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O TMJ, Ceisler E, Broude C, Chan K, Pacicco L, Fay A, Waner M. Distribution and Clinical Characteristics of Periorbital Infantile Hemangiomas. Facial Plast Surg Aesthet Med 2023; 25:172-178. [PMID: 36473202 DOI: 10.1089/fpsam.2022.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: Periorbital infantile hemangiomas (POIHs) are associated with a high incidence of visual complications. Objective(s): To analyze the sites of predilection of POIHs and to determine whether certain sites require earlier intervention due to their higher rate of visual complications. Methods: A retrospective case series study was conducted on patients from two tertiary care centers for 25 years. The location of POIHs was determined from clinical photographs, medical records, and radiological studies. The presence or absence of anisometropic astigmatism (anisoastigmatism) and amblyopia was recorded. Data were analyzed using a chi-square test. Results: There were 486 patients, of which 302 patients had ophthalmology evaluations and 245 patients had refractive error data. At presentation, 10% of patients already had amblyopia and 44% had anisoastigmatism. Medial eyelid lesions had the highest risk of developing anisoastigmatism (anisoastigmatism correlates with eyelid position, p = 0.0001). Segmental and upper medial lesions had the highest risk of amblyopia at initial evaluation. Conclusion: The site of POIH is an important indicator for developing clinically significant anisoastigmatism and amblyopia, underlining the need for early ophthalmologic assessment and management.
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Affiliation(s)
- Teresa Min-Jung O
- Vascular Birthmark Institute of New York, New York, New York, USA.,Department of Otolaryngology, Lenox Hill Hospital, New York, New York, USA
| | - Emily Ceisler
- Department of Ophthalmology, New York University Grossman School of Medicine, New York, New York, USA
| | - Caroline Broude
- Vascular Birthmark Institute of New York, New York, New York, USA.,Department of Otolaryngology, Lenox Hill Hospital, New York, New York, USA
| | - Kimberly Chan
- Vascular Birthmark Institute of New York, New York, New York, USA.,Department of Otolaryngology, Lenox Hill Hospital, New York, New York, USA.,College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania, USA
| | - Lauren Pacicco
- Vascular Birthmark Institute of New York, New York, New York, USA.,Department of Otolaryngology, Lenox Hill Hospital, New York, New York, USA
| | - Aaron Fay
- Vascular Birthmark Institute of New York, New York, New York, USA.,Department of Otolaryngology, Lenox Hill Hospital, New York, New York, USA.,Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Milton Waner
- Vascular Birthmark Institute of New York, New York, New York, USA.,Department of Otolaryngology, Lenox Hill Hospital, New York, New York, USA
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Héran F, Bergès O, Blustajn J, Boucenna M, Charbonneau F, Koskas P, Lafitte F, Nau E, Roux P, Sadik JC, Savatovsky J, Williams M. Tumor pathology of the orbit. Diagn Interv Imaging 2014; 95:933-44. [PMID: 25195185 DOI: 10.1016/j.diii.2014.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The term orbital tumor covers a wide range of benign and malignant diseases affecting specific component of the orbit or developing in contact with them. They are found incidentally or may be investigated as part of the assessment of a systemic disorder or because of orbital signs (exophthalmos, pain, etc.). Computed tomography, MRI and Color Doppler Ultrasound (CDU), play a varying role depending on the clinical presentation and the disease being investigated. This article reflects long experience in a reference center but does not claim to be exhaustive. We have chosen to consider these tumors from the perspective of their usual presentation, emphasizing the most common causes and suggestive radiological and clinical presentations (progressive or sudden-onset exophthalmos, children or adults, lacrimal gland lesions, periorbital lesions and enophthalmos). We will describe in particular muscle involvement (thyrotoxicosis and tumors), vascular lesions (cavernous sinus hemangioma, orbital varix, cystic lymphangioma), childhood lesions and orbital hematomas. We offer straightforward useful protocols for simple investigation and differential diagnosis. Readers who wish to go further to extend their knowledge in this fascinating area can refer to the references in the bibliography.
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Affiliation(s)
- F Héran
- A. de Rothschild Foundation, Imaging Department, 25, rue Manin, 75019 Paris, France.
| | - O Bergès
- A. de Rothschild Foundation, Imaging Department, 25, rue Manin, 75019 Paris, France
| | - J Blustajn
- A. de Rothschild Foundation, Imaging Department, 25, rue Manin, 75019 Paris, France
| | - M Boucenna
- A. de Rothschild Foundation, Imaging Department, 25, rue Manin, 75019 Paris, France
| | - F Charbonneau
- A. de Rothschild Foundation, Imaging Department, 25, rue Manin, 75019 Paris, France
| | - P Koskas
- A. de Rothschild Foundation, Imaging Department, 25, rue Manin, 75019 Paris, France
| | - F Lafitte
- A. de Rothschild Foundation, Imaging Department, 25, rue Manin, 75019 Paris, France
| | - E Nau
- A. de Rothschild Foundation, Imaging Department, 25, rue Manin, 75019 Paris, France
| | - P Roux
- A. de Rothschild Foundation, Imaging Department, 25, rue Manin, 75019 Paris, France
| | - J C Sadik
- A. de Rothschild Foundation, Imaging Department, 25, rue Manin, 75019 Paris, France
| | - J Savatovsky
- A. de Rothschild Foundation, Imaging Department, 25, rue Manin, 75019 Paris, France
| | - M Williams
- A. de Rothschild Foundation, Imaging Department, 25, rue Manin, 75019 Paris, France
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Léauté-Labrèze C, Sans-Martin V. [Infantile hemangioma]. Presse Med 2010; 39:499-510. [PMID: 20207100 DOI: 10.1016/j.lpm.2009.10.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Revised: 10/06/2009] [Accepted: 10/14/2009] [Indexed: 11/19/2022] Open
Abstract
Infantile hemangioma is the most common tumor in children, but its pathophysiology is still not well understood. Infantile hemangioma develops during the first weeks of life, usually builds up over 3 to 6 months, and then regresses very slowly over a period of 3 to 7 years. Three quarters of these hemangiomas are lobular and are not associated with malformations. On the other hand, the hemangiomas referred to as segmental may be associated with developmental abnormalities (PHACES and PELVIS/SACRAL syndromes). Because of their spontaneous involution, most infantile hemangiomas do not require therapeutic intervention. In 10 to 15 % of cases, treatment is necessary because of complications when life or physiological functioning is threatened, or there are local complications or the long-term esthetic risk is too high. Until now, the standard first-line treatment has been general corticosteroid therapy. The usual choice for second-line treatment is interferon or vincristine. The efficacy of propranolol, a non-cardioselective beta-blocker, was recently reported.
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Affiliation(s)
- Christine Léauté-Labrèze
- Unité de dermatologie pédiatrique, centre de référence maladies rares de la peau, hôpital Pellegrin-Enfants, CHU de Bordeaux, F-33076 Bordeaux cedex, France.
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Dompmartin A, Boon LM, Labbé D. [Infantile hemangiomas: differential diagnosis and associated anomalies]. ANN CHIR PLAST ESTH 2006; 51:300-9. [PMID: 17007985 DOI: 10.1016/j.anplas.2006.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Infantile hemangiomas are frequent benign vascular tumors that are often easily recognized. However, the diagnosis between infantile hemangiomas and other vascular tumors, whether benign or malignant, may be difficult. This chapter describes the different clinical presentations of hemangiomas and details the investigations that are needed to confirm the nature of the lesion and to diagnose the potentially associated anomalies. Knowledge on differential diagnosis enables clinicians to detect hemangiomas that can lead to complications and that necessitate a multidisciplinary approach.
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Affiliation(s)
- A Dompmartin
- Service de dermatologie, centre hospitalier universitaire de Caen, avenue Georges-Clemenceau, 14033 Caen cedex, France.
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Abstract
PURPOSE OF REVIEW Patients with vascular and lymphatic anomalies are often 'medical orphans' ascertained through distinct medical specialists. Multidisciplinary vascular anomalies programs provide focused expertise in diagnosis and treatment for patients. National and international workshops on vascular anomalies are fostering clinical and basic science research to enhance our understanding of vascular development and vascular anomalies. Herewith is presented an update of recent advances in the study of vascular/lymphatic anomalies. RECENT FINDINGS New original findings include (1) the identification of distinct cell surface markers and other cellular properties in hemangiomas and vascular malformations relevant to vascular development, (2) the discovery of novel genetic mutations and susceptibility genes in patients with vascular anomalies, (3) recognition of new risk stratifications and clinical issues for patients with hemangiomas and vascular malformations, and (4) the elucidation of sequelae from the disorders as well as side effects of recent and previous therapies for vascular anomalies. SUMMARY Vascular anomalies are an attractive model for the study of human disorders of vasculogenesis and angiogenesis. The etiology of these disorders is unclear and likely represents a multifactorial process. Clinical clues are leading to scientific investigations that may enable targeted therapies, prevention strategies, or both.
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Affiliation(s)
- Francine Blei
- Department of Pediatrics, Stephen D. Hassenfeld Center of NYU Medical Center, New York, New York 10016, USA.
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