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Radiology
Hypertelorism and Hypotelorism
Built from Obstetric Imaging
What’s inside
5 sections · 73 slides
Overview
- What this session covers
- The two words, unpacked
The fetal orbits on a normal scan
What is there, when you can see it, and the three numbers you take
- When the orbits become visible
- Why a rare finding still matters
- What can go wrong with the orbits
- Group one: the orbits are the wrong size or in the wrong place
- Group two: the lens and the jelly inside the eye
- Group three: something is growing in the orbit
- The three measurements you take
- Normal orbits and where the measurements are taken
- Where the calipers go for interocular and binocular distance
- What a normal orbit looks like on ultrasound
- The vessel that is meant to disappear
- How the eyes reach their final position
- Which planes to scan in
- Orbital biometry is not routine, so you have to ask for it
- “
Hypertelorism: the eyes are too far apart
Definition, why it happens, what it travels with, and the work-up it triggers
- What hypertelorism means
- Which number do you trust?
- How common, and when you must measure
- Why the orbits end up too far apart
- The three mechanisms in plain words
- When the midline is destroyed or the orbit is pushed
- The chromosome problems it travels with
- The classic syndrome to remember
- Other conditions on the list
- Nonchromosomal Syndromes Associated With Hypertelorism
- Findings on the left, the syndrome they point to on the right
- A child with Apert syndrome
- What to do the moment you see it
- The dedicated scan
- Which genetic test comes first
- The genetic tests, and what each one misses
- Wide-set orbits on ultrasound, three-dimensional imaging and MRI
- The widened gap on magnetic resonance imaging
- What magnetic resonance adds
- Widely spaced eyes after birth
- The bony gap between the orbits
- What you can tell the parents
Hypotelorism: the eyes are too close together
A narrow gap is a question about the brain, not about the eyes
- What hypotelorism means
- How often it happens
- The face predicts the brain
- Why the eyes end up close together
- When the skull is the problem, not the eyes
- The number to remember
- What to look for in the brain
- Narrow orbits and the brain behind them
- A single ventricle with no midline fissure
- An undivided fetal brain at 14 weeks
- The rest of the company it keeps
- Meckel-Gruber syndrome
- When sutures close too early
- The chromosome to think of first
- Three copies of chromosome 13
- Other Anomalies Associated With Hypotelorism
- The associations grouped by cause
- Which genetic test comes first here
- Look at the parents too
- The scan that must follow
- What the outlook depends on
- What magnetic resonance adds here
After the diagnosis
Treatment, where to deliver, and the three lines to carry away
- What happens after birth
- The surgical side
- Where the baby should be born
- The two findings side by side
- What the referring physician needs to know
- Key points
- Quick revision
- References
- References (continued)
- References (continued)
- Suggested readings
- Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition