Background: Sino-orbital fistulas (SOF) are a well-reported complication of orbitalexenteration and sinonasal carcinoma resection. Despite repair, however, complete fistula closure may be difficult.
Case: A 79 –years-old man had undergone total exenteration of right orbit for spreading sqamous cell carcinoma of conjunctiva. Subsequently he developed two large sinoorbitalfistulae medially to the ethmoid sinus wall of the orbit. Post- operatively good socket hygiene was maintained but the fistulae increased in size. At 3 month follow-up, closure of the fistulae using glabellar rotation advancement flap was done. The defects have remained closed at follow-up with excellent cosmetic results. There is no recurrence of fistula or malignancy till date. Patient was cosmetically rehabilitated with spectacle prosthesis.
Conclusion: Glabellar rotation flap for closure of medially situated sino- orbital fistulae is a good option with excellent cosmetic result.
BACKGROUND Blindness being a major health problem in developing country, affects not only the individual but also his family and society while a number of causes of blindness are preventable if measures are taken at an earlier time. This study mainly focuses on finding these causes. METHODS Secondary data analysis was done from medical records of disability register of a tertiary eye care hospital in Kolkata for a period of one year. The cause of visual disability was ascertained. Additional data collected from records of each patient included age, gender, literacy, percentage of disability, marital and working status and also reason for obtaining the certificate. RESULTS 240 case records (149 male and 91 female) were analysed and it was found that 79.17 % patients were in the working age group (21 – 60 years). 42 % of study population had congenital malformation as a cause of their disability followed closely by retinitis pigmentosa (38 %). 65.41 % were literate of which 54.14 % were working while 57.84 % were not working. 37.5 % patients obtained the certificate to avail travel benefit. CONCLUSIONS Congenital malformation and retinitis pigmentosa are the two major causes of blindness certification. Both can be prevented by genetic counselling and discouraging consanguineous marriage. Even other causes like retinal detachment, glaucoma etc. were all preventable diseases if treated at an earlier stage. Thus, based on these findings, guidelines should be framed to decrease the prevalence of blindness in the society. KEYWORDS Certification, Congenital Malformation, Disability, Best Corrected Visual Acuity (BCVA)
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