Mohammad Said, Mumtaz Ali, Safeer Zaman Zahid Khan.
Spectrum of Asymetrical Proptosis.
Pak J Neuro Surg Jan ;14(2):92-5.

Objectives: To discuss different aspects of unilateral proptosis in our institutions.Material and Methods:Study Design: Observational study.Place and Duration: Department of Neurosurgery/Head and Neck, PGMI, Govt Lady Reading Hospital, Peshawar. Pakistan from May 2004 – April 2008. All patients presented to outpatient clinic of Neurosurgery and ENT departments along with referred cases to these both departments were included in this study. These patients were analyzed in detail. Apart from local ENT examination and neurological examination, ophthalmological and systemic examination was also carried out. Relevant investigations were carried out to see the effects on anatomy as well as on physiology of globe. Patients with bilateral proptosis, relative proptosis due to crowzen's syndrome, Apart's syndrome and post traumatic proptosis were excluded. All these patients were managed surgically either individually or as team case by combined approach in the department. The data was analyzed using SPSS.Results: Thirty eight (38) patients with asymmetrical proptosis in this study were analyzed with regard to their sex, age, site of proptosis, origin and extent, surgical approach adapted, per operative and histological diagnosis. There were 22 male and 16 female patients with male and female ratio of 1.4 and 1. The age range was from 8-65 years with median age of 36.5 years. X-ray skull, PNS and CT brain including orbits and fronto nasal sinuses were done in all cases and MRI in 18 cases. Right sided proptosis was seen in 28 and left side in 10 cases. There were 11 cases of pediatric age group and 27 young and adult groups. A variety of different disorders were observed responsible for unilateral proptosis. These disorders were Orbitonasal encephalocele, Angiofibroma, Metastatic deposits, Hydatid cyst, Aneurismal bone cyst (ABC), Lymphoma, Meningioma, Fibrous dysplasia, post traumatic growing skull fracture and Plexiform neurofibroma. Surgical procedures adopted during surgery were lateral, medial orbitotomy, lateral rhinotomy, skull base sub frontal craniotomy and extradural transcranial orbitotomy.Conclusion: Variety of causes is responsible for unilateral proptosis which present in clinical practice to both ENT and Neuro surgeons. Team work helps a lot in making proper protocol.

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