Spectrum of Asymetrical Proptosis

Abstract

Objectives:  To discuss different aspects of unilateral proptosis in our institutions.

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. 

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. 

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.