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

Prostate carcinoma was previously thought to be a rare source of orbital metastasis. We studied a clinical series of eight cases of orbital metastases from prostate carcinoma. Presenting symptoms included proptosis, pain, diplopia, eyelid swelling, decreased vision, ptosis, and red eye. The mean age at onset was 72.1 years. In three of the eight patients, evaluation of the orbital masses led to the diagnosis of prostate carcinoma. Of the six patients in whom computed tomography was performed, four had predominantly osteoblastic lesions. In our experience, the rapid development of an osteoblastic orbital lesion in an elderly man is highly suggestive of metastatic prostate carcinoma.
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PMID:Orbital metastases from prostate carcinoma. 317 51

An 8-month-old girl had ipsilateral ptosis, proptosis, and glaucoma caused by a massive left-sided plexiform neurofibroma. The tumor extended from the cavernous sinus into the orbit, involving the optic nerve, extraocular muscles, and eyelid. Although the prognosis in such cases is considered very poor, most of the mass was excised by a radical neurosurgical and ophthalmologic procedure. Today, the patient remains asymptomatic with no further neurologic defects. This case is unusual in that the glaucoma developed prior to clinically evident eyelid involvement.
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PMID:Surgical removal of an "inoperable" neurofibroma. 334 Apr 1

Two sisters born to consanguineous parents had a syndrome of short stature, acrocephaly, hypertelorism, proptosis, ptosis, down-slanting palpebral fissures, high nose bridge and anteverted nares, short philtrum, cleft palate, micrognathia, abnormal external ears, preauricular pits, sensorineural and conductive deafness, proximally placed first toes and digitalized thumbs, bulbous digits, metatarsus adductus, and pectus excavatum. Radiological abnormalities included craniosynostosis, increased mandibular angle and antegonial notching of mandible; hypoplastic first metacarpals and metatarsals; hypoplastic distal phalanges; partial duplication of the distal phalanx of the thumb; malformed malleus and incus; tall lumbar vertebrae, increased interpedicular distance, and posterior scalloping; flared iliac wings, narrow supraacetabular regions, acetabular "dysplasia," and coxa valga. Autosomal recessive inheritance is suggested.
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PMID:A new acro-cranio-facial dysostosis syndrome in sisters. 334 80

A new surgical technique is described for the relief of the ocular manifestations of dysthyroid orbitopathy. Surgical decompression of the orbit was reserved for patients who failed to respond to medical treatment. Eleven patients (nine women and two men) were followed for periods from 3 to 48 months. Visual loss was the commonest presentation and the main indication for surgery. All patients had failed to respond to medical therapy, consisting of steroid and/or radiation therapy. Three patients had previously undergone orbital decompressions with limited success. Six patients had preoperative visual acuity of worse than 20/200. Preoperative exophthalmos ranged from 24 to 35 mm (normal 16 mm). The orbits were approached by a bifrontal scalp flap with exposure of the temporal and infratemporal fossae. The orbital roof was approached transcranially. The posterior wall of the frontal sinus was removed together with the mucous lining. To maximize the decompression, the periosteum surrounding the orbital contents was incised, allowing the contents to prolapse through the newly created windows into the maxillary antrum, temporal fossa, anterior cranial fossa, and nose. During the past 3 years, 22 orbits in 11 patients have been decompressed by this technique. Symptomatic relief was obtained in all but one patient who still had significant exophthalmos with keratitis, but did have a dramatic improvement in vision. The decrease in exophthalmos ranged from 1 to 13 mm (mean 7 mm). The most dramatic improvement was in vision, with postoperative acuity of 20/20 to 20/30 in all but two patients. There were no deaths and no major morbidity.
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PMID:A four-wall orbital decompression for dysthyroid orbitopathy. 335 28

The authors report one case of Graves' ophthalmopathy with a palpebral asymmetry, which was characterized by a left ptosis and a right palpebral retraction. In connection with Graves' disease, many ocular signs were described, including exophthalmos, ophthalmoplegia, palpebral retraction and visual loss, but unilateral ptosis was rarely reported. The orbital CT-scanning demonstrated the bilateral enlargement of the extraocular muscles, due to the infiltrative process met in Graves' disease. The ptosis and the palpebral retraction were suspected to be related to the extension of this infiltrative process in the levator palpebrae.
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PMID:[Palpebral asymmetry and Graves' ophthalmopathy]. 343 99

Three patients are described who presented with acute painful proptosis, ptosis and ophthalmoplegia. Orbital cellulitis was initially diagnosed in all cases, but there was no therapeutic response to antibiotics. A dramatic improvement occurred with steroids. All patients had, or developed abnormal thyroid tests and CT Scans showed thickened ocular muscles. This is an unusual presentation of thyroid ophthalmopathy.
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PMID:Acute presentation of thyroid ophthalmopathy. 347

Lymphoid masses can be centered predominantly within an extraocular muscle (EOM), as exemplified by computed tomography (CT) scanning and biopsy confirmation in the seven cases reported in this study. In these patients, an insidious and painless onset of exophthalmos was overshadowed by ptosis or a motility disturbance (particularly limited upgaze) in the absence of chemosis and lid erythema. The lesions were located in the superior rectus-levator complex (6 cases) and in the medial rectus muscle (1 case). One patient, with an exclusive infiltration of the levator, had a complete ptosis, whereas four others had a partial ptosis. Important clinical clues included palpable masses (4 cases) and preserved downward gaze (all cases), the latter suggesting the absence of fibrotic restriction, as is often seen in Graves' myopathy and the idiopathic myositis of pseudotumor. The biopsy specimens showed spill-over of the hypercellular and stroma-free lymphoid tissue into the orbital fat (all cases) and into the lacrimal gland (3 cases). Full extraocular motility on upgaze was restored after local orbital radiotherapy, although a residual ptosis persisted in five cases. Five patients had well-differentiated lesions and nonocular disease did not develop, whereas a widespread disease developed in one of two patients with a cytologically malignant lymphoma; the patient eventually died.
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PMID:Orbital lymphoid tumors located predominantly within extraocular muscles. 362 18

We present two unique cases of unilateral blepharochalasis. Blepharochalasis is an idiopathic disorder of young adults manifested by intermittent, recurrent episodes of eyelid edema. After repeated episodes of swelling, the periorbital tissue develops premature aging with thinned, redundant skin and stretching of the eyelid tendons. Blepharochalasis is considered bilateral; unilateral cases are extremely rare. Ptosis surgery in these cases may be unpredictable due to alterations in the levator aponeurosis. Simple reattachment of the apparent edge of the disinserted levator aponeurosis may cause significant overcorrection and variations in postoperative eyelid heights. Our two unilateral cases demonstrated proptosis on the affected side, and prominent vessels in the levator aponeurosis and suborbicularis muscle planes, plus vascular changes in orbital fat in one case. Blepharochalasis therefore may be an orbital rather than a periorbital disease, as suggested previously. Proptosis is probably overlooked in the usual bilateral cases. When all other causes of unilateral swelling have been ruled out and the findings are consistent with blepharochalasis, this diagnosis should be considered.
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PMID:Unilateral blepharochalasis. 365 15

Mucoceles involving any of the paranasal sinuses may present with ophthalmic disturbances. Maxillary antral mucoceles can encroach on the inferior orbit with ocular displacement and compression, proptosis or enophthalmos, lower lid distortion, tethering of extraocular muscles, and ptosis. Periocular pain, erosion of the inferior orbital rim, infraorbital nerve compression, epiphora, and inner canthal swellings are other important presentations. Postoperative mucoceles may involve only a portion of the antrum. Five illustrative cases are presented.
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PMID:Ophthalmic manifestations of maxillary sinus mucoceles. 365 61

Proptosis and ptosis, caused by a large orbital mass that was excised and determined to be malignant melanoma, developed in a 4-year-old girl with congenital neurocutaneous melanosis (multiple large or giant cutaneous nevi associated with abnormal leptomeningeal pigmentation). Shortly thereafter, the patient had evidence suggestive of systemic metastases and died. The orbital tumor was likely metastatic from a primary meningeal melanoma. Other possible sources of metastatic tumor are discussed. It is unlikely that this was a primary orbital melanoma because the patient had no clinical or pathologic manifestations of pre-existing oculocutaneous melanosis, orbital melanosis, or orbital blue nevus.
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PMID:Congenital neurocutaneous melanosis with metastatic orbital malignant melanoma. 380 23


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