Adnexal Conditions Research Articles

Clinician's approach for spectrum of orbital diseases: An overview.

To study the varied clinical presentation and outcome of management of orbital diseases and to ascertain the concordance of FNAC with histopathology. This is a prospective interventional study wherein each patient's clinical presentation was noted. Outcome of management was evaluated based on symptomatic relief, regression of signs, noting any intraoperative or postsurgical complication, recurrence, and cosmetic result in terms of surgical scar. Neoplasia was commonest 33/76; (43.42%), followed by infective and inflammatory conditions 21/76; (27.63% cases), thyroid-associated orbitopathy accounting for 12/76 cases (15.78%), whereas cystic lesions and vascular malformations were 4/76 (5.26%) each. Other disorders constituted a mere 2.65%. Proptosis was the commonest mode of presentation. It was seen in seventy out of seventy-six patients (92.1%). In 86.3% of the cases, there was successful surgical outcome. Of 22 surgically managed cases, recurrence was noted in three cases (13.6%). 90% concordance was seen with histopathology in cases where FNAC was done prior to surgery for diagnosing nature of disease. Majority of orbital and adnexal conditions can be provisionally diagnosed based on imaging; however, an adjunct invasive investigation such as FNAC or biopsy may be required. In the present study, in seven cases (9.2%) FNAC was needed, whereas in two cases (2.63%) biopsy was needed. A definitive diagnosis was confirmed by histopathology in 22 surgically managed cases and by excision biopsy in two. 22/76 (28.94%) of the cases needed surgical treatment, and other cases required conservative or palliative approach.

Artificial intelligence and machine learning a new frontier in the diagnosis of ocular adnexal tumors: A review.

In our article, we explore the transformative potential of Artificial Intelligence and Machine Learning in oculo-oncology, focusing on the diagnosis and management of ocular adnexal tumors. Delving into the intricacies of adnexal conditions such as conjunctival melanoma and squamous conjunctival carcinoma, the study emphasizes recent breakthroughs, such as Artificial Intelligence-driven early detection methods. While acknowledging challenges like the scarcity of specialized datasets and issues in standardizing image capture, the research underscores encouraging patient acceptance, as demonstrated in melanoma diagnosis studies. The abstract calls for overcoming obstacles, conducting clinical trials, establishing global regulatory norms and fostering collaboration between ophthalmologists and Artificial Intelligence experts. Overall, the article envisions Artificial Intelligence's imminent transformative impact on ocular and periocular cancer diagnosis.

Implikacije pandemije Kovida 19 na laparoskopsku i abdominalnu hirurgiju benignih adneksalnih stanja - iskustvo jednog centra

Introduction/Aim: COVID-19 pandemic posed a challenge in patient treatment and caused problems in the organization of health systems in many countries. The study aimed to analyze and quantify the influence of COVID-19 pandemic on performing surgeries for benign adnexal conditions with classic (open abdominal) and minimally invasive (laparoscopic) approach at the Clinic for Gynecology and Obstetrics University Clinical Center of Serbia. Material and Methods: The study retrospectively analyzed all patients who were operated due to benign adnexal masses at our Clinic during the past five years. We compared numbers and types of operations before and during the pandemic. Results: The study included 2166 patients who significantly more often had laparoscopic (61.9%) than open surgeries (38.1%). Surgeries of benign adnexal masses were elective in 53.2% cases, whereas in 46.8% cases those were emergency surgeries. Before the pandemic laparoscopic surgeries (mostly cystectomies) were on the rise. A reduction in laparoscopic and open surgeries was seen in the year 2020 (p=0.001). Moreover, the majority of surgeries were emergency surgeries (76.2%; p=0.001). Nevertheless, this decrease was significant only for laparoscopic cystectomies (p=0.001), but not for adnexectomies (p=0.224) and salpingectomies (p=0.762). Likewise, the 2020 reduction in open cystectomies (p=0.073), adnexectomies (p=0.836) and salpingectomies (p=0.241) was not significant either. During 2021, the number of surgical procedures for benign adnexal masses started to rise again (p=0.023). No intra-hospital COVID-19 infections were registered. Conclusion: The total number of operations of benign adnexal masses in our Clinic decreased and was limited to emergencies, which was mostly reflected in minimally invasive surgery.

Role of teleophthalmology to manage anterior segment conditions in vision centres of south India: EyeSmart study-I.

Purpose:To study the role of teleophthalmology (TO) in the diagnosis and treatment of anterior segment conditions (including adnexal conditions) in rural areas.Methods:This is a pilot study of 5,604 patients, who visited primary vision centres (VCs) for 1 week from 1-7 September 2018. The patients were examined by a vision technician (VT) to identify those who may need teleconsultation. The centres were located in 16 districts of four Indian states of Andhra Pradesh, Telangana, Odisha, and Karnataka. The demographic profile, along with the role of teleconsultation was reviewed.Results:Teleconsultation was advised in 6.9% of the patients, out of which 59.6% were referred to a higher level of care, and 40.4% were treated directly at the VC. Teleconsultations were higher among males (7.0% as compared to 6.6% in females), though not statistically significant (P = 0.55). Teleconsultation was higher in the older population, that is, 60 years and above (14.5%); those with severe visual impairment (VI) (21%) and blindness (31.1%); and in the states of Telangana (11%) and Andhra Pradesh (6.3%). It was noted that 45% of the patients who underwent teleconsultation had pathologies related to ocular surface, cornea and lid, and adnexa-related conditions.Conclusion:Teleconsultation has a significant role in the management of anterior segment conditions in bridging the gap between the patients and ophthalmologists in rural India. TO can also play an important role in the diagnosis and management of anterior segment, lid, and adnexa-related pathologies.

Current Uses of Robotic Surgery for the Treatment of Benign Adnexal Conditions

Current Uses of Robotic Surgery for the Treatment of Benign Adnexal Conditions

Adnexal masses associated with peritoneal involvement: diagnosis with CT and MRI.

Given the unique intra-peritoneal anatomic location of the adnexa, tubo-ovarian diseases can commonly spread into the peritoneal cavity. Peritoneal seeding may occur in a spectrum of adnexal conditions including infectious diseases, endometriosis, and benign or malignant primary or secondary ovarian tumors. CT is usually the imaging modality on which the concomitant involvement of the peritoneum and the ovary is depicted. The first diagnosis to be considered by the radiologist is generally peritoneal carcinomatosis from ovarian cancer but other conditions cited above have also to be borne in mind and may be suggested on the basis of careful assessment of CT findings or on further MR findings. MRI may indeed help characterize the lesions in some cases. The purpose of this review is to describe the clinical and imaging patterns of peritoneal involvement that may be found in association with different ovarian lesions. Familiarity with these patterns and diagnoses will help the radiologist narrow the differential diagnosis and make an accurate diagnosis, thus facilitating patient management and avoiding unnecessary invasive treatment.

Primary eye care for the general practitioner

AbstractThis article outlines the clinical features and management of the basic eye conditions that every general practitioner should be able to diagnose and treat. These include ocular and adnexal conditions such as stye, conjunctivitis, blepharitis and preseptal cellulitis. The more severe conditions, such as dacryocystitis, corneal ulcer and orbital cellulites, also are presented, along with the criteria for specialist referral.

Efficacy of 123N-isopropyl-p-[ 123I]-iodoamphetamine single photon emission computed tomography for the diagnosis of uveal malignant melanoma

PURPOSE: To evaluate the efficacy of single photon emission computed tomography (SPECT) images with N-isopropyl-p-[ 123I]-iodoamphetamine ( 123I-IMP) as a radiopharmaceutical for the diagnosis of uveal melanoma. METHODS: Consecutive interventional case series. Single photon emission computed tomography images were obtained after intravenous injection of 123I-IMP in 20 patients with clinically suspected uveal melanoma (16 eyes of 16 patients) or ocular adnexal melanoma (four adnexal tumors of four patients). Histologic findings in seven eyes enucleated for uveal melanoma were analyzed with the SPECT images semiquantitavely evaluated. RESULTS: Eight of 20 eyes with suspected uveal melanoma showed high accumulation of 123I-IMP in the late phase in the area corresponding to the uveal tumor, and the diagnosis of uveal melanoma was confirmed histologically in seven enucleated eyes. Tumor size and histologic features did not reflect the intensity of scintillation counts of 123I-IMP. Twelve patients with no accumulation on the SPECT images were found to have clinically or histologically iris nevus, choroidal nevus, and other intraocular and adnexal conditions. CONCLUSION: N-isopropyl p-[ 123I]-iodoamphetamone SPECT may serve as a sensitive and specific examination for the diagnosis of uveal melanoma.

Chronic gynecological conditions reported by US women: findings from the National Health Interview Survey, 1984 to 1992.

This study sought to describe prevalence rates of chronic gynecological conditions and correlates of these conditions in a representative sample of US women. National Health Interview Survey data from 1984 through 1992 for women aged 18 to 50 were used. The estimated annual prevalence rate for the reported presence of one or more gynecological conditions was 97.1 per 1,000 women. Menstrual disorders were most common, with an annual prevalence rate of 53.0 per 1,000 women. Adnexal conditions and fibroids were the next most common conditions, with rates per 1,000 women of 16.6 and 9.2, respectively. Prolapse, endometriosis, and fibroids were the conditions most likely to lead to hysterectomy within the year prior to the interview. More than three quarters (77.1%) of women with gynecological conditions had talked with a doctor in the previous year concerning their condition, and 28.8% reported spending 1 or more days in bed in the previous year because of their condition. Nearly a tenth of American women aged 18 to 50 report having one or more chronic gynecological conditions annually, the most common being disorders of menstruation.

Laparoscopic Conservative cystectomy of ovarian benign cystic teratoma

Laparoscopic surgery has almost totally replaced laparotomy in the management of benign adnexal conditions. Benign cystic teratoma (dermoid cyst) is one of the most common ovarian neoplasms in young women. A prospective non-randomized clinical trial was conducted. To compare the efficacy of two different methods of removal of benign cystic teratoma enucleated laparoscopically. Between January 1991 and June 1993, 37 women, all reproductive-age and desiring future fertility, underwent resection of dermoid cysts between 4 and 8 cm in diameter via laparoscopy using the three-puncture-technique. The removal of the cysts from the abdominal cavity was carried out by traction through an extended incision of one of the puncture sites in the first 17 cases (group A), and the other 20 cases (group B) were managed by embedding the cyst in a plastic bag inserted through one of the trocars, aspirating its contents, and subsequent extraction of the bag without extension of abdominal wall stab wounds. The operating time in both groups was comparable (from 35-130 minutes in group A, and 45-120 minutes in group B. However, the time required for removal of the cyst from the abdominal cavity was significantly shorter in group B (10-15 minutes) compared with group A (20-35 minutes). Spillage of cyst contents occurred in six cases in group A, and in two cases in group B. The average hospital stay in both groups was similar (22.8 hours in group A and 23.4 hours in group B). Postoperative complications in group A included one case of excessive bleeding from the extended incision, and three cases of wound infection. None of the patients in group B had short- or long-term postoperative complications. Operative laparoscopy is a safe and effective method in the management of benign cystic teratoma. We found that removal of the enucleated cyst from the abdominal cavity using a plastic bag is advantageous in terms of operating time and postoperative complication as well as in the cosmetic results compared to extraction of the cyst through an extended abdominal incision.

The Ophthalmic Plastic Surgery Library

For the best patient care, every practicing ophthalmologist should know the fundamentals of ophthalmic plastic surgery whether or not he/she performs such surgery. Those of us who are . sub-specialists in this field occasionally see patients who have endured trichiasis, senescent entropion or other painful adnexal conditions for years because their ophthalmologist (or former ophthalmologist) was unaware that such conditions could be corrected. During their residency, most ophthalmologists acquired Beard and Quickert's Anatomy of the Orbit, Aesculapius, second edition, 1977. This, or some other anatomy book is essential. For a general knowledge of this field so that patients will be properly served, the American Academy's manual of Ophthalmic Plastic Surgery, 1977 edited by Bernd Silver is one of the first books to get. Several excellent chapters on these subjects are in Volume 5 of Duane and Jaeger's Clinical Ophthalmology, Harper & Row, revised edition, 1983. The Symposium on DiseaSes of the Lids, Lacrimal Apparatus and Orbit, published by the New Orleans Academy of Ophthalmology (C. V. Mosby, 1981) goes into further detail. Clinton McCord's Oculoplastic Surgery, Raven Press, 1981, is well done. The standard work on ptosis surgery is Crowell Beard's Ptosis of the Eyelids, third edition, C. V. Mosby, 1982. His lucid text and excellent drawings make ptosis surgery look much easier than it is. A word of caution: those of us who do perform ophthalmic plastic surgery find more complications after ptosis surgery than any other type of ophthalmic plastic surgery. The eyelid blinks hundreds of times each day, looks up and looks down frequently and is more complex than the surgical drawings may convey. For those especially interested in traumatic ophthalmic surgery, Pierre Guibor's Oculoplastic Surgery and Trauma, Symposia Specialists, 1976 is helpful. Charles