—We were very much impressed by the interesting problem Gordon raised as the cause-and-effect relationship between the coexisting infection and fistulas or cysts, whereby he maintained that fistula or cyst formation should precede the course of infection rather than vice versa.Generally speaking, it might be just as hard to deny the fistula or cyst formation predating the infectious process as to disprove the reversed condition, eg, fistula or cyst formation presents itself as sequence of infection or trauma. As far as our series of 20 cases of orbital fistulas are concerned, we are rather inclined to define the cause-and-effect relationship between the fistula and infection in favor of the latter than of the former. Our conclusion was amply substantiated and confirmed by case history, data of physical examination, roentgenogram findings, and results of surgical exploration as well as of treatments. In no case of our series had
Wen-Ji W. Orbital Fistula, Infection, and Cysts-Reply. Arch Ophthalmol. 1984;102(7):972. doi:10.1001/archopht.1984.01040030778014
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