ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

PurposeA new operation to correct lower eyelid laxity was evaluated.MethodsA new transcaruncular, orbital approach to posterior medial canthal tendon plication was performed on eight orbits of four cadavers, which were then analyzed with computed tomography or histologic techniques. The procedure was also performed on 23 eyelids of 15 patients with lower eyelid medial canthal tendon laxity, alone or in conjunction with other procedures. These patients were followed up for a mean of 12 months.ResultsImproved postoperative eyelid position, epiphora, and superficial punctate keratopathy were found. Radiographic and histologic analysis demonstrated consistency of suture placement without involvement of contiguous anatomical structures.ConclusionsThis procedure appears to be a safe, reproducible, and effective corrective procedure for medial canthal tendon laxity and lagophthalmos. When combined with lateral lower eyelid tightening, it is also an effective treatment for lower eyelid retraction and superficial punctate keratopathy. Other potential advantages and complications of this procedure are described in comparison to other reported surgical methods used to address medial canthal tendon laxity and malpositions of the medial lower eyelid.

ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

PurposeThis study describes and tests in a cadaveric model a new method of fixation designed for potential stabilization of the posterior limb of the medial canthal tendon, using biodegradable Tag anchors.MethodsStudy of the possibility of performing surgery to repair medial ectropion using biodegradable polyglyconate Tag anchors was commenced in the sheep cadaveric head model, and in the whole dry human skull model. This was then performed using five preserved human cadaveric whole heads, and pullout tensions were estimated in four of these. Computed tomography and magnetic resonance imaging were obtained for this model in the fifth head, and computed tomography was performed on the whole dry human skull. Dissections were carried out to establish the site of the bony defect in each of the heads.ResultsIt was possible to obtain good Tag anchor fixation in bone overlying the maxillary and ethmoidal sinuses of the sheep, and in a young human skull. It was also possible to place adequately the anchor in the medial wall of the orbit close to the posterior lacrimal crest in all cases in the human cadaveric model. Pullout strengths were evaluated and found to range from 3.5 N to 12.4 N (mean, 7.5 N). Computed tomography and magnetic resonance imaging failed to demonstrate the biodegradable anchors in both the dry human whole skull and in the fifth cadaveric head, but did demonstrate the bony defects in the medial orbital walls through which the anchor passed.ConclusionsWe have shown, for the first time, the stability of biodegradable Tag anchor fixation in a human cadaveric head model using pullout tensions and dissection studies. This method would allow adequate strength and stability to provide for control of fixation of the medial end of the lower eyelid in patients with medial ectropion and medial canthal tendon laxity.

ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

PurposeTo describe tissue-conserving modifications to traditional flap design such as the use of beveled incisions and the pattern of the incisions. These techniques should maintain flap viability and enhance cosmesis.MethodsWe describe the techniques of peripheral flap recruitment.ResultsFlaps conformed to reduced geometry, beveled incisions and bases, and tapered ends maximize vascularity. Peripheral tissues are recruited to fill primary defects; smaller flaps thus can be used to fill larger defects. Additionally, this flap design enhances cosmetic results and maintains a high probability for flap survival.ConclusionThe described novel flap design has many potential advantages over traditional designs. Correctly applied, these flap techniques spare tissue, decrease scarification, trauma and bleeding, and reduce the need for secondary procedures. Potential drawbacks of this flap design include temporary anatomic distortion especially over rounded structures such as the nose. Complications are minimal.

ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

PurposeTo describe an evisceration technique that combines scleral modification with optic nerve release for coverage of any sized orbital implant.MethodsThe medical records of 70 patients who underwent the described evisceration procedure were reviewed.ResultsThe average implant was 20 mm in diameter, with 50 patients (71%) receiving a solid polymethylmethacrylate sphere. Fifty-eight patients (83%) had a history of at least one previous ocular surgery, and 12 patients (17%) had phthisical eyes preoperatively with moderate to severe scleral cicatrization. Postoperatively, there were two cases of new or worsened ptosis, no cases of worsened motility, and no cases of implant extrusion.ConclusionEvisceration with scleral modification is a simple and effective procedure that allows placement of any size orbital implant. Surgical results are excellent with few complications.

ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

PurposeThis study describes lacrimal tract involvement and surgical outcome in patients with mucocutaneous leishmaniasis.MethodsFour patients, ages 20 to 75 years, had nasal lesions resulting from mucocutaneous leishmaniasis and sought treatment for chronic dacryocystitis. Each patient had had lacrimal symptoms since childhood or early adulthood, concomitantly with the development of upper airway lesions. Dacryocystography showed nasolacrimal duct stenosis in all cases on the affected side. Three patients underwent dacryocystorhinostomy (one bilaterally), and one patient had bilateral dacryocystectomy.ResultsTwo patients had surgical fistula closure soon after surgery. A sequential endoscopic operation for remotion of a synechia between the fistula and the middle turbinate was successful in one of these patients. Histopathologic analysis of lacrimal sacs and nasal mucous membranes close to the anastomotic site revealed chronic nonspecific inflammatory process and negative immunohistochemistry forLeishmania.ConclusionsDacryocystitis may result from nasal mucocutaneous leishmaniasis. The surgical outcome was unsatisfactory in one of the four patients.

ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

PurposeA two-stage reconstruction of cryptophthalmia and euryblepharon occurring in the same patient is described.MethodsCase report.ResultsThe 7-month-old patient underwent forniceal reconstruction and upper eyelid reformation in a two-stage procedure that used the excess lower eyelid tissue present in euryblepharon to augment the cryptophthalmia-related upper eyelid deficiency.ConclusionsTo reconstruct the eyelids of this patient with both cryptophthalmia and euryblepharon, we were able to use the manifestations of one disorder to address the deficiencies of the other.

ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

PurposeAn uncommon congenital anomaly of the eyebrows is described.MethodsCase report and review of the literature.ResultsTwo articles in the English literature were found describing patients similar to ours.ConclusionsCongenital upward tenting of the midportion of the eyebrows, resembling the eyebrow line of an owl, is uncommon. This anomaly is thought to be transmitted in an autosomal dominant fashion and may be accompanied by myopia and strabismus, but has not been associated with systemic disease.

ISSN:0740-9303    

出版商:OVID    

年代:2001

数据来源: OVID