ISSN:1040-8738    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Purpose of reviewOrbital facial fractures are a common result of facial trauma. Enophthalmos, diplopia resulting from extraocular muscle dysfunction, and infraorbital nerve hypesthesia may occur. The indications and timing for fracture repair are debated.Recent findingsThe timing and treatment indications for orbital facial fractures are evolving. For orbital floor fractures, nonresolving oculocardiac reflex, the “white-eyed” blowout fracture, and early enophthalmos or hypoglobus are indications for immediate surgical repair. Surgery within 2 weeks is recommended in cases of symptomatic diplopia with positive forced ductions and evidence of orbital soft tissue entrapment on computed tomography examination or large orbital floor fractures, which may cause latent enophthalmos or hypo-ophthalmos. For midfacial, lateral, supraorbital, medial wall, and nasoethmoidal fractures, repair within 2 weeks is indicated to avoid difficult repair from immediate posttraumatic wound healing.SummaryOrbital facial fracture management is germane to ophthalmologists, plastic surgeons, otolaryngologists, and others who treat patients.

ISSN:1040-8738    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Purpose of reviewChemodenervation has evolved greatly over the past 30 years since botulinum toxin was first introduced as a therapeutic injection for managing strabismus.Recent findingsBotulinum toxins are now accepted as a first-line treatment for patients suffering from spasms secondary to facial dystonias. These treatments are extremely effective and well tolerated by most patients. New agents including doxorubicin, Doxil, and ricin mab35 are being developed to create a longer-lasting treatment option for patients with facial dystonias. Recently the use of chemodenervation for managing facial wrinkles has expanded the use of these agents. The botulinum toxins have been found to be extremely efficacious in managing facial wrinkles, especially in the upper half of the face. The federal drug administration approved the use of Botox (Allergan, Irvine, CA) for glabellar furrows. Periocular crow's feet lines and horizontal forehead lines are also amenable to treatment with the botulinum toxins. Further uses including chemical browlift, as well as lower face and neck line treatments have also been described.SummaryThe use of the botulinum toxins has revolutionized the treatment of a broad array of diseases from benign essential blepharospasm to facial wrinkles.

ISSN:1040-8738    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Purpose of reviewIn recent years, many new products and techniques have arisen that are useful in the rejuvenation of facial skin. Most of the therapies are directed at improving the results of photoaging. These cutaneous changes occur from chronic exposure to ultraviolet B light (290 to 320 nm) associated with sunburn, and ultraviolet AII light (320 to 340 nm), and ultraviolet AI light (340 to 400 nm) associated with photoaging. Clinically chronic photoaging may result in fine wrinkles, texture abnormalities, pigment dyschromias, and actinic keratoses.Recent findingsMany methods of patient assessment are available, but the most useful include the Fitzpatrick skin type classification and the Glogau photoaging scale. Although many therapies are available to reduce or even reverse many of these aging changes, patient education regarding lifestyle changes (especially smoking cessation) and sun avoidance need to be a critical foundation of treatment. Indeed, patient participation in their own skin care regimen is important for any program to be effective. Topical therapy including tretinoins, hydroxy acids, bleaching agents, and sunscreens are discussed herein.SummaryThe physician has an important role in understanding which treatment options are appropriate for mild, moderate, and severe photoaging, and in educating patients on the risks and benefits of each. This includes resurfacing modalities with microdermabrasion, chemical peels, and laser skin resurfacing.

ISSN:1040-8738    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Purpose of reviewThe only constant in face lift surgery is the goal—rejuvenation of the lower two thirds of the face and neck. Societal shifts have focused patients on less invasive procedures, with less downtime and more rapid return to daily activities.Recent findingsThe lateral SMASectomy procedure has proven to be an effective technique, with a high degree of safety, minimal morbidity, and high patient satisfaction. Additionally, younger patients often require less extensive procedures to achieve an aesthetically desirable result. Recent advances such as the short scar face lift with SMASectomy, and the S-lift, have centered upon less invasive approaches to lower face and neck restoration. The optimal technique for correction of platysma bands also remains elusive, with multiple options available. All procedures dramatically benefit from the use of tumescent anesthesia to decrease operative time, postoperative morbidity, and recovery time.SummaryThere is no single ideal technique for each patient. The procedure used must be individualized for each patient's unique anatomy and goal for surgical restoration.

ISSN:1040-8738    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Purpose of reviewIn this text, we describe and compare the most current brow-lifting techniques, including endoscopic, coronal, and pretrichial approaches, as well as subperiosteal and subgaleal dissection planes, and we discuss the advantages and disadvantages of each.Recent findingsOver the past decade, we have witnessed tremendous advances in the anatomic understanding of brow ptosis and in the procedures used to correct the resulting functional and aesthetic deformities.

ISSN:1040-8738    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Purpose of reviewThis article reviews the literature on pediatric refractive surgery from 1995 to 2003 and discusses the practical issues surrounding the application of modern refractive surgery to children.Recent findingsPreliminary data show that refractive surgery can be successfully performed in children and that the short term complication rate seems to be similar to that reported in adults.SummaryRefractive surgery may hold promise for cases in which traditional treatment methods have failed. Additional study is needed to define the role of refractive surgery in children and in the treatment of amblyopia and strabismus.

ISSN:1040-8738    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Purpose of reviewRecent studies on the various forms of infantile-onset nystagmus have advanced our understanding of these disorders. The previously described waveforms of infantile nystagmus syndrome (congenital nystagmus) may be identified in infants less than 7 months of age, including the more mature forms; the visual status of these patients may be directly correlated with their mean foveation times.Recent findingsRefractive errors in patients with infantile nystagmus syndrome do not follow the expected trend toward emmetropization during infancy and early childhood. A study on the torsional component of nystagmus present in most patients with infantile nystagmus syndrome found it to be generated centrally and not by peripheral or mechanical dynamics. Two psychophysical studies on patients with infantile nystagmus syndrome revealed significant differences compared with control subjects. Two different animal models imply that lack of normal visual motion during a critical period of development in infancy leads to infantile nystagmus syndrome. An electron microscopic study of the enthesis site—where the extraocular muscle tendon inserts onto the sclera—in normal individuals versus patients with infantile nystagmus syndrome revealed significant abnormalities in the latter. Significant demographic and socioeconomic differences were reported between patients with infantile nystagmus syndrome and those with spasmus nutans.SummaryNew evidence supports a role for sympathomimetic modulation of infantile nystagmus syndrome. Novel surgical treatments for infantile nystagmus syndrome are also discussed.

ISSN:1040-8738    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Purpose of reviewThis review highlights recent advances in basic science and clinical research on retinopathy of prematurity (ROP).Recent findingsThe modern concept of ROP pathophysiology is discussed, as are studies investigating anti-angiogenic agents for treatment. Results of the largest clinical trials are summarized. Current screening criteria, potential modifications to them, and telephotoscreening are discussed.SummaryROP is a challenging and involving area of pediatric ophthalmology.

ISSN:1040-8738    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Purpose of reviewOver the past 10 years, the treatment of retinoblastoma has changed dramatically. The main impetus for these changes, which are more intensive than traditional modalities and require a multidisciplinary approach, has been the avoidance of the serious, often fatal, complications of external beam radiation. The use of potent, well known chemotherapy agents in a novel setting (ie,intraocular tumor) has been successful in treating all but the most advanced disease.Recent findingsThis review will examine recent published work with chemotherapy and local (focal laser) treatment for intraocular (curable) retinoblastoma. Specifically, the concepts behind and the practice of chemoreduction and thermochemotherapy and their efficacies will be evaluated.SummaryThe work discussed herein constitutes an extremely nascent and dynamic field of work in ocular oncology. Much uncertainty remains, especially as most of these patients will live for many decades after their presentation and treatment. The review will show that a significant number of treatment failures still occur and that continued work is needed before we can feel confident treating young patients with all forms of this rare tumor.

ISSN:1040-8738    

出版商:OVID    

年代:2003

数据来源: OVID