Purpose: To describe CT scan findings following orbital exenteration in 27 patients and to identify the factors involved in the development of post exenteration hyperostosis.
Methods: Noncomparative case series. The authors reviewed the charts of 27 patients ranging in age from 33 to 99 years, who underwent unilateral exenteration at King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia and at the School of Medicine of Ribeirão Preto, University of São Paulo, Brazil. Data regarding patient demographics, surgical procedure, clinical diagnosis, and preoperative and postoperative CT imaging of the orbits were obtained. The relationship between hyperostosis and postoperative time, gender, age, adjuvant radiotherapy, and cavity coverage was evaluated by multivariate stepwise logistic regression.
Results: Seventeen (73.9 %) orbits had postoperative orbital hyperostosis. No soft tissue masses were detected in the affected orbits except in 2 cases with tumor recurrence. The only factor associated with hyperostosis was immediate intraoperative socket rehabilitation (odds ratio = 0.13, 95% confidence interval: 0.01-0.89). There was an 87.0% lower chance of hyperostosis in patients whose socket was covered with musculocutaneous flaps. Sequential CT scans showed that orbital hyperostosis followed a specific pattern. Initially, bone thickening appeared as either uniform or undulating endo-osteal minimal thickening along the roof and then on the lateral and medial walls. More advanced hyperostosis had a laminated/lamellated appearance progressing to homogeneous and diffuse circumferential bone thickening. New bone formation and bone overgrowth were late findings. Hyperostosis extended to involve the adjacent facial bone, more obviously on the maxilla. Some patients had minimal thickening of the adjacent frontal and squamous temporal bone. Over-pneumatization of the paranasal sinuses was evident in all cases of hyperostosis.
Conclusions: Development of hyperostosis following exenteration is not rare. Radiologists and surgeons should be aware of the need to monitor the orbital healing process closely to avoid misdiagnoses of tumor recurrence/radionecrosis or infection. Obliteration of the orbital cavity with musculocutaneous flaps significantly reduces the chances of bone hyperostosis.
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http://dx.doi.org/10.1097/IOP.0000000000000719 | DOI Listing |
Rev Med Chil
May 2024
Departamento de Nefrología, Clínica Dávila, Santiago, Chile.
Balkan Med J
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Department of Pediatric Rheumatology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye.
Autoinflammatory bone diseases (AIBDs) constitute a recently identified subset of autoinflammatory diseases. These conditions are characterized by an exaggerated inflammatory response in the bones without any apparent etiology. Inflammatory bone lesions associated with AIBDs exhibit chronic inflammation, are typically culture-negative, and do not exhibit discernible microorganisms on histopathological examination.
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November 2024
Division of Dermatology, Security Forces Hospital, Riyadh.
This study aimed to investigate musculoskeletal complications secondary to isotretinoin use. A systematic review was conducted, and a total of 49 studies, including analytical studies, case reports, and case series, were included in the analysis. The studies examined musculoskeletal symptoms, diagnostic findings, and treatment approaches associated with isotretinoin use.
View Article and Find Full Text PDFAm J Otolaryngol
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Center for Precision Health, McWilliams School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, USA.
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BMC Musculoskelet Disord
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Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, 8 Showa-ku, Nagoya, Japan.
The growth of periacetabular osteophytes with developmental dysplasia of the hip (DDH) remains unclear. This study aimed to perform a three-dimensional assessment of periacetabular osteophytes and the effects of superiorization (SP) and lateralization (LT) of the femoral head on osteophyte formation. Female (n = 105) with unilateral hip osteoarthritis due to DDH who underwent total hip arthroplasty between 2016 and 2022 were included.
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