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Transillumination-guided Study of the Endoscopic Anatomy of the Lacrimal Fossa

RICARDO, Luiz Artur Costa; NAKANISHI, Marcio; FAVA, Antonio Sergio
Fonte: ASSOC BRASILEIRA OTORRINOLARINGOLOGIA & CIRURGIA CERVICOFACIAL Publicador: ASSOC BRASILEIRA OTORRINOLARINGOLOGIA & CIRURGIA CERVICOFACIAL
Tipo: Artigo de Revista Científica
ENG
Relevância na Pesquisa
46.47%
Dacryocystorhinostomy is the treatment of choice for the obstruction of the lachrymal apparatus. At the end of last century, the development of the endoscopic instruments for nasosinusal surgery has made it possible to do it through the endoscopic pathway. Nonetheless, anatomical variations make it difficult to have reproducibility endonasaly. Aim: study the endoscopic anatomy of the lachrymal fossa through transillumination of the common canaliculus. Study design: experimental. Materials and Methods: we dissected 40 lachrymal pathways from 20 human cadavers, in three stages: 1. identification and dilation of the lachrymal canaliculus. 2 Optic fiber beam introduction; 3 - endoscopic dissection of the lachrymal sac, describing its position. Results: the most frequent position of the lachrymal sac was between the free border of the middle turbinate and its insertion immediately underneath it. The maxillary line was seen in 95% of the cases. Septoplasty was needed in 12.5%, unicifectomy in 35% and middle turbinectomy in 7.5%. Conclusion: Although the lachrymal sac has a more frequent location, its position varied considerably. The transillumination of the common canaliculus proved useful, solving the problem of the anatomical variability.

Obstrução de vias lacrimais associada ao tratamento radioiodoterápico de carcinoma de tireoide; Lacrimal drainage system obstruction associated to radioactive iodine therapy for thyroid carcinoma

Fonseca, Fabricio Lopes da; Lunardelli, Patricia; Matayoshi, Suzana
Fonte: CONSEL BRASIL OFTALMOLOGIA; SAO PAULO Publicador: CONSEL BRASIL OFTALMOLOGIA; SAO PAULO
Tipo: Artigo de Revista Científica
POR
Relevância na Pesquisa
46.68%
OBJETIVO: Descrever uma série de pacientes portadores de obstrução do sistema lacrimal associado à radioiodoterapia para tratamento de carcinoma de tireoide, revisar os dados clínicos e a resposta ao tratamento cirúrgico desta rara complicação. MÉTODOS: Foi realizada uma análise retrospectiva dos achados oftalmológicos de pacientes com histórico de carcinoma de tireoide previamente submetidos à tireoidectomia e à RIT que foram encaminhados para cirurgia de vias lacrimais. RESULTADOS: Dezessete pacientes com carcinoma de tireoide tratados com tireoidectomia e RIT apresentaram obstrução do ducto nasolacrimal sintomática após período médio de 13,2 meses do tratamento do câncer. Onze pacientes tiveram epífora bilateral, 8 com mucocele de saco lacrimal. A idade dos pacientes variou entre 30 e 80 anos, sendo 10 com idade menor ou igual a 49 anos. A dose cumulativa média de radioiodo administrada foi de 571 mCi (variação entre 200-1200 mCi). Sintomas de obstrução nasal e aumento de glândulas salivares ocorreram em 53% dos pacientes. Todos os pacientes foram submetidos à dacriocistorrinostomia. Observou-se ainda que nos 3 pacientes mais jovens houve maior sangramento intraoperatótio e dilatação de saco lacrimal. A resolução completa da epífora e da dacriocistite ocorreu em 82...

Comparação entre as técnicas de dacriocistografia por ressonância magnética e por raios X no diagnóstico da obstrução das vias lacrimais; Comparison between magnetic resonance and x-ray dacryocystography in the evaluation of the obstruction of the lacrimal apparatus

Abreu Júnior, Luiz de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 30/07/2008 PT
Relevância na Pesquisa
56.86%
Introdução: Epífora corresponde ao hiperlacrimejamento decorrente de causa obstrutiva. Quase sempre se indica o tratamento cirúrgico, e a determinação do nível e da natureza da obstrução solicita exames de imagem. A ressonância magnética pode ser utilizada nesse contexto. Objetivos: Verificar a eficácia da dacriocistografia por RM, na avaliação de obstrução das vias lacrimais, correlacionando com o exame de imagem padrão-ouro, a dacriocistografia por RX. Métodos: A amostra compreendeu 32 indivíduos (26 mulheres e seis homens, com média de idade de 55,4 ± 21,5 anos) com tempo de sintomatologia oscilando entre três meses e vinte anos. Utilizaram-se seqüências de RM ponderadas em STIR T2 sem e com instilação de soro fisiológico e seqüência gradiente-eco ponderada em T1, após instilação de solução de gadolínio diluído (1:100). Os dados da RM foram correlacionados com o exame padrão-ouro (dacriocistografia por RX). A análise foi realizada por dois observadores. Foram calculados: a sensibilidade, a especificidade e os valores preditivos - positivo (VPP) e negativo (VPN) - de cada uma das seqüências de RM, para a detecção da presença de obstrução das vias lacrimais. Calculou-se, ainda, a concordância intra- e interobservador para os diagnósticos da presença e do nível da obstrução...

Comprometimento da pálpebra e via lacrimal excretora em portador de leishmaniose cutâneo-mucosa: relato de caso

Hoyama, Erika; Schellini, Silvana Artioli; Stolff, Hamilton; Nakagima, Victor; Souto, Eliane
Fonte: Conselho Brasileiro de Oftalmologia Publicador: Conselho Brasileiro de Oftalmologia
Tipo: Artigo de Revista Científica Formato: 580-582
POR
Relevância na Pesquisa
46.66%
Objetivo: Apresentar um portador de leishmaniose com lesão palpebral e dilatação de via lacrimal excretora. Relato de caso: O paciente em questão foi portador de leishmaniose do tipo cutâneo-mucosa, tendo apresentado múltiplas lesões de pele, ectrópio da pálpebra inferior, lesões na mucosa nasal e alterações na drenagem lacrimal. Discussão: O acometimento da pálpebra e da via lacrimal raramente ocorre em portadores de leishmaniose. Os autores chamam atenção para o diagnóstico e para a necessidade de se adotar medidas preventivas contra os vetores e a rápida instituição do tratamento.; Purpose: To report a patient with leishmaniasis with eyelid lesion and dilated lacrimal excretory system. Case report: This patient had mucocutaneous leishmaniasis with multiple skin lesions, ectropium of the inferior eyelid and alterations in the lacrimal excretory system. Discussion: Even though the eyelid and lacrimal ducts are infrequently affected in patients with leishmaniasis, the authors emphasized the necessity of preventing measures against the vector and early treatment.

Avaliação dos produtos finais de glicosilação e o fator nuclear K-B em glandulas lacrimais e superficie ocular de modelos animais de diabetes e envelhecimento; Advanced glycation end-products and Nuclear Factor K-B in lacrimal glands and ocular surface of diabetes and aging animal models

Monica de Cassia Alves
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 21/07/2006 PT
Relevância na Pesquisa
46.66%
Este estudo avaliou as possíveis vias comuns na fisiopatogênese da síndrome do olho seco no Diabetes Mellitus (DM) e no envelhecimento, envolvendo o acúmulo dos produtos de glicosilação ("Advanced Glycation End-products" - AGEs), seu receptor RAGE e a ativação do Fator Nuclear-?B (NF-?B) na glândula lacrimal (GL) e alterações do filme lacrimal nessas condições. Modelos animais de DM induzido com estreptozotocina e animais senis (24 meses de vida) foram comparados a animais controle tratados com tampão citrato e adultos jovens (2 meses de vida). Foram avaliadas vias de sinalização, envolvendo AGEs, RAGE e a ativação do NF-?B na GL e alterações no filme lacrimal em ratos Wistar de todos os grupos. A análise do filme lacrimal foi realizada através de medidas de volume de secreção basal e dosagem de citocinas como a Interleucina-1 ß (IL-1 ß) e Fator de Necrose Tumoral - a (TNF- a). A capacidade secretória da GL foi avaliada através de medidas da atividade de peroxidase. Técnicas de "western blot" foram utilizadas para avaliar a expressão e ativação do NF-?B na GL. A expressão de AGE, RAGE e NF-?B na GL e córnea nos grupos estudados, foi avaliada através de microscopia confocal com imunofluorescência. O volume lacrimal foi significativamente menor nos animais diabéticos e senis (P=0...

Dry eye evaluation and immunohistochemical study of the conjunctiva and lacrimal gland of patients submitted to bone marrow transplantation

Cunha,Rosana Nogueira Pires da; Campos,Mauro; Dulley,Frederico Luis; Rojas,Bianca; Foster,Charles Stephen
Fonte: Conselho Brasileiro de Oftalmologia Publicador: Conselho Brasileiro de Oftalmologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2003 EN
Relevância na Pesquisa
46.59%
PURPOSE: The primary ocular targets of chronic graft-versus-host disease (GVHD) are the lacrimal gland (LG) and the conjunctiva, and their involvement results in keratoconjunctivitis sicca (KCS). The purpose of the present study was to evaluate the frequency of signs and symptoms of KCS present in patients submitted to BMT, to identify the cellular phenotype of the conjunctival and lacrimal gland biopsies of these patients by immunohistochemistry and to correlate the findings with the presence of dry eye due to GVHD. METHODS: Forty-seven patients were clinically classified into two groups: Group I, with ocular GVHD, submitted to allogeneic BMT and Group II, without ocular GVHD, submitted to autologous and allogeneic BMT. Thorough eye examination, including clinical lacrimal function tests and biopsies of the conjunctiva and of the LG were performed in the pre- and posttransplantation period. The biopsies were submitted to immunohistochemical analysis using a panel of monoclonal antibodies. RESULTS: Of the 28 (82.4%) patients with chronic GVHD, 13 (46.4%) presented ocular GVHD. Of the six patients without GVHD, one (16.7%) presented ocular GVHD. None of those submitted to autologous BMT presented ocular GVHD and 14 (41.2%) of 34 patients with allogeneic BMT presented ocular GVHD. All patients with ocular GVHD (Group I) had symptoms and the most frequent were burning...

Plasmacytoma of the orbit involving lacrimal gland with secondary transformation into multiple myeloma: case report

Romero,Ivana Lopes; Campos,Felipe Augusto Garcez de; Damasceno,Renato Wendell Ferreira; Vital Filho,José; Bison,Simone Haber Duellberg Von Faber
Fonte: Conselho Brasileiro de Oftalmologia Publicador: Conselho Brasileiro de Oftalmologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2009 EN
Relevância na Pesquisa
46.43%
The authors present a rare case of plasmacytoma of the orbit involving lacrimal gland with secondary transformation into multiple myeloma in a 42-year-old woman. The lesion was surgically removed and analyzed. Histopathological examination with immunostaining revealed it to be positive for immunoglobulin G and Kappa chains, demonstrating monoclonality. However, no abnormality was observed on serum electrophoresis, skeletal survey and bone marrow aspiration. Therefore, the tumor was diagnosed solitary plasmacytoma of bone. The patient was treated with external beam radiotherapy and has remained disease free for 5 years and 6 months until 2007, when she presented a pathological fracture due to multiple myeloma. Extensive medical work-up to rule out multiple myeloma or other malignant lymphoproliferative conditions involving orbit or ocular adnexa is needed when the diagnosis of solitary plasmacytoma of bone is suspected because treatment and prognosis are very different.

An unusual presentation of lacrimal gland pleomorphic adenoma

Iyeyasu,Josie Naomi; Reis,Fabiano; Altemani,Albina Messias; Carvalho,Keila Monteiro de
Fonte: Sociedade Brasileira de Oftalmologia Publicador: Sociedade Brasileira de Oftalmologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2013 EN
Relevância na Pesquisa
46.55%
Tumors of the lacrimal gland are rare in clinical practice. Among all of them, the most common epithelial tumor is the lacrimal gland pleomorphic adenoma, which is a benign indolent tumor that usually affects adults in the third and fourth decades of life. We present an unusual case of lacrimal gland pleomorphic adenoma. Its management, radiological findings and outcomes are also described, along with a brief review of the literature.

Development of the Lacrimal Apparatus in the Rabbit (Oryctolagus cuniculus) and Its Potential Role as an Animal Model for Humans

Rehorek, S. J.; Holland, J. R.; Johnson, J. L.; Caprez, J. M.; Cray, J.; Mooney, M. P.; Hillenius, W. J.; Smith, T. D.
Fonte: Hindawi Publishing Corporation Publicador: Hindawi Publishing Corporation
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.59%
Rabbits have been proposed as a model organism for the human lacrimal apparatus (LA), including the nasolacrimal duct (NLD), based principally on comparative studies of adult morphology; however, little is known about its development. The NLD first appears as an incomplete primordium in the subcutaneous region of the primordial eyelid and subsequently elongates to reach the naris. One posterior and three anterior orbital glands are present fetally although one of the anterior glands is soon lost. The NLD follows a tortuous path and passes through a bony canal consisting of lacrimal, maxilla, and maxilloturbinal bones at different regions. Although early developmental similarities exist to haplorhine primates, the narial opening of the NLD resembles strepsirrhines. This distinction, along with the ductal and glandular differences at the orbital end of the NLD, indicates that rabbits may be a poor model for LA drainage in primates, specifically humans.

Tratamento cirúrgico da epífora crônica em animais de companhia

Kleiner, Joao Alfredo
Fonte: Universidade Federal do Paraná Publicador: Universidade Federal do Paraná
Tipo: Dissertação Formato: 57f. : il. color.; application/pdf
PORTUGUêS
Relevância na Pesquisa
36.81%
Orientador : Antônio Felipe Wouk; Dissertaçao (mestrado) - Universidade Federal do Paraná, Setor de Ciencias Agrárias; Resumo: A epífora é uma patologia ocular de ocorrência muito comum na clínica veterinária e pode ser caracterizada por um extravasamento do filme lacrimal pela região subocular, causando conjuntivites recorrentes, dermatites, fistulações e mancha suboculares importantes. A epífora pode ser causada por anomalias congênitas ou condições adquiridas as quais provocam um estreitamento ou obstrução em algum nível do sistema excretor lacrimal. O presente projeto de pesquisa tem como objetivo relatar os procedimentos utilizados nas diferentes técnicas cirúrgicas utilizadas para o tratamento da epífora crônica em animais de companhia, bem como demonstrar as variações anatômicas apresentada pelo aparato de drenagem lacrimal em cães e gatos e também a descrição das técnicas utilizadas para o estudo radiográfico contrastado das vias lacrimais.; Abstract: Epiphora is a very common ocular pathology in the small animal practice and can be characterized by a subocular overflow of the preocular lacrimal film that can cause recurrent conjunctivitis, dermatitis, fistulas, and tear staining syndrome. The epiphora can be caused either by congenital anomalies or acquired conditions that lead to a stricture or obstruction in any level of the excretory lacrimal apparatus. The present research project has the objectives of relating the procedures utilized in the different surgical techniques for the treatment of chronic epiphora in companion animals...

Combined external-endonasal approach for complete excision of the lacrimal drainage apparatus

Sullivan, T.; Valenzuela, A.; Selva-Nayagam, D.; McNab, A.
Fonte: Lippincott Williams & Wilkins Publicador: Lippincott Williams & Wilkins
Tipo: Artigo de Revista Científica
Publicado em //2006 EN
Relevância na Pesquisa
46.9%
PURPOSE: The purpose of this study was to describe a new surgical technique for the complete excision of the lacrimal drainage apparatus (LDA) that combines external and endoscopic approaches. METHODS: This study involved a noncomparative, retrospective chart review of the clinical and pathological findings of four patients presenting with LDA papillomas who underwent a combined open and endonasal excision of the lacrimal system. RESULTS: Of the four patients, three were male. The mean age at referral was 41 years, and all cases were unilateral. Histopathology revealed two transitional cell papillomas, one squamous cell papilloma, and one combined transitional/squamous papilloma. Epiphora and an external lesion were the main complaints at presentation. Nasolacrimal duct obstruction was present in all four patients. Papilloma virus infection was suggested in two cases and was confirmed in the only patient who had recurrence. CT identified a solid enhancing mass in two cases. The surgical approach in all cases was performed with the patient under general anesthetic supplemented with infiltration of local anesthesia with vasoconstriction. The lacrimal sac was exposed as per an external dacryocystorhinostomy with biopsy collection from the lacrimal sac lumen to confirm the diagnosis prior LDA excision. The superior aspect of the LDA was isolated by using lacrimal probes in each canaliculus to stabilized parallel incisions and careful dissection toward the common canaliculus until they met the medial aspect of the lacrimal sac. The sac was then separated from the periosteum from the medial orbital wall...

En bloc excision in malignant tumors of the lacrimal drainage apparatus

Valenzuela, A.; Selva-Nayagam, D.; McNab, A.; Simon, G.; Sullivan, T.
Fonte: Lippincott Williams & Wilkins Publicador: Lippincott Williams & Wilkins
Tipo: Artigo de Revista Científica
Publicado em //2006 EN
Relevância na Pesquisa
46.81%
PURPOSE: To describe the surgical technique and results of en bloc excision in a series of patients with extensive malignant tumors of the lacrimal drainage apparatus (LDA). METHODS: This was a noncomparative, retrospective chart review of the clinical and pathologic findings of 11 patients presenting with a malignant tumor affecting the LDA who underwent en bloc excision of the lacrimal system. RESULTS: Of the 11 patients, 7 were male. The mean age at presentation was 58 years (range, 39 to 81 years), and all cases were unilateral. Histopathology revealed 4 squamous cell carcinomas, 3 transitional cell carcinomas, 2 mucoepidermoid carcinomas, and 2 melanomas. Epiphora and a mass were the most common presentations. An external lesion could be identified in 4 cases. Irrigation of the lacrimal system revealed nasolacrimal duct obstruction in 2 cases and common canaliculus obstruction in another 2 patients. The entire LDA and surrounding bony tissues were excised through a lateral rhinotomy approach. Adjuvant radiotherapy was given in 4 cases. Nine patients remain alive and well after a mean follow-up of 2 years (range, 6 months to 7 years). Three cases showed distant disease and 2 patients died of metastatic melanoma involvement. CONCLUSIONS: The use of en bloc excision as a radical treatment to remove the complete LDA and surrounding bony structures affords good local tumor control and may provide the best opportunity for enhanced patient survival.

American Joint Committee on cancer classification predicts outcome of patients with lacrimal gland Adenoid Cystic Carcinoma

Ahmad, S.; Esmaeli, B.; Williams, M.; Nguyen, J.; Fay, A.; Woog, J.; Selvadurai, D.; Rootman, J.; Weis, E.; Selva-Nayagam, D.; McNab, A.; De Angelis, D.; Calle, A.; Lopez, A.
Fonte: Elsevier Science Inc Publicador: Elsevier Science Inc
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
Relevância na Pesquisa
46.55%
PURPOSE: To investigate whether American Joint Committee on Cancer (AJCC) classification at initial diagnosis of lacrimal gland adenoid cystic carcinoma predicts outcome of treatment on local recurrence. DESIGN: Retrospective chart review. PARTICIPANTS: Consecutive patients with adenoid cystic carcinoma of the lacrimal gland treated at 8 institutions between January 1986 and December 2007. METHODS: Clinical records, including pathology reports and imaging studies, were reviewed. MAIN OUTCOME MEASURES: AJCC classification, histologic subtype, local recurrence rate, and survival. RESULTS: AJCC classification at initial diagnosis was assessable for 53 patients and was as follows: T1N0M0, 7 patients; T2N0M0, 8 patients; T3aN0M0, 14 patients; T3aNxM0, 1 patient; T3aN0M1, 1 patient; T3bN0M0, 13 patients; T3bN0M1, 1 patient; T4aN0M0, 2 patients; T4bN0M0, 4 patients; T4bN0M1, 1 patient; and T4bNXM0, 1 patient. Thirty-eight (72%) of the 53 patients had >T3 tumors at presentation. Of the 38 patients with >T3 tumors, 20 were treated with orbital exenteration and postoperative adjuvant radiotherapy (RT), 6 were treated with orbital exenteration without RT, and 12 were treated with globe-preserving surgery (10 with RT and 2 without RT). Of the 15 patients with

The orientation of the lacrimal fossa to the bony nasolacrimal canal: an anatomical study

Park, J.; Takahashi, Y.; Nakano, T.; Asamoto, K.; Iwaki, M.; Selva-Nayagam, D.; Leibovitch, I.; Yang, S.W.; Kakizaki, H.
Fonte: Lippincott Williams & Wilkins Publicador: Lippincott Williams & Wilkins
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
46.43%
PURPOSE: To examine the relative positions of the lacrimal fossa (LF) and the bony nasolacrimal canal (BNLC) in relation to each other and a reference plane. METHODS: Forty-two orbits and BNLCs from 21 Asian cadavers (9 men and 12 women; average age at death, 84.4 years; range, 70–99 years) had been fixed in 10% buffered formalin before use. After exposing the LF and the medial half of the BNLC, the authors measured the angles of the longitudinal axis of the LF and the BNLC relative to the aesthetic horizontal plane respectively. Based on these values, the relative orientation of the LF and the BNLC was determined and defined in terms of [DELTA] BNLC-LF. A positive [DELTA] BNLC-LF represents a nasolacrimal canal that descends posteriorly relative to the LF. RESULTS: The mean LF, BNLC, and [DELTA] BNLC-LF were 9.5°, 19.8°, and 10.3°, respectively. In 39 passages (92.9%), the [DELTA] BNLC-LF was positive, representing a nasolacrimal canal that is more posteriorly oriented than the LF. In 3 passages (7.1%), the [DELTA] BNLC-LF was equal to or less than 0°; 2 of them (4.8%) had a straight course and 1 passage (2.4%) had a negative value. CONCLUSIONS: In most patients, the BNLC is directed more posteriorly than the LF. This finding may help in preventing an inadvertent false passage during probing and intubation in patients with epiphora.; Juwan Park...

Insulin replacement restores the vesicular secretory apparatus in the diabetic rat lacrimal gland

Dias,Ana Carolina; Batista,Thiago Martins; Roma,Letícia Prates; Módulo,Carolina Maria; Malki,Leonardo Tannus; Dias,Lara Cristina; Alves,Mônica; Reinach,Peter Sol; Carneiro,Everardo Magalhães; Rocha,Eduardo Melani
Fonte: Conselho Brasileiro de Oftalmologia Publicador: Conselho Brasileiro de Oftalmologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2015 EN
Relevância na Pesquisa
46.68%
ABSTRACT Purpose: In the lacrimal gland (LG) acinar cells, signaling regulates the release of secretory vesicles through specific Rab and SNARE exocytotic proteins. In diabetes mellitus (DM), the LGs are dysfunctional. The aim of this work was to determine if secretory apparatus changes were associated with any effects on the secretory vesicles (SV) in diabetic rats as well as the expression levels of constituent Rab and members of the SNARE family, and if insulin supplementation reversed those changes. Methods: DM was induced in male Wistar rats with an intravenous dose of streptozotocin (60 mg/kg). One of the two diabetic groups was then treated every other day with insulin (1 IU). A third control group was injected with vehicle. After 10 weeks, Western blotting and RT-PCR were used to compared the Rab and SNARE secretory factor levels in the LGs. Transmission electron microscopy evaluated acinar cell SV density and integrity. Results: In the diabetes mellitus group, there were fewer and enlarged SV. The Rab 27b, Rab 3d, and syntaxin-1 protein expression declined in the rats with diabetes mellitus. Insulin treatment restored the SV density and the Rab 27b and syntaxin expression to their control protein levels, whereas the Vamp 2 mRNA expression increased above the control levels. Conclusions: Diabetes mellitus LG changes were associated with the declines in protein expression levels that were involved in supporting exocytosis and vesicular formation. They were partially reversed by insulin replacement therapy. These findings may help to improve therapeutic management of dry eye in diabetes mellitus.

The anatomical relationships between the lower eyelid retractors and the lacrimal caruncle: A microscopic study

Kakizaki, H.; Takahashi, Y.; Nakano, T.; Ikeda, H.; Selva-Nayagam, D.; Leibovitch, I.
Fonte: Elsevier Science Inc Publicador: Elsevier Science Inc
Tipo: Artigo de Revista Científica
Publicado em //2010 EN
Relevância na Pesquisa
46.64%
PURPOSE: To characterize the microscopic relationships between the lower eyelid retractors and the lacrimal caruncle and to define the possible role of the caruncle in the lacrimal drainage process. DESIGN: Observational anatomic study. METHODS: Twelve eyelids with their orbital tissues (6 right and 6 left), fixed in 10% buffered formalin, were studied in 10 Asian cadavers (mean age at death: 77.1 years, age range: 62-92 years). An oblique incision in the harvested tissue specimen passed through the lower eyelid retractors and the lacrimal caruncle. The sliced specimens were stained with Masson's trichrome. RESULTS: In all specimens, the lower eyelid retractors were shown to have direct connections to the lacrimal caruncle at the level of the medial horn of the lower eyelid retractors and to reach the medial rectus capsulopalpebral fascia. At this level, smooth muscle fibers were abundant both in the lower eyelid retractors and in the medial rectus capsulopalpebral fascia, which were symmetrically situated to the caruncle. CONCLUSIONS: The lower eyelid retractors have direct connections to the lacrimal caruncle, at a level that is rich in smooth muscle fibers. These anatomic findings may confer functional advantages to the lacrimal drainage system.; Hirohiko Kakizaki...

Clinical features and management of tumors affecting the lacrimal drainage apparatus

Valenzuela, A.; McNab, A.; Selva-Nayagam, D.; O'Donnell, B.; Whitehead, K.; Sullivan, T.
Fonte: Lippincott Williams & Wilkins Publicador: Lippincott Williams & Wilkins
Tipo: Artigo de Revista Científica
Publicado em //2006 EN
Relevância na Pesquisa
46.9%
Purpose: To report the clinical features of a series of patients with lacrimal drainage apparatus tumors and present guidelines for management based on histopathology. Methods: A noncomparative retrospective chart review of the clinical, imaging, and pathologic findings of 37 patients presenting to four regional orbital Surgery departments with tumors affecting the lacrimal drainage apparatus between 1990 and 2004. Results: There were 37 patients, of whom 62% were male. The mean age at referral was 54 years. Epiphora, a palpable mass, and dacryocystitis were the most common presentations. Two thirds of the tumors were epithelial. with carcinomas being the most frequent (38%). followed by papillomas (27%). Lymphomas were the most common nonepithelial malignancy (30%). Epithelial tumors were more common in men (87%), whereas lymphomas were more common in women (57%). Treatment modalities included surgery, in addition to radiotherapy and/or chemotherapy and immunotherapy. Mean follow-up was 38 months. Thirty-three patients (89%) remain alive without evidence of disease and 4 patients died of recurrence and/or metastases. Conclusions: Lacrimal drainage apparatus tumors require careful initial management to ensure adequate local and systemic disease control. Atypical mucosa encountered during dacryocystorhinostomy should be biopsied and small papillomas or pedunculated tumors excised and analyzed with frozen sections. If a diffuse or infiltrative mass is encountered...

Lesions mimicking lacrimal gland pleomorphic adenoma

Prabhakaran, V.; Cannon, P.; McNab, A.; Davis, G.; O'Donnell, B.; Dolman, P.; Ghabrial, R.; Selva-Nayagam, D.
Fonte: British Med Journal Publ Group Publicador: British Med Journal Publ Group
Tipo: Artigo de Revista Científica
Publicado em //2010 EN
Relevância na Pesquisa
46.59%
Aim: To report a series of patients with lacrimal gland lesions simulating the clinicoradiological features of lacrimal gland pleomorphic adenoma (LGPA). Methods: Multicentre retrospective, interventional case series. Clinical records of all patients with lesions mimicking LGPA seen in five orbital units were reviewed. Results: The study included 14 patients (seven men and seven women) with a mean age of 50.9 years. The diagnosis of LGPA was made in all cases by experienced orbital surgeons, based on clinicoradiological features, and lacrimal gland excision was performed. Postoperative histology revealed lymphoma (four patients), chronic dacryoadenitis (three patients), adenoid cystic carcinoma (two patients), Sjogren's syndrome (two patients), cavernous haemangioma (one patient), benign lymphoid hyperplasia (one patient) and granulomatous dacryoadenitis (one patient). Comparison with the total number of histologically confirmed LGPA cases seen during the study period revealed that 22.6% of cases of suspected LGPA were misdiagnosed based on clinicoradiological criteria. Conclusions: Many different lesions may mimic the clinicoradiological features of LGPA. The accepted clinicoradiological criteria used for the diagnosis of LGPA have a high false-positive rate...

The lacrimal bypass tube for lacrimal pump failure attributable to facial palsy

Madge, S.; Malhotra, R.; deSousa, J.L.; McNab, A.; O'Donnell, B.; Dolman, P.; Selva-Nayagam, D.
Fonte: Elsevier Science Inc Publicador: Elsevier Science Inc
Tipo: Artigo de Revista Científica
Publicado em //2010 EN
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46.55%
PURPOSE: To describe the use of a lacrimal bypass tube in the management of epiphora in patients with epiphora attributable to lacrimal pump failure in facial palsy. DESIGN: Multicenter retrospective interventional study. METHODS: Information regarding patient demographics, diagnoses, symptoms, oculoplastic interventions, dacryocystorhinostomy, and Jones tube insertion were collected from patient charts. RESULTS: Eighteen patients were identified, in all of whom epiphora was clinically and/or radiologically assessed as being attributable to pump failure, lid laxity having been corrected. All had constant epiphora prior to Jones tube insertion. Dacryocystorhinostomy was performed in all; insertion of a Jones tube was performed simultaneously in 12, with delayed insertion in 6. Patients' subjective epiphora improved postoperatively in 15 of 18 (83.3%) and at final median follow-up of 27.5 months (range, 6 months to 31 years); symptoms were improved in 13 of 18 (72.2%). Complications occurred in 13 of 18 (72.2%), including tube extrusion and the need for repositioning. CONCLUSIONS: In this highly selected group of patients, Jones tube insertion led to symptom improvement in 83.3% postoperatively and in 72.2% at median follow-up of 27.5 months. Tube extrusion and migration were common...

Ten-year follow-up of a case series of primary epithelial neoplasms of the lacrimal gland: clinical features, surgical treatment and histopathological findings

Santos,Rodrigo Ribeiro; Damasceno,Renato Wendell Ferreira; de Pontes,Fernanda Silva Lopes; Cursino,Sylvia Regina T.; Nishiwaki-Dantas,Maria Cristina; Vital Filho,José; Dantas,Paulo Elias Correa
Fonte: Conselho Brasileiro de Oftalmologia Publicador: Conselho Brasileiro de Oftalmologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2010 EN
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PURPOSE: To describe and analyze the features of a cases series of patients with primary epithelial neoplasms of the lacrimal gland, its surgical treatment, and histopathological findings. METHODS: Retrospective evaluation of files from patients with primary epithelial neoplasms of the lacrimal gland in the period from 1997 to 2007. All patients with primary epithelial tumors of the lacrimal gland were included in this study. Data on gender, age, clinical features, surgical treatment, histopathological findings and follow-up were collected. The slides with histological sections of the tumors were reviewed by the same pathologist. RESULTS: During the study period, there were 12 patients, 5 (41.7%) with benign tumors, all pleomorphic adenomas (benign mixed tumor) and 7 (58.3%) with malignant neoplasms, thus distributed: four cases of adenoid cystic carcinoma, two of mucoepidermoid carcinoma and one carcinoma expleomorphic adenoma. Globally, patients mean age was 54.1 years-old (ranging from 14 to 70 years-old), with mean age of 52.4 years-old (ranging from 14 to 65 years-old) for benign neoplasms, and 55.3years-old for malignant neoplasms (ranging from 26 to 70 years-old). Clinical follow-up information, ranging from 2 to 10 years-old...