Orbitotemporal neurofibromatosis: a case report

Neurofibromatosis is an autosomal dominant abnormality that may affect multiple organ systems. The eyelids, the orbits, the adjacent tissues and bones may be involved with varying frequency and severity. The management of orbitotemporal neurofibromatosis depends very much on the type and severity of the orbital involvement and on the functional state of the eye. Experience with surgical management of orbitotemporal neurofibromatosis involved in the orbit, the temporal soft tissue and bone with blind eye is reported. The goal of surgery is tumor resection, reconstruction of the orbital socket, aesthetic eyelids, and insertion of the artificial prosthesis. A two stage approach is recommended. In the first stage, tumor is resected and the orbital socket is reconstructed with titanium mesh plate and cranial bone graft. After reconstruction of the orbital socket, galeal flap is rotated posteriorly to cover the mesh plate and canthopexy is accomplished. Mask lift is performed to enhance aesthetics. In the second stage, correction of the bulky eyelids is achieved and orbital space for insertion of the artificial prosthesis is reconstructed. Authors have managed a orbitotemporal neurofibromatosis with blind eye of a 41-year-old male using titanium mesh plate and bone graft with satisfactory results.

THE THERAPEUTIC EFFECTS OF THE Q-SWITCHED RUBY LASER ON TATTOOS AND PIGMENTED LESIONS OF KOREANS

The Q-switched ruby laser has been used in clinics since the early 1980s. It was tried to remove tattoos at first with good effects. Thereafter, some physicians reported the usefulness of the laser in the treatment of some kinds of pigmented lesions such as nevus of Ota, freckles and lentigines. The reason why the Q-switched ruby laser has a lot of effect on tattoos and some pigmented lesions is that the laser has the function of selective photothermolysis on those cutaneous lesions. The authors have treated 185 patients with tattoos and cutaneous pigmented lesions using the Q-switched ruby laser during last 4 years ago. Patients had tattoos, nevus of Ota, freckles, lentigines, melasma, postinflammatory hyperpigmentation, and were followed up over 5 months after the end of the laser treatment. The authors analysed the results and compared them with other's results in Caucasians, and we intended to present a guide of the treatment using Q-switched ruby laser in Koreans. The results were as follows 1. Tattoos showed good results after the treatment because the most of tattoos are black or dark blue in color and cheated by amateur. We repeated the laser treatments with the interval of 2 weeks. 2. Nevus of Ota, freckles and lentigines showed good results after treatment of the Q-switched ruby laser 3. Melasma showed no improvement after the treatment. 4. The treatment of postinflammatory hyperpigmentation using the Q-switched ruby laser must be confined within a part of the lesion at the first visit of patient, because the therapeutic effects were observed in some patients only and the degree of depigmention after treatment was diverse. 5. The most common complication after Q-switched ruby laser treatment was pigmentary change, including hyperpigmentation in most of the cases and hypopigmentation in some cases. However, there was no visible scar or remarkable change of skin texture in all of the cases.