Byron Smith

THE ORBITAL contour may be distorted by comminution of bone and telescoping of fragments in maxillary and zygomatic fractures, congenital malformations, loss of bone from osteomyelitis, radiation necrosis and destructive surgical procedures necessary in the eradication of malignant disease. Such distortion or disorganization points to the need for a suitable technic for restoration of the orbital floor and replacement of missing bone.In the case of comminution of bone along the ...

Two patients presented with slowly developing papillated or hyperkeratotic lesions of their lid margins that began early in the fourth decade. Upon excision, these tumors were discovered to be examples of syringocystadenoma papilliferum, a lesion not previously well documented in the ophthalmic literature. By light microscopy, each tumor displayed surface poral openings where the epidermis underwent a transition into duct-like epithelium, which ramified as luminal channels throughout the ...

A 31-year-old woman had an extruding ocular implant in her right orbit. After surgically removing the implant, we transferred an autogenous dermis-fat graft from the hip region to the freshly prepared socket. The graft was sutured to the conjunctiva, and a conformer was placed in the socket. Eight weeks postoperatively, the dermis-fat graft was covered with conjunctival epithelium and a prosthesis was fitted successfully. No evidence of infection has occurred. This technique of using ...

AN ACCEPTABLE method of repairing a blowout fracture of the orbital floor is to place a pliable implant (Teflon, Silastic, Supramid, etc) over the fracture site.1 Unless the implant is fixed in position, it is possible for it to migrate over the orbital rim requiring a reoperation for its removal or for repair of the recurrence of the herniation of the orbital contents through the fracture site.2One method of preventing migration of the implant is to drill a hole in the orbital rim and ...

Paralytic ectropion can be corrected with numerous procedures. Advocates of particular procedures have previously been unable to quote statistical rates of success for each procedure over significant lengths of time. This study reviews over 200 cases of paralytic ectropion, representing the spectrum of seventh nerve disease seen at an eye and ear specialty hospital and a general medical facility. Of all eyelid implantation devices 93 to 95% failed to work or needed reoperation by 3 years ...

Naso-orbital fractures designate a backward displacement of the bones of the nasoskeletal framework into the interorbital space. This anatomical disruption results in deformities, lacrimal dysfunction, medial canthal deformities, ptosis, blow-out fractures, ocular complication, and most severely, penetration of bony fragments into the anterior cranial fossa. Early and late treatment methods are considered. Restoration of the bony contour of the nose and medial canthoplasty procedures are discussed.

What possible connection is there between Project Management, Systems Engineering and DNA? The answer is the double helix and the amino acid pairs. It is the contention of the authors that, just like the DNA double helix, Project Management and Systems Engineering could also be thought to have a double helix. A unique amino acid like Thiamin appears at one location on a DNA strand, it is opposed on the opposite strand by Adenine. This same kind of synergy can be found in the relationship ...

Herniation of the lacrimal gland is a condition that occurs unilaterally or bilaterally. Either or both lobes of the lacrimal gland may prolapse. Orbital lobe prolapse may be associated with blepharochalasis, a disease of puberty. We developed a surgical technique for the repair of prolapsed lacrimal glands. It is important to have adequate hemostasis and closure of the orbital septum.

Acute dacryocystic retention is a disease of adults under 50 years old due to a noninfective foreign body blocking the nasolacrimal duct. It is characterized by the sudden onset of severe unilateral facial pain without significant localized swelling or erythema. Palpation of the involved lacrimal sac reveals slight induration and marked tenderness. Percutaneous aspiration of lacrimal sac contents, followed by probing of the nasolacrimal duct, is usually curative.

Malignant lesions of the nasopharynx and paranasal sinuses often encroach upon the orbit. A series of nineteen patients who underwent partial or radical maxillectomy is presented to summarize the eyelid and orbital findings that required further treatment. Fifteen of these patients were left with an intact globe and a visually useful eye, but the defects of epiphora, eyelid malposition, dacryocystitis, and diplopia were visually threatening and required treatment. The cosmetic ...