Dacryocystorhinostomy indications

Dacryocystorhinostomy Scar

Dacryocystorhinostomy DCR involves removal of the bone lying between the lacrimal sac and the nose, with anastomosis between the lacrimal sac and nasal mucosa the lacrimal sac, with the internal opening of the common canaliculus, is incorporated into the lateral wall of the nose and provides a direct route for tears to reach the nose. The usual indication for DCR is complete or partial obstruction of the nasolacrimal duct such obstruction can cause skin excoriation, visual impairment, social...

Lower eyelid reconstruction

Mustarde Flap

Defects of the lower eyelid can be divided into those that involve the eyelid margin, and those that do not. An eyelid defect of 25 or less may be closed directly. In patients with marked eyelid laxity, even a defect occupying up to 50 of the eyelid may be closed directly. The two edges of the defect should be grasped and pulled together to judge the facility of closure. If there is no excess tension on the lid, the edges may be approximated directly. The lid margin is reapproximated with a...

Fractures of the orbital floor and medial wall

Blowout Fracture Medial

The indirect, blowout fracture of the orbital floor occurs when a major blunt blow is applied across the anterior orbital entrance, the fracture resulting from hydraulic collapse of the orbital floor and possibly by transmission of energy from a transient deformation of the inferior orbital rim. Typically one edge of the fracture involves the infraorbital nerve canal and a transient neuropraxia of this nerve is extremely common, with hypoaesthesia of the ipsilateral cheek, side of nose and...

Benign vascular anomalies of the orbit

Episcleral Branches

Many vascular anomalies, such as varices, lymphangiomas and cavernous haemangiomas, are probably present from birth but may only become manifest in early adulthood. Capillary haemangiomas occur in 1-2 of infants and are more common in females and children of low birth weight most appear soon after birth, can enlarge dramatically and then undergo a spontaneous involution - with 75 resolving within five years. Involvement is usually unilateral and the intradermal eyelid lesions are bright red and...

Benign lacrimal gland disease

Lacrimal Tumor Pictures

The lacrimal gland is liable to inflammation, cysts and benign tumours, but these conditions can present in a similar fashion to malignancy and this complicates the clinical management of these patients. Inappropriate management of benign conditions can lead to serious consequences - as with, for example, malignant recurrence after biopsy of a benign pleomorphic adenoma. Dacryocoele is a retention cyst of a gland ductule and often presents in young adults, with a variable swelling in the...

Direct brow lift Figure

Deep Sutures

The principle is to raise the brow by the excision of an ellipse of skin and frontalis plate and orbicularis muscle, (b) orbicularis muscle plate and orbicularis muscle, (b) orbicularis muscle Figure 7.7 Deep sutures inserted in direct brow lift. Figure 7.7 Deep sutures inserted in direct brow lift. muscle, fixing it to the periosium of the forehead. Mark the ellipse of tissue to be excised mark first the superior border of the brow across its full width. Now manually lift the brow to the...

Benign cystic anomalies of the orbit

Interhemispheric Dermoid Imaging

Orbital cysts generally arise from epithelium sequestered within the orbit during embryological development, by implantation after trauma or due to expansion of epithelial-lined sinus lesions into the orbit. These lesions arise from surface epithelium implanted at sites of embryological folding and, if situated anteriorly within the orbit, are commonly noted soon after birth. Due to the accumulation of epithelial debris and sebaceous oil in the lumen of the cyst, the cysts slowly enlarge and...