Ebrahim Elahi

Enophthalmos as a Complication of Rhinoplasty

Silent sinus syndrome is a known clinical entity caused by negative sinus pressure from acquired obstruction of the maxillary sinus ostium with resulting enophthalmos and hypoglobus. We present a case in which, after septorhinoplasty, a patient developed progressive enophthalmos and hypoglobus. His evaluation was consistent with silent sinus syndrome. This case illustrates the complex reconstructive challenges of repairing an orbit in the setting of fistulization of the orbit with the maxillary sinus cavity. In particular, we highlight the inferior fornyx transconjunctival approach with simultaneous intranasal endoscopic maxillary sinus aeration.

Canaliculitis involving Mycobacterium fortuitum after dacryocystorhinostomy with silicone stenting

Although the care of IGP patients may only need careful observation as in our case, it is important for the clinician to recognize IGP when it happens. Signs and symptoms of IGP include (i), sudden and severe pain during the injection; (ii), subtle globe enlargement (due to the stretch of the scleral shell after a rapid rise of intraocular pressure); (iii), loss of red reflex; and (iv), appearance of a dark red reflex. These signs and symptoms are frequently overlooked and are only recognized in 50% of cases. If properly recognized and managed, the final visual acuity in cases of IGP can be favourable. It has been suggested that the final visual outcome is unfavourable if ocular penetration/perforation is complicated by retinal detachment or proliferative vitreoretinopathy. In our case, these complications were not present and the patient’s final visual acuity returned to normal in 1 month.

Frontorbital Fibrous Dysplasia Resection and Reconstruction With Custom Polyetherlatone Alloplast.

AbstractFibrous dysplasia (FD) is a benign, pathological development of bone. Craniofacial bones are the most commonly involved and can potentially cause visual disturbance, proptosis, orbital dystopia, and facial deformity. This case involves a 13-year-old girl with significant proptosis (20 mm left, 17.5 mm right) and downward displacement of the left globe (1.5 mm) due to fibrous dysplasia. Reconstruction was performed with computed tomography-derived and 3D printed custom polyetheretherketone (PEEK) implantation. PEEK is a nonabsorbable, nonporous thermoplastic polymer notable for its ability to be modified intraoperatively and ideal imaging properties postoperatively. Never, to our knowledge, has PEEK been used for primary reconstruction of the frontal orbital region in fibrous dysplasia in a child. The lesion was successfully repaired with excellent aesthetic and no apparent damage to neurovascular or ocular structures.