Benign Orbital Tumors with Bone Destruction in Children

Purpose: To present rare benign orbital tumors with bone destruction in children who could not be diagnosed presurgically and may simulate malignant ones. Methods: A retrospective review of cases. Clinical, operative and pathological records in all children with a diagnosis of benign orbital tumors who showed remarkable bone destruction at a tertiary Ophthalmic Center in China between Jan 1, 2000 and Dec 31, 2009 were reviewed. All patients had definitive histopathologic diagnosis. Results: Eight patients with benign orbital tumors showed obvious bone destruction, including six cases of eosinophilic granuloma, one case of leiomyoma and one case of primary orbital intraosseous hemangioma. Among them, three patients were females and five patients were males. Tumors were unilateral in all cases, with both the right and left side affected equally. Age ranged from 3 to 7 years (mean 4.1 years). Symptom duration ranged from 1 to 5 weeks (mean 4.8 weeks). Eyelid swelling and palpable mass were the most common complaint. There was no evidence for multifocal involvement in cases with eosinophilic granuloma. Among six patients with eosinophilic granuloma, two were treated with low dose radiation (10 Gy), three received systemic corticosteroid and one was periodically observed only after incisional biopsy or subtotal curettage. There was no postoperative therapeutic intervention in the two patients with leiomyoma and intraosseous hemangioma. All eight patients regained normal vision without local recurrence after a mean follow-up time o

ICAR: endoscopic skull‐base surgery

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Retinal and Choroidal Optical Coherence Tomography Findings of Carotid Cavernous Fistula.

Purpose To define the retinal and choroidal imaging findings of carotid cavernous fistula (CCF) including central foveal thickness, subfoveal choroidal thickness, choroidal vascularity index (CVI) parameters, and tortuosity indexes (TIs) as compared to a control group (CG). Design Cross-sectional study. Materials and Methods The spectral domain enhanced-depth imaging optical coherence tomography images of 19 eyes of 19 consecutive patients with angiographically proven CCF and 19 eyes of 19 age- and sex-matched healthy control subjects were included. The patient group was divided according to CCF venous drainage pattern as anterior (A-CCF: draining into ophthalmic veins) and posterior (P-CCF: not draining into ophthalmic veins). The clinically affected eyes of the patient group, ipsilateral to the fistula, were included in the analysis. Results There were 15 A-CCFs (78.9%) and 4 P-CCFs (21.1%). The mean SFCT of the A-CCF group (395.21 ± 111.69 μm) was significantly higher than those of the P-CCF (246.84 ± 94.12 μm) and CG groups (280.79 ± 111.36 μm) (P = .039 and P = .006, respectively). The mean CVI of the A-CCF group was significantly higher than that of the CG (68.97 ± 4.81 and 65.66 ± 3.37, respectively, P = .033). The A-CCF group had significantly higher inferior, superior, and total venous TI than the CG group (P = .001, P = .001, and P < .001, respectively). Conclusion In this first study investigating the CVI and TI in CCF patients, we demonstrated that SFCT, CVI, and TI could potentially be used to aid in the diagnosis of A-CCF.Wo

Cholesterol Granuloma of the Orbit. Report of Cases and Analysis of Controversial Treatment

Cholesterol granuloma of the orbit is a rare entity originated from a foreign body reaction against cholesterol crystal. Its pathogenesis still remains unclear, while controversy is still present concerning its management. In the present report, two new cases of cholesterol granuloma of the orbit are presented and the authors focus on treatment considerations

Incidence, risk factors, and outcomes of Fusobacterium species bacteremia

Background: Fusobacterium species (spp.) bacteremia is uncommon and has been associated with a variety of clinical presentations. We conducted a retrospective, population based study to determine the relative proportion of species in this genus causing bacteremia and the risk factors for infection and adverse clinical outcomes. Methods: All cases of Fusobacterium spp. bacteremia detected at a regional microbiology laboratory serving outpatient and acute care for a population of approximately 1.3 million people over 11 years were identified from a computerized database. Clinical data on these cases was extracted from an administrative database and analyzed to determine underlying risk factors for and outcomes of infection. Results: There were 72 incident cases of Fusobacterium spp. bacteremia over the study period (0.55 cases/100,000 population per annum). F. nucleatum was the most frequent species (61%), followed by F. necrophorum (25%). F. necrophorum bacteremia occurred in a younger population without underlying comorbidities and was not associated with mortality. F. nucleatum bacteremia was found in an older population and was associated with underlying malignancy or receiving dialysis. Death occurred in approximately 10% of F. nucleatum cases but causality was not established in this study. Conclusions: Fusobacterium spp. bacteremia in our community is uncommon and occurs in approximately 5.5 cases per million population per annum. F. necrophorum occurred in an otherwise young healthy population and was not associated with any mortality. F. nucleatum was found primarily in older patients with chronic medical conditions and was associated with a mortality of approximately 10%. Bacteremias from other Fusobacterium spp. were rare.</p