with orbital fat-pad prolapse at the fracture site, rather than muscle incarceration. Blow-out fractures should be evaluated by computed tomographic computer reformations in the oblique sagittal plane.
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PMID:Blow-out fractures of the orbit: a comparison of computed tomography and conventional radiography with anatomical correlation. 707 52

Enophthalmos and ptosis of the globe is usually a consequence of orbital trauma resulting in a blowout fracture of the orbital floor. Surgical exploration reveals a loss of inferior support due to a disruption of the bony orbital floor. We document five patients with a syndrome of spontaneous enophthalmos and ptosis of the globe unassociated with orbital trauma. The apparent dissolution of the orbital floor causes the loss of inferior support. There is a strong association with ipsilateral chronic maxillary sinus disease.
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PMID:Spontaneous enophthalmos associated with chronic maxillary sinusitis. 730 15


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