ABSTRACT
Introdução: A ptose palpebral ou blefaroptose caracteriza-se pela disfunção, ou inabilidade do paciente em realizar a abertura da fenda palpebral de maneira normal. Geralmente é decorrente do acometimento do músculo levantador da pálpebra, possuindo diferentes etiologias, quais sejam, congênitas ou adquiridas. Método: No período de 2005 a 2008, foram diagnosticados 16 pacientes portadores de ptose palpebral, totalizando 24 pálpebras submetidas a tratamento cirúrgico, pelo autor. Foram realizadas 18 cirurgias abordando a fáscia do músculo levantadore, em 6 casos, a ressecção do músculo levantador da pálpebra. Resultados: O grau de ptose nos casos estudados variou entre 2,0 e 7,0 mm, com média de 4,33 mm. Os resultados pós operatóriosforam avaliados por meio de exame físico e de análise fotográfica e classificados em insatisfatórios, regulares e bons, de acordo com o grau de ptose residual. A média de seguimento foi de 14,87 meses. Em 83,3% dos casos, os resultados foram considerados bons, em 12,5%, regulares e, em 4,16%, insatisfatórios. A complicação mais frequentemente observada foi a hipocorreção cirúrgica e a assimetria entre as fendas palpebrais. Encontrou-se um caso com retração cicatricial na pálpebra superior e apenas um paciente foi submetido à revisão cirúrgica após seis meses do ato operatório.
Introduction: Eyelid ptosis or blepharoptosis is characterized by dysfunction or the patientsinability to elevate the upper eyelid normally. It is usually due to a compromised levator muscle and has different etiologies, namely congenital or acquired. Method: From 2005 to 2008, 16 patients were diagnosed with ptosis, perfoming a total of 24 surgically treated eyelids. Eighteen surgeries were performed approaching the fascia of the eyelid levator muscle and in 6 cases through resection of the eyelid levator muscle. Results: The degree of ptosis in the cases studied ranged between 2.0 and 7.0 mm, with an average of 4.33 mm. The postoperative results were evaluated by physical examination and photographic analysis and classified as poor, fair and good, according to the degree of residual ptosis. The average follow-up was 14.87 months. In 83.3% of the cases, the results were considered good, regular in 12.5% and in 4.16% unsatisfactory. The most frequently observed complication was surgical under correction and asymmetry of the eyes. In one case we could observe of scar retraction in the upper eyelid and only one patient underwent surgical revision six months after the initial surgery.
Subject(s)
Humans , Male , Female , Child , Adult , Middle Aged , Blepharoplasty , Blepharoptosis , Eyelid Diseases , Phenylephrine , Surgical Procedures, Operative , Surgical Wound Dehiscence , Diagnostic Techniques and Procedures , Methods , PatientsABSTRACT
Scalp avulsion is a devastating physical, functional, and psychological injury to patients. The emergence of surgery and the first replantation by Miller, in 1976, was a major breakthrough in the management of scalp avulsion that became the treatment of choice, whenever possible.This study aims to present the 7 last years of experience of the Discipline of Plastic Surgery of the Medical School of the University of São Paulo and to compare it with the literature, so as to standardize the care for the cases herein addressed and thus achieve the best possible results.The cases presented consist of 6 female patients with scalp avulsion, their ages ranging between 9 and 29 years. Warm ischemia time ranged between 9 and 25 hours (average 14 hours). Four cases were totally successful, one case was partially successful (40 (per cent)), and the remaining cases lost the replantation.The current techniques and the structure available in specialized facilities enable the appropriate management of avulsed scalps through microsurgical replantation, thus leading to satisfactory results that are superior to the previously available options.