Orbital pseudotumor: clinical features and outcomes.

To describe the clinical characteristics of orbital pseudotumor, a retrospective analysis was performed on patients with orbital pseudotumor at Siriraj Hospital for ten years. Forty-nine patients (24 males and 25 females; 62 eyes) with a mean age of 43.75 years were included (a mean follow-up of 25 months). Thirty-six patients (73.5%) had unilateral disease. The clinical features were proptosis (79.6%), ocular motor deficit (61.2%), pain (51%), lid swelling or lid mass (44.9%), ptosis (24.5%), and chemosis (18.4%). The most common presenting sign was proptosis (49%). All were treated with corticosteroids with clinical improvement in 40 (81.6%) patients. Ten (83.3%) of 12 patients with visual loss improved with mean recovery time of 10.3 days. Ocular motility recovered in 24 (80%) patients, occurring an average of 17.8 days after initiation of therapy. It is concluded that the clinical features of orbital pseudotumor are varied. Most patients were improved with corticosteroids treatment.

Skull base surgery: Access to anterior and middle cranial fossa.

Although skull base lesions, which differ in comparison to other areas of pathology, are difficult to deal with, much has been published of the subject in the last two decades. Access, visualization, surgical skill, and technique are keys of surgical success. Since June 1995 – December 1996, 47 cases were performed by the basal skull group; (neurosurgeon, ENT, ophthalmic and plastic surgeons). Among these cases, 28 fronto-orbito-zygotomies were performed for anterior and middle cranial fossa lesions including tumors of the cavernous sinus, vascular aneurysms and orbital tumours, etc. Most benign lesions were totally removed and functional preservation was achieved in most cases. Only one case of morbidity from injury to the frontal nerve and two mortalities from intracerebellar haemorrage and sepsis occurred. Access is the major crucial factor which can determine the functional result, and involvement of multidisciplinary fields will provide good cosmetic results.