The radiological investigation of proptosis

Abstract

A series of 212 patients investigated for proptosis are reviewed. The important categories are: (1) intracranial causes of proptosis; (2) lesions causing proptosis which originate in the paranasal sinuses or nasopharynx; and (3) intra-orbital causes. The intracranial lesions in the series were all diagnosable either on plain X-ray or on carotid angiography, while the sinus and naso-pharyngeal conditions were diagnosed on plain X-ray aided in some cases by tomography. The intraorbital lesions were the most difficult to diagnose radiologically. In a series of 37 patients with proved intraorbital pathology, nine failed to show any abnormality either on plain X-ray or contrast investigation, and in only 14 (38 per cent) was the correct aetiology suggested pre-operatively. The plain X-ray changes in this group are discussed in detail followed by a description of the contrast techniques used to investigate the orbit, viz.: carotid angiography, orbital pneumography and orbital venography. A brief evaluation of these techniques is given based upon the knowledge gained from this series.