2008-2009 Basic and Clinical Science Course: Section 7: by John Bryan Holds, MD

By John Bryan Holds, MD

Emphasizing a pragmatic method of prognosis and therapy, this quantity summarizes present details on congenital, infectious, inflammatory, neoplastic, and aggravating stipulations of the orbit and adnexa. Highlights contain broad dialogue of thyroid-associated orbitopathy, lymphoproliferative issues, and eyelid neoplasms. includes up to date references and diverse new colour photographs.

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Additional resources for 2008-2009 Basic and Clinical Science Course: Section 7: Orbit, Eyelids, and Lacrimal System (Basic and Clinical Science Course 2008-2009)

Sample text

Orbit, Eyelids, and Lacrimal System fasciitis, as do typical changes in skin color progressing from rose to blue-gray with bullous formation and frank necrosis. Usually, the course is rapid and the patient requires ICU support. Treatment includes early surgical debridement along with IV antibiotics. If the involved pathogen is unknown, then broad-spectrum coverage for gram-positive and gram-negative as well as anaerobic organisms is indicated. Clindamycin is of particular value as it is uniquely effective against the toxins produced by group A Streptococcus.

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. The frontal sinuses develop from evaginations of the frontal recess and cannot be seen radiographically until the sixth year of life. Pneumatization of the frontal bone continues through childhood and is complete by early adulthood (Fig 1-10).

Thus, CT is superior to MRI for the evaluation of fractures, bone destruction, and tissue calcification. Motion artifact remains a problem in MRI, which requires more time to perform than does CT. Patient anxiety and claustrophobia may also be issues because of the tighter confines of the MRI equipment. To minimize claustrophobia, "open MRI" scanners, which 30 . Orbit, Eyelids, and Lacrimal System have a markedly larger bore, are available. These scanners generally have lower resolution, however, and their use of MR surface coils may reintroduce the problem of claustrophobia.

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