The spectrum of orbital lesions occurring in childhood is wide, including a variety of both benign and malignant disorders. Although physical examination and fundoscopy may aid in establishing the diagnosis of retro-ocular lesions, imaging remains a critical step in the evaluation of the pediatric orbit. Ultrasonography, CT, and MR imaging are the primary modalities for the evaluation of the diseased orbit, and careful observation of the characteristic radiological features usually leads to correct diagnosis; however, some of the lesions look very similar and are difficult to differentiate from each other. The purpose of this article is to review the common and unusual entities that may involve the pediatric orbit, to describe the radiological features, and to evaluate the efficacy of US, CT, and MRI in the diagnosis and management of these conditions.

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Objectives: To assess the patency and flow of the internal jugular vein after functional neck dissection. Study Design: Prospective study of 54 internal jugular veins in 29 oncologic patients undergoing functional neck dissection between September 1994 and February 1997. Methods: Patency, presence of thrombosis, characteristics of the vein wall, compressibility, area of the vein both in rest and during Valsalva maneuver, expiratory flow speed, Valsalva flow speed, jugular flow in each side, and total jugular flow were assessed in all veins before and after dissection. All patients were evaluated before and after the procedure by means of duplex Doppler ultrasonography. Results: In no case was there thrombosis before or after the operation. Although total jugular flow decreases during the early postoperative period, it recovers to normal parameters within 3 months after surgery. Conclusions: According to these results, the patency of the internal jugular vein remains unaltered after functional neck dissection. Ultrasonographically there is no thrombosis after this procedure.

A case of a radiation-induced osteochondroma arising from the vertebral body of T4 in an 18-year-old man is reported. The patient presented with a history of progressive left lower extremity weakness. At 7 years of age, he had undergone resection of a cerebellar medulloblastoma and received adjunctive craniospinal irradiation and systemic chemotherapy. Both CT and MR imaging revealed an extradural mass contiguous with the posteroinferior endplate of the T4 vertebral body. This case indicates that radiation-induced osteochondroma should be considered in the differential diagnosis of patients with symptoms of myelopathy or nerve root compression and a history of radiation therapy involving the spine in childhood.

Benign osteoblastoma is an uncommon primary tumor of the bone. Any area of the skeleton may be affected by this tumor, but its occurrence in the temporal bone and middle ear is extremely rare. Clinical symptoms are nonspecific, even in the middle ear, and the diagnosis is often difficult in spite a complete physical and radiological examination. A biopsy is usually necessary for definitive diagnosis. Because of its potential for recurrence, local invasion, and, rarely, malignant transformation, a complete surgical excision remains the treatment of choice for osteoblastoma. We report a case of benign osteoblastoma involving the temporal bone and the middle ear and a review of the literature. Although in 14 to 20% of cases this tumor affects the skull, its occurrence in the temporal bone and in the middle ear is extremely rare.2-4 We present a case of osteoblastoma in a young woman involving only the temporal bone and associated with tinnitus and progressive hearing loss. CASE REPORTA 26-year-old woman presented with a 6-month history of right pulsatile tinnitus and progressive hearing loss. She had no otalgia, otorrhea, otorrhagia, dizziness, or vertigo. In addition, no problem on the left ear was revealed. Her medical history was unremarkable except for a right hemithyroidectomy 3 years before and an antibiotic allergy. Clinical examination revealed a blush and swelling of the superior quadrants of the right tympanic membrane. The left ear and the facial function were normal. The Rinne test was negative in 256 and 512 Hz, and the Weber test showed lateralization to the right ear. The audiogram showed a 50 to 60 dB right conductive hearing loss.Computed tomography of the right temporal bone showed a soft tissue lesion with areas of calcification located at the epitympanum and 1