OCR Text |
Show lo(} UILRAHI/<f ABSTRACTS cesiul treatment invulves ,1 cumbined sinus and orbit,ll ,1ppw.lch. The sur~eun musl strip the rl'Spil-' ltUI'V epithelium iwm llll' wall ui the sinus and 1"l'-est,lblish ,1 dr,lin,lgl' p,lthW,ly tu the nuse tu prl'ye nt rl'l'U rre nCl'. TIll' ,1lIthurs repurt three p,ltienls with urbit,ll C\'sts lilll'd with upper respir,ltury tr,Kt epithelium. In l',Kh C,lSl', thl'rl' W,IS nu evidence Lli dn assllci,llL'd mUCllL'ele. TWLl p,ltients had d past histl) r\' lli llrbit,ll tr,lum,l, ,lnd the third had precedin~ sinus surgen' . The ,llIthurs postulate that these Cysts wt're L.llIsed by traumatic ht'rniatiLln of nasal sinus l'pithelium cells into the orbit. Excision of the Cysts rt'sulted in cl good pw~nosis. Walter M. lay, M.D. Congenital Nystagmus in Identical Twins: Discordant Features. Spooner SN, Batt'man JB, Yee RD. I Pediatr Opht/wllllol Stm/JislIIlIs 1986;23:115-9 (May/June). [Reprint requests to Dr. Spooner, Jules Stein Eye Institute 2-154, UCLA School oi Medicine, Los Angeles, CA 90024.1 Identical twins were the products of an uncomplicated 9-month pregnancy and normal vaginal delivery. Nystagmus was observed during the iirst months of life in each and was more noticeable in the second born twin (case 1). By history, a maternal uncle and the younger sister had nystagmus. The authors believed the pedigree ,,~as most compatible with an X-linked recessive trait with expression in the carrier female. However, they could not exclude the possibility of an autosomal dominant inheritance. During infancy, case 1 developed a left head turn, while case 2 developed a right head turn of lesser degree. At age 4 years 10 months, case 1 underwent a Kestenbaum procedure for a 45-degree left head turn. Both children were examined at 11 years oi age. Case 1 had a leit face turn of 20 degrees and bt'st corrected visual acuity of 20/25. Case 2 had a 40degree right face turn and best correctt'd visual acuity of 20/20. In each twin, the irides wt're without transillumination defects and strabismus was absent. Cycloplegic refraction revealed hyperopic astigmatism of +0.75 + 1.25 x 90 i~ tht' right eye and + 1.00 + 2.25 x HO in tht' left eve in case I and + 1.00 + 0.50 x 90 in each t'yt' 0( case 2. The fundi wt're normal in each child. The twins Wt'rt' studied by mL'ans of eye movemL'nt rL'cordings and vidt·otaping. The nystagmus m the twins differed in its location oi the null zone, its frequency and amplitude, the degree of persistence in the dark, and the degree of impairment of pursuit and optokinetic nystagmus. The authors postulate that the discordant features of the nystagmus represent variable gene expressivity or, alternatively, the influence of environmental factors. Walter M. Jay, M.D. Extraocular Muscle Aplasia in Moebius Syndrome. Traboulsi EI, Maumenee IH. JPediatr Ophthallllol 5tm/JislIIlIs 1986;23:120-2 (May/June). [Reprint requests to Dr. Irene Maumenee, Maumenee Building, Room 321, Wilmer Ophthalmological Institute, Johns Hopkins HospitaL 600 N. Wolfe St., Baltimore, MD 21205.) The distinctive features of the Moebius syndrome are: (a) a usuallY bilateral and asymmetric iacial paralysis that tends when incompl~te not to aiiect the lower face and platysma; and (b) an inability to abduct either eve beyond the midline with 'normal vertical conju'gate ~oYements. Two theories have been proposed to explain the abnormalities noted in the Moebius syndrome. The iirst implicates a primary mesode~al defect leading to abnormal musculature with secondary brainstem nuclear neuronal dropout; the second postulates a primary developmental defect to the central nen'ous system with aplaSia of the motor nuclei and secondary denervation atrophY of the facial and extraocular muscles. ' The authors report a case of Moebius syndrome with bilateral aplasia of the medial and lateral recti muscles. The fibrous bands that replaced the medial recti were inserted posteriorly on the globe, resultmg m a restrictive large angle esotropia. SurgICal mtervention resulted in alignment in the primary posllion. The authors argue that their case tayors d primary mesodermal d~'splasia of the extraocular musculature, rather than a developmental detect ot the central nervous sYstem. The authurs' c.onclusions, however, are b~sed solely upon tmdmgs noted at the time of strabismus surgery. Nl) gross or histopathology of the brainstem is included. ' Walter M. Jay, M.D. Posttraumatic Seesaw Nystagmus Abolished by Ethanol Ingestion. Frisen L, Wikkelso C. Nell- |