Orbital Cavity Research Articles

Combined Upper Fornix Transconjunctival and Endoscopic Transnasal Approach for Frontoethmoidal Osteoma with Orbital Extension - A Case Report

Abstract Rationale: Intraorbital osteomas are incidentally found and occasionally require surgical treatment. Depending on their localisation, a single technique may not provide a sufficient surgical field. Patient Concerns: We report a 16-year-old male with a left upper medial palpable mass. Diagnosis: Computed tomography revealed a dense bony mass extending from the ethmoid sinus to the superior wall of the frontal sinus, with protrusion into the orbital cavity. Treatment: The combination of upper fornix transconjunctival and endoscopic transnasal approaches was chosen for the surgical removal procedure. Outcomes: The two-pathway approaches resulted in the clear removal of the mass. Post-operative recovery was rapid, although a slight restriction of the inferomedial duction remained at three months. Take-away Lessons: This combination of techniques can provide a wide surgical field for the resection of frontoethmoidal osteomas with orbital extension.

Quantifying gender differences in orbital morphology with large MRI datasets

PurposeTo investigate gender differences in orbital morphology using large MRI datasets. MethodsUsing a deep learning-based approach, the orbit and eyeball were automatically segmented from high resolution 3D MRI images of the IXI and OASIS3 datasets. Orbital and eyeball morphological parameters, including orbital volume, eyeball volume, effective orbital volume (EOV, defined as the orbital cavity volume excluding the eyeball), and coronal orbital dimensions and shape, were quantitatively assessed. The volume index was defined as the ratio of orbital volume to eyeball volume. ResultsThis study included 1926 subjects with a mean age of 63.9 ​± ​15.3 years. The mean volumes of the eyeball and orbit were 7.1 ​± ​1.0 ​ml and 25.9 ​± ​3.5 ​ml, respectively. Significant gender differences (all P ​< ​0.001) were observed in the following parameters (males versus females): orbital volume (28.3 ​± ​3.0 ​ml versus 24.0 ​± ​2.7 ​ml), EOV (25.1 ​± ​3.0 ​ml versus 21.1 ​± ​2.6 ​ml), eyeball volume (7.3 ​± ​1.0 ​ml versus 6.9 ​± ​1.0 ​ml), volume index (3.9 ​± ​0.6 versus 3.5 ​± ​0.5), orbital depth (40.0 ​± ​3.1 ​mm versus 37.4 ​± ​2.9 ​mm), coronal orbital height (40.8 ​± ​3.0 ​mm versus 38.4 ​± ​2.4 ​mm), coronal orbital width (38.0 ​± ​1.9 ​mm versus 36.6 ​± ​1.7 ​mm) and coronal orbital area (1292.5 ​± ​97.1 ​mm2 versus 1177.9 ​± ​89.7 ​mm2). ConclusionsThis study employed deep learning to analyze a large dataset of 3D head MRI scans, achieving accurate and objective measurements of orbital morphology. We identified significant gender differences in orbital parameters, with males generally having larger structures. Additionally, we established a normative database for orbital dimensions, providing a valuable resource for future research on orbital disorders and potentially improving clinical diagnosis and treatment.

Concurrent delayed recurrence of peripheral primitive neuroectodermal tumors in orbital and sellar/suprasellar regions in an older adult.

Peripheral primitive neuroectodermal tumors (pPNETs) are rare and aggressive small round cell tumors, tending to occur in the thoracic and paravertebral soft tissues in children and young adults. This report describes an exceptionally rare case of concurrent delayed recurrence of pPNET in the orbital and sellar/suprasellar regions in an older adult, with a discussion supported by a literature review. We report an 82-year-old woman with a history of orbital pPNETs resection at age 62, followed by gamma knife radiosurgery for local recurrence at age 66. She presented left eye pain, left eye protrusion, decreased vision in the right eye, and right homonymous hemianopia. MRI revealed extensive lesions in the left orbital cavity and sellar/suprasellar region, contiguous through the optic canal. The recurrent tumor was treated through a two-stage resection via transcranial and transsphenoidal approaches, which resulted in symptom improvement and a pathologic diagnosis of pPNETs. This case highlights a highly rare instance of late-onset orbital pPNETs recurrence in an elderly patient, with evidence suggesting tumor progression into the sellar/suprasellar regions through the optic canal.

Ligation of anterior ethmoidal artery nasal branch: anatomical-based management of recalcitrant epistaxis.

Recurrent epistaxis, despite conservative therapies (i.e. nasal packing or direct vessel coagulation), is generally treated with ligation of the sphenopalatine artery (SPA). Indeed, the rationale behind SPA ligation lies in its ability to disrupt arterial blood supply to the nasal mucosa, thereby reducing the likelihood of recurrent bleeding episodes (1). Nevertheless, in some cases, nosebleeds persist despite appropriate SPA ligation, opening discussion of the anterior ethmoidal artery (AEA) contribution in recalcitrant epistaxis that, for some authors, is up to 28.8% (2). From an anatomical point of view, the AEA leaves the orbital cavity and passes the ethmoidal roof through the ethmoidal canal, before entering inside the anterior cranial fossa via the lateral lamella (3). Endocranially, the AEA gives posterior branches which vascularize the anterior cribriform plate, whereas its many trunk continues anteriorly and divides into two branches: the anterior meningeal branch, and a second vessel that enters inside the nasal fossa through the cribroethmoidal foramen located 2.86 ± 1.93 mm (range, 1-7 mm) (4) anteriorly to the first olfactory phylum, giving rise to the so-called nasal branch (NbAEA) (5).

Determining orbital volumes of sheep, goats and gazelles via computed tomography.

Orbital volume refers to the sum of bulbus oculi volume and orbital cavity volume. Scientists use orbital volume as a guide to diagnose, treat and prognose various eye diseases such as thyroid eye disease and enophthalmos. This study aims to examine the orbital volumes of sheep, goats and gazelles to demonstrate homotypic variations and interspecific differences between them. Crania of six male tuj sheep, five male hair goats and five male gazelle were used in this study. The crania were scanned using a 64-detector multi-detector computed tomography with a slice thickness of 0.625mm at 80kV, 200 MA and 639 mGy. The cross-sectional images were stored in DICOM format and then transferred to MIMICS 20.1 software. Afterwards, models were made by establishing the orbital borders on the cross-sections. Volume values were calculated based on the models. No homotypic variation was found between the right and left volumes within the species (p > 0.05). A statistically significant difference was observed in terms of interspecific right and left orbital volumes between sheep and gazelles (p < 0.05). It was concluded that the orbital parameters of the sheep, goats and gazelles in the same family help reveal their differences in the visual anatomy of these species and provide reference data for clinical diagnosis, treatment and the prognosis follow-up of ocular diseases in animals.

Myiasis in Patients after Surgery, Brachytherapy, and Exenteration of the Orbit Due to Basal Cell Carcinoma.

Massive infiltration of the orbital tissues by dipterous fly larvae (ophthalmomyiasis) occurs throughout the world but is very rare in middle Europe countries. We report a patient with periocular basal cell carcinoma treated by surgical excisions, due to relapses followed by a high dose rate of HDR Ir192 brachytherapy which led to the necessity of orbital exenteration. The patient after many surgical operations and radiotherapy for recurrent periocular basal cell carcinoma through the years. Since 2021 the patient has not attended doctors during the COVID pandemic period. Due to socioeconomic problems, the patient continued in 2023 with infiltration of the orbital cavity and paranasal sinuses with myiasis. Exenteration of the orbit can be necessary after a relapsed infiltrative type of basal cell carcinoma infiltrating also periorbital cavities. Fly maggots may have had beneficial but also destructive effects on the exenterated cavity healing process.

Head of Zebu cattle (Bos Taurus indicus): sectional anatomy and 3D computed tomography

The research was designed to use computed tomography (CT) with 3D-CT reconstruction imaging techniques and the various anatomical sections—plana transversalia, frontalis, and dorsalia—to describe the anatomical architecture of the Zebu cattle head. Our study used nine mature heads. The CT bone window created detailed images of cranial bones, mandibles, teeth, and hyoid bones. All of the head cavities were evaluated, including the cranial, orbital, oral, auricular, and nasal cavities with their paranasal and conchal sinuses. The septum nasi, attached to the vomer and maxillary bones, did not reach the nasal cavity floor caudally at the level of the second premolar teeth, resulting in a single median channel from the choanae to the nasopharynx. The positions, boundaries, and connections of the paranasal sinuses were clearly identified. There were four nasal conchal sinuses (that were named the dorsal, middle, ethmoidal, and ventral) and five paranasal sinuses that were described as the following: sinus frontalis, maxillaris, palatinorum, and lacrimalis, as defined in the different anatomical sections and computed tomographic images. The complicated sinus frontalis caused the pneumatization of all bones that surrounded the cranial cavity, with the exception of the ethmoidal and body of basisphenoid bones. The sinus maxillaris was connected to the sinus lacrimalis and palatinorum through the maxillolacrimal and palatomaxillary openings, and to the middle nasal meatus through the nasomaxillary opening. Our findings provide a detailed anatomical knowledge for disease diagnosis to internal medicine veterinarians and surgeons by offering a comprehensive atlas of the Zebu cattle anatomy.

DESCRIPTIVE OSTEOLOGY OF THE BOVINE SKULL

The bovine skull performs vital functions, protecting the brain and sensory organs, as well as providing structure and support for the head. Composed of various bones, such as the frontal, parietal, occipital, temporal, maxillary, and mandibular bones, each has a specific role. The frontal bone, for instance, forms the forehead and part of the orbital cavities, while the occipital bone protects the posterior part of the brain and articulates with the vertebral column. The mandible, essential for mastication, is one of the most robust bones, supporting the molar and premolar teeth, which are fundamental for grinding fibrous foods. The nasal and maxillary bones form the structure of the snout and house the incisor teeth, important for grasping food. Studying the osteology of the bovine skull is crucial for understanding the functional anatomy and health of the animals. Detailed knowledge of the bone structure aids veterinarians and animal scientists in identifying anomalies, fractures, and bone diseases, as well as being fundamental for surgical procedures and imaging diagnostics. These detailed anatomical informations are generally found in specialized books, not in scientific articles. Therefore, this article aims to describe the osteology of the bovine skull, providing an accessible and practical reference for students and professionals in the field. A deep understanding of bovine cranial anatomy is essential to ensure the well-being and productivity of the animals, directly reflecting the efficiency of agricultural practices.

A case of varicose necrotic phlegmon of the orbit in a child

AIM: This study aimed to analyze the peculiarities of a clinical case of orbital cellulitis in a child with varicella-zoster virus infection. MATERIAL AND METHODS: In this report of a rare case, necrotizing orbital cellulitis developed on day 6 from the onset of varicella-zoster disease in a 5-year-old child. The child was hospitalized in a serious condition at the intensive care unit of an infectious disease hospital and was subsequently transferred to an ophthalmology department of another hospital. The patient was subjected to comprehensive laboratory examinations and received conservative and surgical treatments. Computed tomography was performed to detect changes in the status of the orbits. RESULTS: The disease manifested with a pronounced pain syndrome in the right orbit, intoxication, and hyperthermia. Exophthalmos, purulent discharge, and necrosis of the conjunctiva of the affected eye were also observed. Computed tomography revealed infiltration of the right orbit without changes in the sinuses. The clinical blood analysis demonstrated leukocytosis, left shift in neutrophils, eosinophilia, and high levels of C-reactive protein and lactate dehydrogenase. The coagulogram demonstrated a proclivity toward hypercoagulation, as evidenced by diminished prothrombin activity according to Quick’s test, increased active partial thromboplastin time, and high D-dimer levels. Urinalysis revealed leukocyturia. Cultures from the conjunctival cavity yielded Streptococcus pyogenes, and a polymerase chain reaction tested positive for S. pyogenes. Antiviral, antibacterial, and symptomatic treatments were initiated. Necrotic masses were obtained during the drainage of the orbital cavity. The child was hospitalized for 21 days. The symptoms were controlled, and the patient’s condition was satisfactory at discharge. Visual functions remained fully preserved. At the examination 1.5 months later, a slight residual exophthalmos was detected. CONCLUSION: Employing a complex multidisciplinary approach, timely prescription of antibacterial and antiviral therapy, and surgical assistance (drainage of the orbit) ensures a successful disease outcome.

A retrospective analysis of the management and surgical treatment of orbital lesions: Outcomes and rationale

The orbital cavity is a subject of interest for various specialists, and achieving optimal outcomes requires comprehensive, multidisciplinary management. This study aims to report 10 years of experience in the preoperative, surgical, and postoperative care of patients with orbital lesions, examining their clinical, radiological, and anatomopathological features and outcomes.A retrospective review of 125 patients who underwent surgical treatment for intraorbital masses between January 2012 and December 2021 was performed. Outcome measures included postoperative diplopia, exophthalmos, decimal visual acuity, eyeball position, ocular motility, operative time, complications, and aesthetic results. A total of 107 patients were included. All cases were discussed with a neuroradiologist to determine the best therapeutic approach based on preoperative imaging.Preoperative diplopia was linked to extraconal (p = 0.03) and anterior (p = 0.001) lesions, and exophthalmos and visual acuity deterioration were associated with intraconal (p = 0.02; p = 0.03) and retrobulbar (p = 0.001; p = 0.02) lesions. Complications (11.2%) included diplopia, worsened visual acuity, postoperative blepharoptosis, and postoperative ectropion. Of the patients, 80.4% reported an "excellent" aesthetic outcome.This study underscores the importance of a multidisciplinary approach based on a thorough analysis of preoperative imaging. Periorbital approaches tailored to the lesion's three-dimensional location enables safe access to most intraorbital lesions, resulting in minimal complications and good aesthetic results.

Post Traumatic Intra Orbital Encephalocele, a Rare Cause of Pulsating Orbit: Case Report

Orbital trauma is a prevalent condition in clinical practice, particularly in situations of head trauma. Orbital roof fractures following a blunt trauma are an uncommon consequence of trauma. Traumatic encephaloceles in the orbital cavity are much more uncommon, with only a few examples reported to date. Early detection and therapy of raised intraorbital pressure can avoid irreparable optic nerve injury. In trauma patients with concomitant orbital injuries, orbital computed tomography (CT) with thin axial and coronal slices is beneficial. Decompression of the orbital roof is the most important stage in surgical therapy and should be done in all cases. We report the case of an adult with a post-traumatic orbital encephalocele. A few hours after a road traffic accident with head injury, the patient developed progressive pulsatile enophtalmosis. Computed tomography revealed multiple fractures of the orbital rim with herniation of the left frontal lobe into the orbit.

“Ice cream cone” design of forearm free flap for orbital exenteration reconstruction

BackgroundsReconstruction post-orbital exenteration serves the dual purpose of expediting healing, laying the groundwork for cosmetic restoration, and minimising complications such as orbitosinusal fistulae. The aim of this study was to introduce a modified "Ice cream cone" (ICC) design of the Radial Forearm Free Flap (RFFF) technique used for reconstruction of orbital exenteration cavity, along with the oncological, functional, and aesthetic outcomes. MethodsThe authors conducted a retrospective study between January 2005 and December 2020. Inclusion criteria encompassed patients treated for orbitosinusal malignancies undergoing exenteration with subsequent ICC design of RFFF reconstruction. ResultsTwenty-two patients underwent exenteration with the ICC design of RFFF. At the follow-up conclusion, 65% of patients regularly used orbital prosthesis. The average waiting time until the prosthesis was 10 months. Quality of life questionnaires yielded average RFFF POSAS scores of 23.5 (SD 13,6), cervical POSAS scores of 8 (SD 13,2), and orbital cavity rehabilitation scores of 5.9 (SD: 3,32). ConclusionsICC design of RFFF is a reliable technique. It can be proposed in cases of extended exenteration with a high risk of cerebrospinal fluid (CSF) but more generally in cases of total exenteration. This technique facilitates optimal postoperative wound healing and accommodates early radiotherapy. Importantly, the bowl-shaped aspect of the orbital socket supports effective prosthetic rehabilitation for patients opting for orbital prosthesis post-surgery.

PEDIATRIC OCULAR TRAUMA MANAGEMENT: A CASE STUDY OF EFFECTIVE INTRA-ORBITAL FOREIGN BODY IOFB EXTRACTION

Highlights: The rare nature of Orbitocranial Injury with Intraorbital Foreign Body (IOFB). Utilizing a 3D Head CT Scan to ascertain the precise location of the IOFB and its impact on anatomical structures is pivotal in shaping immediate treatment strategies, thereby reducing the potential for complications. Abstract: Introduction: Penetrating intraorbital foreign body (IOFB) injuries are a rare form of traumatic injury. Recognized as a surgical emergency, meticulous history-taking and a thorough examination are essential for determining the trauma's mechanism and cause, facilitating accurate diagnosis and effective disease management. Case Illustration: In the emergency room, a 5-year-old female patient was presented with a craniofacial injury resulting from an IOFB. An evacuation procedure, conducted through a subsidiary incision, was performed to extract the foreign body. Interestingly, the object removed from the orbital cavity was a plastic foreign body, initially suspected to be a fractured orbital bone. Discussion: The clinical presentation, management, and outcomes of orbital foreign body injuries can differ based on the material composition of the foreign body. In cases of intraorbital foreign body trauma, the primary treatment goal is foreign body removal. Conclusion: Precise and accurate initial management in the emergency department is crucial. Early diagnosis, aided by a 3D head CT scan, is instrumental in locating the IOFB and identifying the involved anatomical structures. This, in turn, enables timely treatment decisions to minimize the risk of complications.

Acute megakaryoblastic leukemia (AML7) about a case

Acute myeloid megakaryoblastic leukemia (AML7) is a rare and severe form of acute myeloid leukemia. Its diagnosis is based essentially on cytometric and cytogenetic data, given the complexity of morphological diagnosis. Myelofibrosis and osteolytic lesions may be a particular feature of AML7. Treatment with chemotherapy is considered, but the outcome is often unfavorable. The gold standard of treatment is bone marrow transplantation. Our article reports the case of an infant diagnosed with acute megakaryoblastic leukemia initially revealed by a bone marrow failure syndrome and aggravated by a cerebro-orbital extension with osteolytic lesions of the orbital cavity, treated with chemotherapy with a good clinical-biological evolution.

A New Approach in Management of Orbital Adherence Syndrome.

Orbital walls are one of the most common sites of midface fractures and account for ~40% of traumatic injuries in this region. These fractures are often associated with changes in the anatomy of the orbital cavity and frequently affect the orbital inferior wall, infraorbital groove and canal, and medial orbital wall, which leads to changes in its pattern and volume as well. Generally, the forces required for brake superior and lateral walls are greater than those required for thin medial and inferior walls. Disruption of any of these structures leads to the expansion of orbital volume that brings to the appearance of enophthalmos, diplopia, and impaired ocular mobility. The gold standard in the treatment of orbital wall fractures is surgical reconstruction, that includes fracture site exposure, freeing tissue prolapsed into the fracture site, and re-approximating the orbital wall support, usually with an orbital implant. It usually could be achieved by the usage of such as transconjunctival, subciliary, and coronal approaches and implementation of graft and reconstructive materials, including bones, cartilage, titanium, and resorbable mesh. Today, the gold standard in orbital floor reconstruction is the application of titanium mesh orbital plates. However, their implementation could be associated with a number of postoperative complications, such as mispositioning and orbital adherence syndrome. Orbital adherence syndrome is a poorly described and understood phenomenon and appears to occur after the use of large-pored titanium mesh for orbital reconstruction. It usually appears as limited eye movement that appears 1 to 2 weeks after reconstructive procedure. Prevention is possible through careful patient selection and the placement of a smooth interface medium in the initial surgery. The aim of the current study is to present the outcomes of orbital reconstruction done by both orbital mesh and customized ​​smooth-surfaced titanium orbital implants.

Biomechanical analysis using finite element analysis of orbital floor fractures reproduced in a realistic experimental environment with an anatomical model.

Introduction: In this study, we attempted to demonstrate the actual process of orbital floor fracture visually and computationally in anatomically reconstructed structures and to investigate them using finite element analysis. Methods: A finite element model of the skull and cervical vertebrae was reconstructed from computed tomography data, and an eyeball surrounded by extraocular adipose was modeled in the orbital cavity. Three-dimensional volume mesh was generated using 173,894 of the 4-node hexahedral solid elements. Results: For the cases where the impactor hit the infraorbital foramen, buckling occurred at the orbital bone as a result of the compressive force, and the von Mises stress exceeded 150MPa. The range of stress components included inferior orbital rim and orbital floor. For the cases where the impactor hit the eyeball first, the orbital bone experienced less stress and the range of stress components limited in orbital floor. The critical speeds for blowout fracture were 4m/s and 6m/s for buckling and hydraulic mechanism. Conclusion: Each mechanism has its own fracture inducing energy and its transmission process, type of force causing the fracture, and fracture pattern. It is possible to determine the mechanism of the fracture based on whether an orbital rim fracture is present.

Transpalpebral transorbital endoscopic lateral approach to the middle cranial fossa: anatomical study in cadaver

Transorbital expanded endoscopic approaches allow different areas of the skull base to be approached. The aim of our study is to analyse the main anatomical bone and neurovascular structures of the middle cranial fossa by means of a transpalpebral transorbital lateral endoscopic approach (TTLEA). An anatomical study was performed on 12 orbital cavities corresponding to 6 cadaver heads. All specimens were previously injected with colored latex through both carotid systems. The mean distance from the orbital rim to the zygomatic-facial foramen and to the zygomatic-temporal foramen was 11 mm and 16 mm respectively. In all cases the meningo-orbital foramen was found at a mean distance from the orbital rim of 34 mm. The superior orbital fissure (SOF) was located posterior to the meningo-orbital foramen at 39 mm. The foramen rotundum and foramen ovale were located separated from each other by 10 mm on average. Anterior to the foramen ovale a bony prominence was observed in all cases. In 11 cases (92%) the entrance of the accessory meningeal artery into the foramen ovale was evident and in one case an accessory foramen was observed. The middle meningeal artery was located in all dissections within the foramen spinosum. The TTLEA offers a wide and direct exposure of the middle cranial fossa. It should be considered as an alternative to transcranial approaches in certain lesions invading the lateral region of the middle cranial fossa, the lateral wall of the cavernous sinus or the infratemporal fossa.

The Profile of Sinonasal Tumors with Orbital Involvement in Dr. M. Djamil General Hospital, Padang, Indonesia: A 10-Year Overview

Background: Sinonasal tumors are rare tumors, either malignant or benign, that vary greatly based on the origin and primary tumor location in the sinonasal tract. The close anatomical relationship between the sinonasal tract and the orbital cavity makes orbital involvement very common (50%-80%) in sinonasal tumors, and this indicates a negative prognostic factor in sinonasal malignancy. The purpose of this study is to demonstrate the profile of sinonasal tumors with orbital involvement in our center.&#x0D; Methods: Retrospective study from oncology subdivision files and medical records from January 2011 – December 2020. Collected data including age, gender, the clinical manifestations of orbital involvement, primary location, histopathology, and management of sinonasal tumors.&#x0D; Results: There were 35 patients examined by the oncology subdivision either directly came or consulted from the ENT department, consisting of 18 (51.4%) males and 17 (48.6%) females. The age of patients ranged from 11 to 83 years old. with the most common age groups being 41-50 and 51-60 (25.7% in each age group). The majority of the patients (77.1%) had presented with proptosis. Maxillary sinus was the most common (45.7%) primary site of tumors, and squamous cell carcinoma was the most common (51.4%) histopathology found. Most of the patients (37.1%) were treated with a combination of chemotherapy and radiotherapy.&#x0D; Conclusion: Orbital involvement commonly occurs in malignant sinonasal tumors with proptosis as a major clinical presentation. A combination of chemotherapy and radiotherapy was the most common practice management because the tumors were unresectable at the time of presentation.

Semiautomated MRI-Based Method for Orbital Volume and Contour Analysis.

The architecture of the orbital cavity is intricate, and precise measurement of its growth is essential for managing ocular and orbital pathologies. Most methods for those measurements are by CT imaging, although MRI for soft tissue assessment is indicated in many cases, specifically pediatric patients. This study introduces a novel semiautomated MRI-based approach for depicting orbital shape and dimensions. A retrospective cohort study. Patients with at least 1 normal orbit who underwent both CT and MRI imaging at a single center from 2015 to 2023. Orbital dimensions included volume, horizontal and vertical lengths, and depth. These were determined by manual segmentation followed by 3-dimensional image processing software. Differences in orbital measurements between MRI and CT scans. Thirty-one patients (mean age 47.7 ± 23.8 years, 21 [67.7%]) females, were included. The mean differences in delta values between orbital measurements on CT versus MRI were: volume 0.03 ± 2.01 ml, horizontal length 0.53 ± 2.12 mm, vertical length, 0.36 ± 2.53 mm, and depth 0.97 ± 3.90 mm. The CT and. MRI orbital measurements were strongly correlated: volume (r = 0.92, p < 0.001), horizontal length (r = 0.65, p < 0.001), vertical length (r = 0.57, p = 0.001), and depth (r = 0.46, p = 0.009). The mean values of all measurements were similar on the paired-samples t test: p = 0.9 for volume (30.86 ± 5.04 ml on CT and 30.88 ± 4.92 ml on MRI), p = 0.2 for horizontal length, p = 0.4 for vertical length, and p = 0.2 for depth. We present an innovative semiautomated method capable of calculating orbital volume and demonstrating orbital contour by MRI validated against the gold standard CT-based measurements. This method can serve as a valuable tool for evaluating diverse orbital processes.

The Preternatural First Premolar: A Ground Section Tooth Case Report

Ectopic eruption is a developmental disturbance in eruption pattern of permanent dentition most often associated with maxillary first permanent molar (2-6%of general population), mandibular lateral incisors (&lt;1%), maxillary permanent canines (1.5-2%). Ectopic eruption of teeth is a rare phenomenon although cases have been reported in nasal cavity, maxillary sinus, mandible, palate, orbital cavity. Ectopic eruption of mandibular first premolar is a rare condition and there were no discussions in the literature about its eruption in coronoid process. Premature loss of primary second molar and second permanent premolar can lead to disturbed eruption of first premolar. In this case report, we present an ectopic mandibular first premolar at the level of sigmoid notch below the right coronoid process.