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CYSTIC ORBITAL LESIONS

CYSTIC ORBITAL LESIONS. 1. Dacryops. 2. Dermoid cyst. Superficial Deep. 3. Mucocele. 4. Encephalocele. Anterior Posterior. Dacryops. Ductal cyst of lacrimal gland. Frequently bilateral. Round, cystic lesion originating from palpebral portion of lacrimal gland

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CYSTIC ORBITAL LESIONS

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  1. CYSTIC ORBITAL LESIONS 1. Dacryops 2. Dermoid cyst • Superficial • Deep 3. Mucocele 4. Encephalocele • Anterior • Posterior

  2. Dacryops • Ductal cyst of lacrimal gland • Frequently bilateral • Round, cystic lesion originating from palpebral • portion of lacrimal gland • Protrudes into superior fornix

  3. Superficial dermoid cyst • Presents in infancy • No displacement of globe • Most commonly superotemporal • Occasionally superonasal • Posterior margins are easily palpable • Freely mobile under skin

  4. Deep dermoid cyst Presentsin adolescence or adult life • Non-axial proptosis • May be extension into temporalis • fossa or intracranially • Associated bony defects • May leak and cause granulomatous • inflammation and fibrosis CT shows a heterogenous, well-circumscribed lesion

  5. Mucocele • Presents - adult life • Caused by obstruction of drainage of normal sinus secretions • (frontal or ethmoidal) • Slowly expanding lesion which gradually erodes sinus walls Gradual proptosis or globe displacement Periorbital or upper lid swelling

  6. Encephalocele Encephalocele - herniation of intracranial contents through congenital skull defect Meningocele - contains only dura Meningoencephalocele - contains dura and brain tissue • Anterior (fronto-ethmoidal) • Posterior (spheno-orbital) Transmission of CSF pulsation causes pulsating proptosis without a bruit

  7. Anterior encephalocele • Involves supero-medial part of orbit • Displaces globe forwards and laterally

  8. Posterior encephalocele Caused by congenital defect in sphenoid bone Globe displacement forward and downward

  9. Associations of encephaloceles Neurofibromatosis - 1 Other congenital bony defects Ocular • Common in posterior • encephalocele • Colobomas • Morning glory anomaly • Hypertelorism • Hare lip and cleft palate

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