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2014-2015 Basic and Clinical Science Course (BCSC): Section by American Academy of Ophthalmology, John Bryan Holds MD

By American Academy of Ophthalmology, John Bryan Holds MD

Information the anatomy of the orbit and adnexa, and emphasizes a realistic method of the evaluate and administration of orbital and eyelid problems, together with malpositions and involutional adjustments. Updates present details on congenital, inflammatory, infectious, neoplastic and demanding stipulations of the orbit and accent buildings. Covers key facets of orbital, eyelid and facial surgery.

Upon finishing touch of part 7, readers will be capable to:

Describe the conventional anatomy and serve as of orbital and periocular tissues
Choose acceptable exam thoughts and protocols for diagnosing issues of the orbit, eyelids, and lacrimal system
Describe useful and beauty symptoms within the surgical administration of eyelid and periorbital stipulations

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Extra resources for 2014-2015 Basic and Clinical Science Course (BCSC): Section 7: Orbit Eyelids and Lacrimal System

Example text

The conchae are covered by nasal rnucosa, and they overhang the corresponding meatuses. Just cephalad to the superior concha is the sphenoethmoidal recess, into which the sphenoid sinus drains. The frontal sinus and the anterior and middle ethmoid air cells drain into the middle meatus. The nasolacrimal duct opens into the inferior meatus. The nasal cavity is lined by a pseudostratified, ciliated columnar epithelium with copious goblet cells. The mucous membrane overlying the lateral alar cartilage is hair bearing and therefore less suitable for use as a composite graft in eyelid reconstruction than the mucoperichondrium over the nasal septum, which is devoid of hair.

Dermoid cysts that do not present until adulthood often are not palpable because they are situated posteriorly in the orbit, usually in the superior and temporal portions adjacent to the bony sutures. The globe and adnexa may be displaced, causing progressive proptosis, and erosion or remodeling of bone can occur. Long-standing dermoids in the superior orbit may completely erode the orbital roof and become adherent to the dura mater. An uncommon variant is the intradiploic epidermoid cyst, which tends to present late, after it has broken through and expanded the bony perimeter.

Medical monitoring of a patient with serious health problems is easier in the environment of the CT room than in the MRI chamber. Because patients with acute head trauma are usually being evaluated for bone fractures, acute hemorrhagic problems, and possible foreign bodies, CT is usually the best choice in such cases, because it can be performed more rapidly. For subacute trauma, MRI may be preferable because it is better at differentiating between fresh and old hemorrhages (Fig 2-6). Although CT and MRI yield different images, it is unusual for both techniques to be required in the evaluation of an orbital disorder.

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