Orbital Region Research Articles

Penetrating Orbitocranial Injuries in the Republic of Korea.

Penetrating brain injury occurs when an object enters the skull and pierces the brain. These injuries can damage small or large parts of the brain, are life-threatening, and require emergency care. This study is a summary of penetrating head injuries at our hospital and an analysis of their treatments and prognoses. Patients with penetrating brain involving the orbit and/or cranial region were recruited among patients with trauma who visited our regional trauma center between 2019 and 2022. Eight patients with penetrating brain injuries were enrolled. One patient was female; the median age was 53 years (range, 24-72 years). Five patients with Glasgow Coma Scale (GCS) scores of 14 or 15 showed no major vessel injury or midline intracranial involvement on imaging and were discharged safely. The other three patients with suspected major vessel injuries and midline involvement did not survive. The greatest influences on patient prognosis were the area of damage and level of consciousness, along with the GCS score at the time of the visit. The probability of survival is extremely low if the midline structure is damaged.

Electromagnetic pinned solitons for space debris detection

Electromagnetic “pinned” solitons in the form of stationary nonlinear waves are studied within the framework of an inertial magneto-hydrodynamic model. These structures, that can arise when a charged source moves in a magnetized plasma, have a velocity that is equal to the source velocity and, hence, appear as “pinned” structures that envelope the source. We investigate the excitation of such solitons in the Low Earth Orbit region due to the passage of charged orbital debris objects. The spatial size of these electromagnetic solitons, typically of the order of a few ion skin depths, can be very large in this region. Such solitons can be detected using a variety of ground- or orbit-based radio sounding techniques and may provide a convenient additional means of tracking small sized orbital debris objects that are difficult to spot optically.

ORBIAL DERMOID CYST: CLINICAL SCENARIO

In this case report, we describe a case of superotemporal orbital dermoid that came to our tertiary care center. An 8-year-old female presented with swelling of the left superolateral orbital region, which gradually increased over the past 3 years. A CT scan was performed, which showed a welldened non-enhancing cystic lesion with thin internal septa in the extraconal space of the left orbit, in the superolateral compartment. Although the denitive diagnosis was not clear, it appeared to be a dermoid cyst on CT ndings. Surgical excision of the mass was performed by the sub-brow approach and histopathological examination of the specimen was performed, which conrmed that it was a dermoid cyst. After the surgery, the swelling subsided

Parasitismo em local incomum de Dermacentor nitens (Acari: Ixodidae) em um cavalo

ABSTRACT: Dermacentor nitens Neumann is the most common tick species infesting horses in the main Brazilian biomes. It has a predilection to attach to horse the ears, the nasal diverticulum, perineal and perianal regions. The infestations can generate severe damage in the ears, anemia, and the tick also acts as vector of Babesia caballi (Nuttall and Strickland), the causative agent of equine babesiosis. Our study describes unusual parasitism site of D. nitens on a female cross breed horse, approximately ten years old that presented high parasitism by ticks on the perineal and perianal region, ears, and the left eye orbit region, where an enucleation process had been performed a few years earlier. To our knowledge this is the first report of D. nitens parasitism on a formerly enucleated eye orbit.

Atypical metastasis localization, buccal mucosa, in a patient with invasive lobular breast cancer: a case report

Background: Buccal mucosa metastasis is rare in breast cancer patients. Case Presentation: A 50-year-old female breast cancer patient with invasive lobular carcinoma (ILC) in his eight years follow-up period presented with a swelling in the right eye. Head and neck MRI was showed soft tissue formation with dimensions of 59x31 mm was detected in the axial plane, extending from the level of the right infratemporal fossa to the right buccinator muscle and right maxillary sinus in front of the alveolar process. In the right periorbital region, there was a thickness increase of up to 1 cm in the thickest part of the globe, which was evident in the anterolateral. In addition, there was no bone destruction in the right infratemporal region in maxillofacial CT, and no additional organ metastasis was detected in PET-CT performed for systemic scanning. In the histopathological examination of the tissue, carcinoma infiltration was detected. Radiotherapy was applied to the right buccal and orbital region of the patient as 30 Gy in 12 fractions (2.5 Gy per fraction) with volumetric modulated arc therapy technique and then 15 Gy in 6 fractions (2.5 Gy per fraction) boost radiotherapy with the adaptive technique were applied. At the follow-up 2 months later, clinical response was observed in the patient, and significant regression of the lesion was observed in facial and orbital MRI. At the 15th month follow-up of the patient, clinical and radiological remission continues. All clinical complaints regressed. Conclusion: ILC is a subtype of breast cancer that is characterized by unusual metastasis. Therefore, during the follow-up of these patients, it is necessary to monitor both laboratory values and clinical complaints very carefully.

The use of width measurements taken from the upper face and orbital regions in sex determination

Amaç: Cinsiyet ayrımı açısından öne çıkan anatomik bölgelerden birisi yüz bölgesi ve bu bölgeyi oluşturan kemik yapılardır. Yapılan çalışmalar yüz bölgesindeki genişlik ölçülerinin, özellikle de bizigomatik genişliğin önemli bir cinsiyet ayırıcı değişken olduğunu ortaya koymakla birlikte üst yüz bölgesini oluşturan diğer elemanlar bu açıdan yeterince incelenmemiştir. Bu çalışmanın amacı, üst yüz bölgesini mercek altına alarak, görece az incelenmiş genişlik ölçülerinin cinsiyet ayrımında kullanılıp kullanılamayacağı sorusuna cevap aramaktır. 
 
 Yöntem: Bu çerçevede, yaşları 18 ve 75 arasında değişen 200 yetişkin bireyin (100 kadın, 100 erkek) BT (bilgisayarlı tomografi) görüntüsü üzerinden 5 genişlik ölçüsü alınmıştır. Bu ölçüler şunlardır: (1) bimalar (interzigomatik) genişlik, (2) bizigomaksiller genişlik, (3) orbital genişlik, (4) biorbital genişlik ve (5) interorbital genişlik. Ölçülerin seksüel dimorfizm dereceleri, tek değişkenli ve çok değişkenli diskriminant fonksiyonları oluşturularak analiz edilmiştir. 
 
 Bulgular: Analiz sonuçları, tek değişkenli fonksiyonların cinsiyeti doğru belirleme oranının %63.5 ila %76.5 arasında değiştiğini ortaya koymuştur. Cinsiyeti en iyi ayıran değişkenler sırasıyla bimalar (interzigomatik) genişlik (%76.5) ve biorbital genişliktir (%73). Cinsiyetleri doğru olarak ayıran en başarılı çok değişkenli fonksiyonda bimalar genişlik ve orbital genişlik olup, bu eşitliğin cinsiyeti doğru belirleme oranı %77 olarak tespit edilmiştir. 
 
 Sonuç: Bulgular, üst yüz ve orbita bölgesindeki genişlik ölçülerinin cinsiyet belirlemedeki başarısının orta seviyede olduğunu, dolayısıyla pelvisi oluşturan kemik elemanların ele geçmediği durumlarda üst yüz bölgesindeki genişlik ölçülerine başvurulabileceğini ortaya koymaktadır.

PHYSICAL PROPERTIES OF “HOT POPULATION” OBJECTS IN THE KUIPER BELT

Most planetesimals formed at distances of 15 - 30 a.u. were gravitationally ejected from the Solar system as a result of the migration of the giant planets, but a small part remained, captured by Jupiter and the Kuiper belt. As a result, we can now observe such a variety, in terms of physical and dynamic characteristics, in the Trojan asteroids of Jupiter and in the Kuiper belt. Planetesimals captured by the Kuiper Belt are a "hot population" now. The term "hot" does not refer to the temperature of bodies, but characterizes the orbit of objects. ~120,000 objects larger than 100 km. in diameter are known in the "hot population". This population is characterized by an orbital inclina- tion greater than 5 degrees and a large eccentricity. The main task of the work, based on physical and dynamic characteristics, is to search for the same properties Trojan asteroids of Jupiter and objects from the "hot population" of the Kuiper belt, which supposedly migrated earlier from the region of the original orbit of Neptune. The data from ground-based observations and space missions is used in the work.

Clinical characteristics, pathology features and outcomes of pediatric myeloid sarcoma: A retrospective case series.

Myeloid sarcoma (MS) is a rare extramedullary mass with myeloid expression, which is easy to be missed and misdiagnosed, especially in the pediatric population. We analyze the clinicopathological characteristics, immunophenotypic, cytogenetic, and molecular studies, therapeutic approaches, and outcomes, to optimize the management of such patients. A retrospective, single-center, case series study of eleven children diagnosed with MS by pathology was performed. The male-to-female ratio was 8:3, and the median age at diagnosis was 7 years. The most commonly involved sites were the skin and orbital region, followed by lymph nodes, central nervous system, and testis. Seven cases (64%) with Class I-MS and four cases (36%) presented as Class II-MS. Immunohistochemically, MPO and CD117 were the most commonly expressed markers, followed by CD33, CD43, CD34, CD68, and lysozyme. Chromosomal abnormalities were detected in 4 patients. Two patients had the presence of deleterious mutations (FLT3, ASXL, KIT, and DHX15) on molecular detection. Ten patients were treated with chemotherapy based on AML regimens. The median follow-up time was 33.5 months in eleven patients. Two patients relapsed, one died, and one lost to follow-up. The 2-year overall survival (OS) rate estimated by Kaplan-Meier curves was 90.9% ± 8.7%, and the event-free survival (EFS) rate was 64.9% ± 16.7%. MS diagnosis is usually challenging. Adequate tumor biopsy and expanded immunohistochemistry are necessary for the correct diagnosis of MS. Early and regular systemic chemotherapy promises long-term survival.

Periastron precession effect of f -mode dynamical tides on gravitational waves from eccentric double white dwarfs

The dynamical tide can play an important role in the orbital motion of close eccentric double white dwarf binaries. As the launching of the space-based gravitational-wave detector, the Laser Interferometer Space Antenna (LISA), is just around the corner, detection of gravitational wave signals from such systems is anticipated. In this paper, we discuss the influence of the dynamical tide on eccentric orbits, focusing on the effect on periastron precession. We show that, in orbits with a high eccentricity, resonance can cause a large precession when a harmonic of the orbital frequency matches the natural frequencies of the normal modes of the star. In contrast to the case with circular orbits, each mode can encounter multiple resonances with different harmonics and these resonant regions can cover about 10% of the frequency space for orbits with close separations. In this case, the tidal precession effect is distinct from the other contributions and can be identified with LISA if the signal-to-noise ratio is high enough. However, within the highly eccentric-small separation region, the dynamical tide causes chaotic motion and the gravitational wave signal becomes unpredictable. Even not at resonance, the dynamical tide can contribute up to 20% of the precession for orbits close to Roche-lobe filling separation with low eccentricities and LISA can resolve these off-resonant dynamical tide effects within the low eccentricity-small orbital separation region of the parameter space. For lower mass systems, the dynamical tide effect can degenerate with the uncertainties of the eccentricity, making it unmeasurable from the precession rate alone. For higher mass systems, the radiation reaction effect becomes significant enough to constrain the eccentricity, allowing the measurement of the dynamical tide.

A new impact assessment model to integrate space debris within the life cycle assessment-based environmental footprint of space systems

By analogy to conventional environmental impacts, the potential release of debris or generation of fragments can be considered as the emission of an environmental stressor damaging the orbital ‘natural’ resource which supports space activities. Hence, it appears relevant to integrate systematically the impact of the emission of debris on the orbital resource within the life cycle impact assessment (LCIA) step to broaden the scope of life cycle assessment (LCA) for space systems. The main objective of this article is to propose a set of characterization factors to compute the impact caused by the generation of debris within the orbital environment. To do so, the proposed approach follows the methodology of emission-related characterization models in LCIA. the characterization model enables to link the emission of debris and final economic damages to space activities through a complete impact pathway including the fate of debris in downstream orbital compartments, the exposure of targeted space objects to this debris, and the economic damage in case of collision between the debris and the space object. The model is computed for different compartments of the low earth orbit (LEO) region thanks to a discretization of the orbital environment. Results show that the potential damages are the highest for orbital compartments located in the orbital bands of altitude/inclination: 550–2000 km/52–54°, 1,200–2000 km/86–88°, 400–2000 km/96–100°, because of the downstream location of Starlink constellation, OneWeb constellation, and earth observation satellites, respectively. The proposed set of CFs can be used in the LCA of different space systems in order to include impacts and damages related to space debris, along with other environmental impacts. This original development fully in line with the standardized LCIA framework would have potential for further integration into harmonised sector-specific rules for the European space sector such as product environmental footprint category rules (PEFCR).

ЭФФЕКТИВНОСТЬ ПРИМЕНЕНИЯ ТЕХНОЛОГИЙ 3D-МОДЕЛИРОВАНИЯ И ТРЕХМЕРНОЙ ПЕЧАТИ В ДИАГНОСТИКЕ И ЛЕЧЕНИИ ПАЦИЕНТОВ С ПЕРЕЛОМАМИ КОСТЕЙ СРЕДНЕЙ ЗОНЫ ЛИЦА

Nowadays, the relevance of the diagnosis and treatment of facial bones, especially the midfacial region, is undoubted. According to scientific literature, the incidence of facial bone fractures is up to 16% in the total structure of fractures [5, 10, 13]. Such injuries can lead to aesthetic disorders in the form of various post-traumatic deformities, often disfiguring the face of patients, as well as lead to functional disorders of varying severity. According to variability of traumatic injuries of the facial bones, polymorphism of clinical manifestations, as well as the aesthetic and functional significance of the area under consideration, the need to individualize the medical and diagnostic process is formed [7–9, 11, 14, 15, 17].
 The individualization of the approach to the diagnosis and treatment of patients is gaining more and more popularity and today is one of the more significant vectors for the development of practical medicine, opening new horizons for specialists in various fields of medical science. One of the most interest directions of this approach is the use of additive manufacturing technologies.
 Additive prototyping and virtual modeling open up wide possibilities for customizing diagnostics and treatment in accordance with a specific clinical situation. Modern computer modeling technologies enable representatives of various medical specialties, including maxillofacial surgeons, not only to be limited to preoperative planning using virtual prototypes of defective zones and also to model structures that replace various bone defects based on additive technologies by printing of high-precision physical models of the damaged zone. In turn, the presence of such means of visualization of injury areas already at the preoperative stage makes it possible to develop individualized augments of bony defects, taking into account all the features of the anatomical structures of a particular patient [1–4, 6, 16].
 The article deals on the results of a comparative study of the effectiveness of surgical treatment of maxillary fractures in the orbital region using an algorithm based on the use of additive manufacturing technologies and traditional methods.

Maxillofacial Radiology 203

19-year-old male patient, known with a diagnosis of neurofibromatosis type 1, presented with a plexiform neurofibroma involving the left orbit, zygoma, temporal, and parotid regions. The patient reported a history of left eye enucleation 7-years-ago. What are the pertinent radiologic findings? (Figs.1 and 2)

Different Features of a Metabolic Connectivity Map and the Granger Causality Method in Revealing Directed Dopamine Pathways: A Study Based on Integrated PET/MR Imaging.

Exploring the directionality of neural information in the brain is important for understanding brain mechanisms and neurodisease development. Granger causality analysis and the metabolic connectivity map can be used to investigate directional transmission of information between brain regions, but their differences in depicting functional effective connectivity are not clear. Using the Monash rs-PET/MR imaging data set, we conducted Granger causality and metabolic connectivity map analyses of the dopamine reward circuit in the brain. The dopamine reward circuit is a well-known system consisting primarily of the bilateral orbital frontal cortex, caudate, nucleus accumbens, thalamus, and substantia nigra. We validated these circuit pathways using Granger causality and the metabolic connectivity map for identifying effective connectivities against a priori knowledge by testing the significance of directed pathways (P < .05, false discovery rate-corrected). We found 3 types of effective connectivities in the dopamine reward circuit: long-range, neighborhood, and symmetric. Granger causality analysis revealed long-range connections in the orbital frontal cortex-caudate and orbital frontal cortex-nucleus accumbens regions. Metabolic connectivity map analysis revealed neighborhood connections in the nucleus accumbens-caudate, substantia nigra-thalamus, and thalamus-caudate regions. Metabolic connectivity map analysis also found symmetric connections in each of the bilateral nucleus accumbens, caudate, thalamus, and orbital frontal cortex-caudate regions. Different patterns in directional networks of the dopamine reward circuit were revealed by Granger causality and metabolic connectivity map analyses. Granger causality analysis primarily identified bidirectional cortico-nucleus connections, while the metabolic connectivity map primarily identified direct connections among neighborhood and symmetric regions. The results of this study indicated that investigations of effective connectivities should use an appropriate analysis method depending on the purpose of the study.

Comprehensive Management of Preseptal Cellulitis with Massive Palpebral Abscess in 72-year-old Man

Introduction: Infectious inflammation of the periorbital and orbital soft tissue can be classified as preseptal (periorbital) or postseptal (orbital) cellulitis. Eyelid abscess, an accumulation of pus in the palpebral tissue, can occur in isolation or in association with preseptal cellulitis. Preseptal cellulitis is nearly three times more common than orbital cellulitis. Case Presentation: The patient, in this case, was admitted with a complaint of swollen left eyelid ten days before being admitted. Swollen eyelid with the inability to open the left eye was accompanied by pus discharge five days before coming to the hospital. Current complaints include eyelid pain, swelling, and discharge of thick yellow fluid. Massive abscess with active pus and crust was present in the left superior and inferior eyelid and frontotemporal area. A head CT scan revealed a soft tissue mass in the left sub galea soft tissue, left frontal region, left orbit, and left temporal region. Multi-department consultations and several workups were done to reveal the etiology and plan the appropriate management of this condition. Conclusion: A comprehensive assessment must be done to distinguish preseptal and orbital cellulitis. Ophthalmology examination and imaging are crucial to detect any extension of the palpebral abscess beyond the orbital septum. Examining an immunocompromised state and focal infection is crucial in determining proper treatment.

Case report: a paroxysmal hemicrania responsive to verapamil

Introduction Paroxysmal hemicrania (PH), a trigeminal autonomic headache, is characterized by unilateral pain in the orbital, supraorbital, and temporal regions, accompanied by nasal congestion and ocular hyperemia, with a predominance (not exclusively) in women, with attacks lasting 2 to 30 minutes and occurring several times daily. Pain crises have been known to cease completely or almost completely with the use of indomethacin. However, in some patients, the side effects caused by taking the drug prevent continuation of treatment. There is also the possibility of a partial response to the first-line drug. In these cases, alternative drugs are chosen, with verapamil being one of the drugs of choice. Objectives In this report, we present a case of a patient with a partial response to the first-line drug therapy and good responsiveness to verapamil. Methods We collected patient data through the electronic medical record. Afterward, we reviewed the literature regarding paroxysmal hemicrania and its responsiveness to indomethacin and verapamil. Results A 56-year-old woman presented with a 1-year history of throbbing pain in the left hemiface, and retro-orbital and temporal ipsilateral pain, lasting approximately 30 minutes with a frequency of 5-6 episodes per day and a maximum remission period of 3 months. The headache attacks were associated with nasal congestion and allodynia and had worsened recently. Her medical history was positive for major depressive disorder and hypertension. At the time she presented, she was taking carbamazepine 900 mg per day, which resulted in partial relief of pain. Clinical examination revealed pain on palpation of the trigeminal branches on the left side, bilateral temporomandibular pain, and pain on palpation of the right greater occipital nerve. Magnetic resonance angiography of the head showed no abnormalities... (Too see the complet abstract, please, check out PDF.)

A Missed Periorbital Foreign Body

Trauma involving the eye, orbital and periorbital regions are commonly seen in cases of road traffic accidents, sports injuries and physical assaults, but cases of intraorbital / periorbital foreign bodies are rare. Early presentation, history of trauma, and imaging help in diagnosis. However, sometimes the diagnosis is missed, particularly in cases with late presentation and a vague history of minor trauma and trauma with a non-metallic foreign body. A missed foreign body may present later with infection, repeated inflammation, ptosis, and proptosis and motility defect, further complicating the management.&#x0D; Here, we present a case of missed foreign body during the primary repair of facial injury in a 32-year male with polytrauma sustained in a road traffic accident. Evidence of foreign body was reported in a CT scan head advised for head injury. Re-exploration of wound and removal of foreign body is performed under local anaesthesia.

Evaluation of Orbitomalar Region Projection in Patients With Operated Cleft Lip and Palate (Cephalometric Study).

The aim of this study was to compare the orbitomalar region projection in patients with cleft lip and palate (CLP) with skeletal class 1 cases. Retrospective. Single center. Cephalometric data of 52 cases with unilateral CLP, 25 cases with bilateral CLP, and 60 healthy participants in skeletal class 1 without CLP were included. A total of 5 parameters, 3 in the orbital and 2 in the suborbital region, that determine the projection of the orbitomalar region on lateral cephalograms, and 13 parameters of the craniofacial region were evaluated. Lateral, inferior, and anterior orbital parameters were similar between groups, while suborbital parameters were in a retrusive position in the CLP groups compared to the control group (P < .05). No significant difference was found between the CLP groups in terms of suborbital parameters. A moderate positive correlation was found between orbitomalar parameters and the anteroposterior positions of the maxilla and mandible. The lateral orbital region had a moderate negative correlation with anterior maxillary height, and the suborbital region had a negative moderate correlation with maxillary inclination. Suborbital projection was more retrusive in CLP compared to the control group, but no difference was found between the CLP groups. On the other hand, the correlation between orbitomalar projection and maxillary and mandibular development was significant. The results show that there is a need for alternative treatment modalities for the suborbital region in patients with CLP.

Ask the Experts: An International Consensus on Managing Post-Infectious Olfactory Dysfunction Including COVID-19.

Purpose of ReviewTo summarise the current understanding of post-infectious olfactory dysfunction (PIOD) and provide a consensus on management of the condition through an evidence-based approach, critically reviewing the available management options.Recent FindingsNew studies investigating the pathophysiology of PIOD in COVID-19 patients have found that in those with persistent symptoms there is an association with lower tissue perfusion in the orbital and medial regions of the frontal lobe. Recent meta-analyses have listed olfactory training as the first line management for PIOD.SummaryOlfactory training remains the most recommended management option for PIOD. The use of systemic corticosteroids to treat PIOD is not encouraged due to poor evidence.

Orbital Dynamics Landscape near the Most Distant Known Trans-Neptunian Objects

The most distant known trans-Neptunian objects (TNOs), those with perihelion distance above 38 au and semimajor axis above 150 au, are of interest for their potential to reveal past, external, or present but unseen perturbers. Realizing this potential requires understanding how the known planets influence their orbital dynamics. We use a recently developed Poincaré mapping approach for orbital phase space studies of the circular planar restricted three-body problem, which we have extended to the case of the 3D restricted problem with N planetary perturbers. With this approach, we explore the dynamical landscape of the 23 most distant TNOs under the perturbations of the known giant planets. We find that, counter to common expectations, almost none of these TNOs are far removed from Neptune’s resonances. Nearly half (11) of these TNOs have orbits consistent with stable libration in Neptune’s resonances; in particular, the orbits of TNOs 148209 and 474640 overlap with Neptune’s 20:1 and 36:1 resonances, respectively. Five objects can be ruled currently nonresonant, despite their large orbital uncertainties, because our mapping approach determines the resonance boundaries in angular phase space in addition to semimajor axis. Only three objects are in orbital regions not appreciably affected by resonances: Sedna, 2012 VP113 and 2015 KG163. Our analysis also demonstrates that Neptune’s resonances impart a modest (few percent) nonuniformity in the longitude of perihelion distribution of the currently observable distant TNOs. While not large enough to explain the observed clustering, this small dynamical sculpting of the perihelion longitudes could become relevant for future, larger TNO data sets.

Cavernous Sinus Thrombosis as a Complication of Cerebro-Rhino Orbital Mucormycosis Associated With Covid-19: A Case Report

Cavernous sinus thrombosis is a life-threatening condition that arises as a complication of facial infection, sinusitis, orbital cellulitis, pharyngitis, or otitis of fungal or bacterial origin or after traumatic injury or surgery. Rhinocerebral mucormycosis is an aggressive infection that, depending on its level of extension, affects nasal passages, paranasal sinuses and the orbital region.