orbital pseudotumor
Introduction
Introduction to orbital pseudotumor The pseudotumotoforbit is a relatively common eyelid disease, accounting for the third place in the primary tumor of the eyelid. It can occur at different ages and has more male patients, which is essentially a chronic non-specific inflammation. It is named after the symptoms of eyelid tumors such as eyeballs and eye movement disorders, so it is necessary to sign a contract with eyelid tumors. Orbital pseudotumor is a non-specific chronic proliferative inflammation, not a tumor. basic knowledge The proportion of illness: 0.004% Susceptible population: can occur at different ages, more male patients Mode of infection: non-infectious Complications: exposed keratitis
Cause
Cause of orbital pseudotumor
Pathologically includes the following 6 types:
1. Lymphocytic inflammatory pseudotumor: mainly based on a large number of lymphocytes, but no tumor cells.
2, plasma cell type inflammatory pseudotumor: mainly plasma cell proliferation.
3, orbital muscle inflammation type: that is, muscle hypertrophy, accompanied by inflammatory cell proliferation.
4, chronic granuloma type: eyelid fat necrosis, accompanied by a large number of granulation tissue proliferation.
5, orbital vasculitis type: vasculitis associated with degeneration of granulation tissue hyperplasia.
6, sclerosing pseudotumor: fibrous tissue components a large number of hyperplasia, accompanied by collagen degeneration, and a little inflammatory cell infiltration.
Prevention
Eyelid pseudotumor prevention
1, go to bed early and get up early, exercise the body. Insufficient sleep can reduce the body's immune function, and it is also easy to stimulate the fire, causing external injuries.
2. Keep your mind calm. Avoid anger in the spring, do not be too impatient, always keep your peace of mind.
3. Quit smoking, drink less and drink coffee. Smoking is the most vulnerable to damage to the respiratory surface barrier and induces disease onset. Tobacco, alcohol and coffee all stimulate nervous excitement. Some people want to "eliminate tension and fatigue", but actually weaken the body's disease resistance.
4. Keep away from allergens and stay away from crowded places.
5, diet should be light and nutritious and easy to digest, eat less greasy frying and spicy food.
Complication
Orbital pseudotumor complications Complications exposed keratitis
In most cases, the disease course is long, continuous development, and the eyeball is highly prominent, which may affect visual function or even blindness due to exposed keratitis.
Symptom
Orbital pseudotumor symptoms Common symptoms Eyelid foreign body eyelid pain Visual impairment Chronic keratitis Eyeball protrusion Conjunctival edema and corneal ulcer Optic papilledema Eyeball oblique eye muscle paralysis
Eyeball is the main clinical symptom, mostly monocular, a small number can affect both sides, but the incidence of both eyes can be sequential, and some of them have red eyes, eyes, eye movement disorder or diplopia at the beginning of the onset. More prominent or recurrent episodes, it is easy to distinguish from true orbital tumors. In a few cases, once the eyeballs are protruding, they can retract themselves, even the eyelids are depressed, the eye movement is highly obstructed or the eyeball is fixed; in most cases, the disease course is longer and lasts. Development, high eyeballs, can affect visual function or even blindness due to exposure keratitis. In advanced cases, the pupil cavity is enlarged on the orbital x-ray film, even with bone resorption, but no bone destruction, if The bottom is formed, so most of the cases are skewed inward and downward, and the rotation of the eyeball is mainly restricted from the upward and upward rotation. The pulling test can be used to explore whether there is any Adhesion exists. The method is a point surface anesthetic. The tendon is clamped to the opposite side of the eyeball by the gingival force. If the deviation is caused by the paralysis of the superior rectus muscle or the swelling block above, when pulling upwards, The eyeball can be raised to reduce the skewness; on the other hand, if the eyeball is skewed due to adhesion at the bottom of the eyelid, it will feel great resistance when pulling the eyeball upward, and the deflection of the eyeball cannot be reduced. The test can distinguish the deviation of the eye caused by the tissue from the eye muscle paralysis or the eyelid tumor, which contributes to the diagnosis of the orbital pseudotumor to a certain extent.
Examine
Eyelid pseudotumor examination
Through the diagnosis of orbital pseudotumor B-ultrasound, CT, MRI and color Doppler imaging (CDI), the value of imaging examination in the diagnosis and differential diagnosis of orbital pseudotumor was explored.
Diagnosis
Diagnosis and diagnosis of orbital pseudotumor
Atypical orbital pseudotumor should be differentiated from the following diseases:
Thyroid-related eye disease: the eyeball is prominent, the extraocular muscle is enlarged, the muscle abdomen is enlarged, the edge is clear, smooth, and the tendon is not thickened, and the thyroid biochemical examination and clinical manifestation can be identified.
Lacrimal gland lymphoma: often wrapped around the outer wall of the eye, can invade the entire lacrimal gland, can be mildly strengthened, need to puncture biopsy when identification is difficult.
Optic nerve meningioma: manifested as irregular thickening of the optic nerve in the periphery, marginal strips or ring calcification, the tumor can significantly enhance the surrounding unenhanced optic nerve.
Granulomatous lesions: soft tissue lesions in the sputum, which should be differentiated from eosinophilic granuloma, mycosis, sarcoidosis, and vasculitic systemic lesions when steroid therapy is ineffective.
