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Flashcards in BCSC Plastics Deck (238)
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61

What is the classic clinical appearance of a lymphoproliferative lesion?

Salmon patch underneath the conjunctiva or located anteriorly in the orbit

62

What type of biopsy is preferred for lymphoproliferative lesions?

Open biopsy

63

What percent of orbital lymphoproliferative lesions have on diagnosis or will have associated systemic disease within 5 years?

50%

64

What is the treatment of choice for localized orbital lymphoproliferative lesions?

Radiation, with a dose of 2000 to 3000 cGy

65

What is the most common presentation of Langerhans cell hystiocytosis in the orbit?

A lytic lesion of the superotemporal orbit with associated orbital inflammation (which may be confused initially for infectious orbital cellulitis)

66

What are the 4 types of adult xanthogranuloma of the orbit (in order of frequency)?

1) Necrobiotic xanthogranuloma (NBX), 2) Adult-onset asthma with periocular xanthogranuloma (AAPOX), 3) Erdheim-Chester disease (ECD), 4) Adult-onset xanthogranuloma (AOX)

67

What do most lacrimal gland masses represent?

Non-specific inflammation of the lacrimal gland (dacryoadenitis)

68

What is a common dichotomy of lacrimal gland tumors?

Epithelial origin vs. non-epithelial origin

69

What is the most common epithelial tumor of the lacrimal gland?

The pleomorphic adenoma (benign mixed tumor)

70

What is the common clinical presentation of a pleomorphic adenoma of the lacrimal gland?

Patient in the 4th or 5th decade of life presenting with slowly progressive, painless downward displacement of the globe with axial proptosis

71

Should a suspected pleomorphic adenoma of the lacrimal gland be biopsied?

No, it should be completely excised surgically maintaining an intact pseudocapsule

72

What is the most common malignant tumor of the lacrimal gland?

The adenoid cystic carcinoma (cylindroma)

73

What percent of patients with orbital neuroblastoma survive?

90% if diagnosed before age 1, 10% if diagnosed after age 1

74

What is the most common type of leukemia to metastasize to the orbit?

Acute lymphoblastic leukemia

75

What are the two most common metastases to the orbit?

Breast and lung tumors

76

What is the most common orbital metastasis in women?

Breast carcinoma

77

What is the most common orbital metastasis in men?

Bronchogenic carcinoma

78

What part of the face do Le Fort fractures involve?

the maxilla

79

What is a Le Fort I fracture?

a low transverse maxillary fracture above the teeth with no orbital involvement

80

What is a Le Fort II fracture?

a pyramidal fracture involving the nasal, lacrimal, and maxillary bones, as well as the medial orbital floor

81

What is a Le Fort III fracture?

craniofacial disjunction with involvement of the orbital floor and medial and lateral orbital walls

82

What is craniofacial disjunction?

A condition in which the entire facial skeleton is completely detached from the base of the skull and suspended only by soft tissues

83

What are the sites of fracture in a tripod fracture of the zygomaticomaxillary complex (ZMC)?

the lateral orbital rim, inferior orbital rim, zygomatic arch, lateral wall of the maxillary sinus

84

Are orbital roof fractures more common in adults or children?

Children. Since the frontal bone has not pneumatized yet in children, frontal trauma is more likely to extend to the orbital roof in children, whereas in adults, the frontal sinus acts as a crumple zone and dissipates energy of frontal impacts

85

What is another name for a direct medial orbital fracture?

A naso-orbital-ethmoidal fracture

86

What are the common clinical characteristics of a nas-orbital-themoidal fracture?

Depressed bridge fo the nose and traumatic telecanthus

87

What is an indirect medial orbital fracture?

A fracture of the medial orbit resulting from a blowout fracture of the orbital floor

88

What are the common physicial sings of an orbital floor fracture?

Eyelid edema and ecchymosis; diplopia with limitation of upgaze, downgaze, or both; enophthalmos and ptosis of the globe; hypoesthesia in the distribution of the infraorbital nerve; orbital and eyelid emphysema

89

What is an exception to initial observation of an orbital floor fracture?

Inferior rectus trapping beneath a trapdoor fracture (IR in maxillary sinus on CT) in pediatric patients

90

In which situations is surgery advisable in the case of an orbital floor fracture?

1) Diplopia with limitation of upgaze and/or downgaze within 30 degrees of primary position with positive forced ductions 7-10 days after injury and with radiologic confirmation; 2) Enophthalmos that exceeds 2mm and is cosmetically unacceptable to the patient; 3) Large fractures involving at least half of the orbital floor, particularly when associated with large medial wall fractures (determined by CT)