A Modified Kronlein Operation

Berke, Raynold N.

doi:10.1001/archopht.1954.00920040619006

Cited by 110 publications

(38 citation statements)

References 7 publications

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“…The lateral orbital approach was first proposed by Krönlein in 1889 (17), and it was later modified by Berke (2). The lateral orbitotomy is useful for retrobulbar lesions, and it can be extended for more posterior lesions.…”

Section: Peer-review Short Reportsmentioning

confidence: 99%

Intraorbital Abducens Nerve Schwannoma

et al. 2012

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Section: Peer-review Short Reportsmentioning

confidence: 99%

Intraorbital Abducens Nerve Schwannoma

et al. 2012

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“…In 1889, Kronlein [1] described the lateral orbital approach [2,3] later on transformed by Berke [2] in 1953 and by Maroon [3] and Kennerdell in 1976. This particular approach has been helpful in reaching out to the lateral, superior and inferior parts of the orbit but has a limitation in accessing the orbital apex.…”

Section: Discussionmentioning

confidence: 99%

A sidewalk into the lateral orbit

Kurien

Vinod

et al. 2015

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An easy gentle walk is advised into any enclosed place rather than an approach where bony pillars are transected.Tumor size and location are analysed to decide on the entry into the orbit. All of the main approaches published to date are mainly based on an osteotomy of the orbital wall and hence when a relatively accessible lesion crossed our way, we decided on a non-osteotomised approach allowing us to preserve the function, anatomy and good aesthetic results; thereby avoiding the need for subsequent reconstruction.

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“…Several surgical approaches have been used in the treatment of opti c nerve glioma (Berke, 1954;Bucy et al, 1950, Dandy, 1922, 1941Fog et aL, 1970;Housepian, 1969;Jain, 1961, Ray, 1971Richards & Lynn, 1966, Stallard, 1947Wright, 1949). The literature dealing with the subject has been extensively reviewed by Wagener (1961).…”

Section: Prognosis and Treatmentmentioning

confidence: 99%

Tumors of the optic nerve

1976

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This is a review of primary and secondary tumors of the optic nerve. The emphasis is an optic nerve gliomas and meningiomas. Optic nerve gliomas are slowly growing astrocytic neoplasms of the anterior visual pathways, the majority of which occur within the first two decades of life, with equal sex incidence in about 1 of 200,000 patients presenting with eye complaints. The incidence is greater in neurofibromatosis. The typical presentation is visual impairment in a verbal pre-school child with optic canal enlargement and optic atrophy. An intraorbital location of the tumor leads to axial, irreducible, non-pulsatile proptosis. An intracranial location may disturb hypothalamic and pituitary function and produce hydrocephalus. Ocular findings may also include limited motility on a mechanical-restrictive basis, a pupillary relative afferent defect, nystagmus, and variable, non-specific visual field defects. Roentgenographic studies may show concentric unilateral enlargement of the optic canal with preservation of a well corticated margin, a fossa under the anterior clinoid process in continuity with the optic canal ('J'-shaped sella), and findings of increased intracranial pressure. On pathologic examination the tumor is a smooth, fusiform, intradural enlargement of the optic nerve. Histologically there is proliferation of elongated (pilocytic) astrocytes in reticulated patterns with intervening microcystic spaces containing mucosubstance and surrounding reactive hyperplasia of the arachnoid. Mitoses are not found. The diagnosis is clinical X-ray studies and brain scan should be performed. The differential diagnosis is that of unilateral proptosis in a child and includes acute ethmoiditis, hyperthyrobidism, craniostenosis, other neoplasms, Hand-Schuller-Christian disease, and orbital hemorrhage due to trauma. Surgical resection is performed in cases with unilateral optic nerve involvement, the surgical approach being determined by tumor location. Bilateral or chiasmal cases are treated with radiotherapy when progression occurs. Malignant optic nerve gliomas and optic nerve hyperplasia are also discussed. Optic nerve meningiomas arise from the nerve sheath and are to be distinguished from orbital meningiomas arising from ectopic arachnoidal cells or those secondarily involving the orbit by extension from adjacent sites. Up to 80% of orbital meningiomas occur in females, in two age peaks, 25% in the first decade, and the rest in the 5th decade. Meningiomas present with visual loss and may produce proptosis, papilledema and/or optic atrophy, retinal striae, opticociliary shunts, limitation of extra-ocular movements, and lid edema, Signs of von Recklinghausen's disease should be sought. X-rays are the mainstay of diagnosis. Orbital meningiomas are composed of cells in sheets or in whorls with some spindle shaped cells. Calcifications are typical. Usually the dura is penetrated and the orbit invaded. Primary orbital meningiomas are locally infiltrating but do not metastasize. Complete local excision en bloc is recommended...

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A Modified Kronlein Operation

Cited by 110 publications

References 7 publications

Intraorbital Abducens Nerve Schwannoma

Intraorbital Abducens Nerve Schwannoma

A sidewalk into the lateral orbit

Tumors of the optic nerve

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