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Orbital Inflammatory Syndromes
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Jaspreet Sukhija, Savleen Kaur
Localized OIS may occur in the lacrimal gland, EOMs, or optic nerve sheath. The typical acute presentation of dacryoadenitis includes pain, enlargement of the lacrimal gland, an S-shaped ptosis of the upper eyelid, and tenderness to palpation. Inflammatory disease of the lacrimal gland may also present in a subacute or chronic form in which a painless mass appears in the region of the lacrimal fossa.
Cosmetic Facial Interventions
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
In general, the removal of fat from the upper eyelid should be avoided or restricted to the medial fat compartment to prevent ‘hollowing’ of the eyelid that post-operatively manifests a ‘cadaveric’ appearance, which is not easily amenable to correction. Other anomalies include a prolapsed lacrimal gland, which can be repositioned by suturing the capsule of the lacrimal gland to the inner aspect of the periosteum of the lacrimal fossa. Rare anomalies such as a prominent supra-orbital rim can be reduced by drilling.
Head and Neck
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The tarsal glands are embedded in the posterior surface of each tarsal plate, the fibrous “skeleton” of the upper eyelid. The orbital septum is a sheet of connective tissue separating the superficial facial fascia and the contents of the orbit. The tarsal glands drain by orifices lying posteriorly to the eyelashes and secrete an oily substance onto the margin of the eyelids that prevents the overflow of tears (lacrimal fluid). The lacrimal gland lies in the lacrimal fossa of the frontal bone. The lacrimal sac lies posterior to the medial palpebral ligament, which is attached to the anterior lacrimal crest that forms the anterior border of the lacrimal groove (Plate 3.32). The lacrimal sac receives lacrimal fluid from the medial angle of the eye through the lacrimal canaliculi. When lacrimal fluid accumulates in excess and cannot be removed from the medial corner of the eye via the lacrimal canaliculi, it overflows the eyelids (visible crying or shedding of tears). Tears also drain into the nasal cavity via the lacrimal sac, resulting in a runny nose.
Mapping Resident Immune Cells in the Murine Ocular Surface and Lacrimal Gland by Flow Cytometry
Published in Ocular Immunology and Inflammation, 2023
Baikai Ma, Yifan Zhou, Yuzhe Hu, Hongyu Duan, Zhengze Sun, Pingzhang Wang, Wei Li, Wenling Han, Hong Qi
Healthy corneas were confirmed by CFS scores < 3. No obvious inflammatory changes of included conjunctiva were observed by slit-lamp microscope. The conjunctiva, central corneas, peripheral corneas, and lacrimal gland were dissected under a stereo microscope (SOPTOP-SZN, Sunny instruments, Ningbo, China) in sequence. The conjunctiva was isolated completely along the corneal conjunctival junction and the conjunctival tarsal plate junction, including bulbar and palpebral conjunctiva as well as the conjunctival fornix. Then, the corneas were dissected from the lateral side of the limbus, without attachment of the iris or ciliary body. The corneal diameter of 6–8 weeks old C57BL/6 was about 3 mm.15 The central cornea was harvested using a 1.5 mm corneal trephine and the remainder was the peripheral cornea. The lacrimal gland was separated in the superficial lacrimal fossa.
Flap suturing endonasal dacryocystorhinostomy assisted by ultrasonic bone aspirator
Published in Acta Oto-Laryngologica, 2022
Hirohiko Tachino, Hiromasa Takakura, Hideo Shojaku, Michiro Fujisaka, Shinsuke Ito, Yutaro Oi, Anh Tram Do, Chiharu Fuchizawa, Tatsuya Yunoki, Atsushi Hayashi
The lacrimal sac sits in the lacrimal fossa, which is formed from the hard frontal process of the maxilla anteriorly and the thin lacrimal bone posteriorly. As the bone not only overlying the lacrimal sac but also underlying the anterior nasal mucosa is very thick, powered instruments such as drills have been widely used to remove the hard bone tissue. The inherent danger in using these devices is the possibility of injury to the underlying lacrimal sac or nearby nasal mucosa, which may result in failure of flap suturing. The ultrasonic bone aspirator (UBA), as a piezoelectric device, uses metal cutting tips oscillating at an ultrasonic frequency between 25 and 30 kHz. It selectively emulsifies the bone while displacing and preserving adjacent soft tissues [9]. The UBA may preserve delicate nasal mucosa during the DCR and facilitate the creation of lacrimal sac-nasal mucosal flaps [9,10]. Therefore, the purpose of the present study was to assess the advantage of the UBA during the osteotomy compared with the diamond burr in our new modified technique.
Lacrimal Fossa Bony Changes in Chronic Primary Acquired Nasolacrimal Duct Obstruction and Acute Dacryocystitis
Published in Current Eye Research, 2021
Mohammad Javed Ali, Dilip Kumar Mishra, Nandini Bothra
Primary acquired nasolacrimal duct obstruction (PANDO) is a common lacrimal drainage disorder usually managed with a dacryocystorhinostomy (DCR). Acute dacryocystitis and its sequelae can be complications of a pre-existing nasolacrimal duct obstruction and can be managed either medically first followed by surgery or a direct endoscopic DCR.1 The histopathological changes in the lacrimal sac in cases of PANDO and acute dacryocystitis are well known. However, the same is not true of the changes in the overlying bony lacrimal fossa. Since the lacrimal sac is housed in the bony lacrimal fossa (LF), it is only natural to be curious to know changes in the vicinity when the lacrimal drainage is diseased. Lacrimal bone involvement has been reported in tuberculous dacryocystitis.2 However, to the best of the authors’ knowledge, only three studies reported the bony findings in patients with PANDO earlier but with conflicting results.3–5 Of these, only one study was focused on bony changes.3 The current study has attempted to assess the bony lacrimal fossa changes in chronic cases of primary acquired nasolacrimal duct obstruction and acute dacryocystitis and add to the existing sparse literature on this topic.