Pediatric canalicular laceration repair using the Mini Monoka versus Masterka monocanalicular stent / Correção de laceração canalicular pediátrica usando os stents monocanaliculares Mini-Monoka versus Masterka

ABSTRACT Purpose: One of the most important disadvantages of using Mini Monoka stents in pediatric canalicular laceration repair is premature stent loss. In this study, we aimed to compare clinical outcomes between the use of Mini Monoka and Masterka monocanalicular stents in children and discuss the potential causes of premature stent loss. Methods: The medical records of 36 patients who underwent surgical repair of canalicular lacerations were retrospectively reviewed. Children aged <18 years who underwent canalicular laceration repair with either Mini Monoka or Masterka and had at least 6 months of follow-up after stent removal were included in the study. The patients' demographics, mechanism of injury, type of stent used, premature stent loss, and success rate were analyzed. Success was defined as stent removal without subsequent epiphora and premature stent loss. Results: Twenty-seven children fulfilled our study criteria, and their data were included in the analyses. Mini Monoka was used in 14 patients (51.9%), whereas Masterka was used in 13 patients (48.1%). The preoperative clinical features, including age, sex, and mechanism of injury, were similar between the two groups. The mean age was 8.3 ± 5.5 years in the Mini Monoka group and 7.8 ± 5.9 years in the Masterka group (p=0.61). Three patients in the Mini Monoka group (21.4%) underwent reoperation due to premature stent loss. No premature stent loss was observed in the Masterka group. As a result, the rate of success was 78.6% in the Mini Monoka group, whereas it was 100% in the Masterka group (p=0.22). Conclusions: Even though the two groups did not show any statistically significant difference in success rate, we did not observe any premature stent loss in the Masterka group. Further studies with larger and randomized series are warranted to elaborate on these findings.

RESUMO Objetivo: Uma das desvantagens mais importantes do uso de stents Mini Monoka no reparo de lacerações canaliculares pediátricas é a perda prematura do stent. Neste estudo, objetivamos comparar os resultados clínicos dos stents monocanaliculares Mini Monoka e Masterka em crianças e discutir as possíveis causas da perda prematura do stent. Métodos: Foram incluídos nesta revisão retrospectiva 36 pacientes <18 anos de idade que se submeteram ao reparo cirúrgico de uma laceração canalicular com um stent Mini Monoka ou Masterka e tiveram pelo menos 6 meses de acompanhamento após a remoção do stent. Foram analisados os dados demográficos, o mecanismo da lesão, o tipo de stent utilizado, a ocorrência de perda prematura de stent e o sucesso da intervenção. O sucesso foi definido como a ausência de epífora após a remoção do stent, sem a perda prematura deste. Resultados: Vinte e sete pacientes preencheram os critérios do presente estudo e foram incluídos nas análises. O stent Mini Monoka foi usado em 14 pacientes (51,9%), enquanto o Masterka foi usado em 13 pacientes (48,1%). As características clínicas pré-operatórias, incluindo idade, sexo e mecanismo de lesão, foram semelhantes entre os dois grupos. A média de idade foi de 8,3 ± 5,5 anos no grupo Mini Monoka e de 7,8 ± 5,9 anos no grupo Masterka (p=0,61). Três pacientes do grupo Mini-Monoka (21,4%) tiveram que ser operados novamente por perda prematura do stent. Nenhuma perda prematura do stent foi observada no grupo Masterka. Como resultado, a taxa de sucesso foi de 78,6% no grupo Mini Monoka e de 100% no grupo Masterka (p=0,22). Conclusões: Embora nenhuma diferença estatisticamente significativa tenha sido detectada entre os dois grupos em termos de taxas de sucesso, não observamos nenhuma perda prematura de stent no grupo Masterka. São necessários mais estudos, com séries maiores e randomizadas, para chegar a maiores conclusões sobre esses achados.

Application of Worst lacrimal probe combined with modified lacrimal duct threading intubation in anastomosis of complex canalicular laceration / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the application value of Worst lacrimal probe combined with modified lacrimal duct intubation in anastomosis of complex canalicular laceration.METHODS: Retrospective study. A total of 68 cases(68 eyes)with complex traumatic canalicular laceration treated in the ophthalmology department of the Second Affiliated Hospital of Zunyi Medical University from March 1, 2019 to March 31, 2021 were selected. They were divided into two groups according to the surgical methods, with 36 patients(36 eyes)who were treated with the Worst lacrimal probe to find the broken end of lacrimal duct combined with improved lacrimal duct threading intubation in group A, and 32 patients(32 eyes)who were treated with microscope to find the broken end of lacrimal duct and two-way intubation anastomosis canaliculus intubation in group B. The clinical efficacy, success rate of intraoperative search for the broken end of lacrimal duct, searching time, operation time, the degree of pain, postoperative ocular foreign body sensation and complications were compared between the two groups.RESULTS: The total effective rate of clinical efficacy in patients of group A was higher than that in group B(94% vs. 38%), the success rate of intraoperative search for broken end of lacrimal duct was higher than that in group B(100% vs. 47%), the searching time and operation time were shorter than those in group B, and the score of pain degree was lower than that in group B(all P&#x0026;#x003C;0.05). The postoperative follow-up for 6mo-1a showed that the ocular foreign body sensation score, the incidence of lacrimal punctum rupture and morphological change, and the degree of tear overflow in group A were all lower than those in group B(all P&#x0026;#x003C;0.05).CONCLUSION: Worst lacrimal probe combined with modified lacrimal duct intubation for the treatment of complex traumatic canalicular laceration can find the broken end of lacrimal duct more accurately, shorten the operation time, reduce the pain and foreign body sensation of patients, improve clinical efficacy and reduce the incidence of complications.

Safety and efficacy of lacrimal canalicular plug in the treatment of severe chronic ocular graft-versus-host disease / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the safety and efficacy of lacrimal canalicular plug in the treatment of severe chronic ocular graft-versus-host disease(coGVHD).METHODS: Retrospective study. A total of 9 patients with severe coGVHD admitted to the dry eye clinic of the Affiliated Hospital of Xuzhou Medical University from June to September 2022 were included. All patients underwent binocular inferior lacrimal canaliculus plug. Ocular surface disease index(OSDI)score, tear meniscus height(TMH), corneal fluorescein staining(CFS)scores, conjunctival lisamine green staining(CLGS)score, noninvasive breakup time(NIBUT), Schirmer Ⅰ test(SⅠt)and the infiltration of Langerhans cells in the superficial corneal stroma tested by confocal corneal microscopy were observed before treatment and at 1 and 3 mo after treatment. At the same time, the complications related to lacrimal canalicular plug implantation were evaluated.RESULTS: The OSDI score decreased from 67.33±12.64 before treatment to 21.89±6.07 after 3mo of treatment(P&#x003C;0.01); TMH increased from 0.09±0.02mm to 0.21±0.03mm after 3mo of treatment(P&#x003C;0.05), and NIBUT increased from 2.24±0.68s before treatment to 6.77±2.05s after 3mo of treatment(P&#x003C;0.01). In addition, the CFS and CLGS also changed significantly, from 9.11±1.45 and 6.33±1.00 before treatment to 2.22±0.67 and 2.56±0.88 at 3mo after treatment, respectively(all P&#x003C;0.01). The density of Langerhans cells decreased from 140.22±38.18cells/mm2 before treatment to 39.67±9.75cells/mm2 3mo after treatment(P&#x003C;0.01). SⅠt showed no significant difference before and after treatment(F=0.059, P=0.943). During the whole follow-up period, no complications such as plug abscission were observed.CONCLUSION: Lacrimal canalicular plug is safe and effective in the treatment of severe coGVHD. It can significantly improve the symptoms and signs of dry eye patients and reduce inflammatory reaction.

Effect of nasolacrimal duct packing combined with sodium hyaluronate gel injection in locating the nasal broken end in lacrimal canaliculus anastomosis which is difficult to find the broken end / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the effect of nasolacrimal duct packing combined with sodium hyaluronate gel injection in locating the nasal broken end in lacrimal canaliculus anastomosis which is difficult to find the broken end.METHODS:A total of 13 patients(13 eyes)with traumatic single lacrimal canaliculus rupture were treated in our hospital. RS lacrimal duct drainage tube was inserted into the lacrimal duct from intact lacrimal canaliculus to fill the nasolacrimal duct, then sodium hyaluronate gel was injected to make sodium hyaluronate gel overflow from the nasal broken end of fractured lacrimal canaliculus, which was used to locate the nasal broken end which was difficult to find and completed the lacrimal anastomosis operation.RESULTS: Among the patients with 13 eyes who were difficult to find the broken end, the nasolacrimal duct was filled with RS lacrimal duct drainage tube. After injection of sodium hyaluronate gel, the gel overflowed from the nasal broken end under direct vision of the microscope, and the lacrimal duct drainage tube was successfully inserted, and the success rate of finding the broken end was 100%. Thirteen eyes were extubated after being placed for 3mo, and then were followed up for 6mo. Among them, 9 eyes were cured, 3 eyes were markedly effective and 1 eye was ineffective. The cure rate was 69%, and the total effective rate was 92%.CONCLUSION: A new technique for rapid location of nasal broken end is proposed for patients in which are difficult to find the broken end. This method is simple to operate and requires a relatively low clinical experience. It is suitable for patients with different degrees of single lacrimal canaliculus rupture and can complete complex lacrimal canaliculus rupture anastomosis in a short time.

Técnicas de reposicionamiento canalicular efectivas para rehabilitación del vértigo posicional paroxístico benigno / Técnicas de reposicionamiento canalicular efectivas para rehabilitación del vértigo posicional paroxístico benigno / Effective canalicular repositioning techniques for rehabilitation of benign paroxysmal positional vertigo

El Vértigo Posicional Paroxístico Benigno es uno de los diagnósticos más comunes y consultados en la práctica clínica de patologías de vértigo, por lo tanto, el presente artículo tiene como finalidad, describir las técnicas de reposicionamiento canalicular más utilizadas por Audiólogos expertos en rehabilitación vestibular específicamente para los conductos semicirculares de mayor prevalencia que se ven afectados en esta patología, los cuales son; el conducto semicircular posterior y el conducto semicircular horizontal, en contraste con las técnicas de mayor efectividad reportadas en la literatura. Lo anterior, sustentado en la aplicación de una encuesta, y, revisión de literatura especializada a través de una metodología con enfoque cualitativo y alcance descriptivo, se encuestó a doce Audiólogos especialistas en rehabilitación vestibular mediante la técnica bola de nieve. En cuanto a la revisión de literatura científica se tuvo en cuenta publicaciones de los últimos cinco años de bases de datos especializadas, seleccionando quince artículos de acuerdo con los criterios de inclusión, obteniendo como resultado que actualmente existe correspondencia entre las técnicas recomendadas en la literatura y las aplicadas en la práctica audiológica.

Benign Paroxysmal Positional Vertigo is one of the most common and consulted diagnoses in the clinical practice of vertigo pathologies, therefore, the purpose of this article is to describe the Canalicular repositioning techniques most used by expert Audiologists in vestibular rehabilitation specifically for the most prevalent semicircular canals that are affected in this pathology, which are the posterior semicircular canal and the horizontal semicircular canal, in contrast to the most effective techniques reported in the literature. The above, based on the application of a survey and review of specialized literature through a qualitative approach methodology with descriptive scope, twelve Audiologists specialized in vestibular rehabilitation were surveyed by means of the snowball technique. As for the review of scientific literature, publications of the last five years of specialized databases were taken into account, selecting fifteen articles according to the inclusion criteria, obtaining as a result that currently there is correspondence between the techniques recommended in the literature and those applied in audiological practice.

Clinical effect of new silicone tube retrograde catheterization in the treatment of lacrimal canaliculus rupture in children / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To observe the clinical effect of retrograde lacrimal duct drainage tube(RS-1 type)in the treatment of lacrimal canaliculus rupture in children.<p>METHODS: The clinical data of 37 cases(37 eyes)with lacrimal canaliculus rupture admitted to Handan Eye Hospital and Handan Central Hospital from March 2016 to November 2019 were retrospectively analyzed. New silicone tubes were retrograde implanted in all patients during the operation. 8-0 absorbable sutures were used to anastomose the broken end of the lacrimal canaliculus, 6-0 absorbable sutures were used to anastomose the “medial canthus ligament-orbicularis” complex intermittently, and muscle, subcutaneous tissue, skin wounds and conjunctival wounds were sutured intermittently. The catheter was extubated 2-3mo after operation, and the lacrimal passage patency and lacrimal ectorrhea were observed for 6-12mo. <p>RESULTS: Totally 31 eyes(84%)were cured, 5 eyes(14%)were improved, and 1 eyes(3%)was ineffective. The total effective rate reached 97%. None of the patients had lacrimal dot tearing, abnormal location of lacrimal dot, angulation deformity and other related complications, and 1 invalid eyes(3%)was combined with bone lacrimal tubule fracture, without obvious lacrimal ectorsion symptoms.<p>CONCLUSION: The new type of silicone tube combined with retrograde catheterization has the characteristics of simple operation, light postoperative stimulation, safe catheterization state and significant anastomosis effect. The retrograde catheterization can better protect the small lacrimal spots.

Management of pediatric canalicular lacerations with the RS-1 silicone tube and the conventional silicone tube / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the clinical effecacy of the RS-1 silicone tube and the conventional silicone tube in the management of pediatric canalicular lacerations.<p>METHODS: We retrospectively reviewed the medical records of 48 pediatric patients(48 eyes)with canalicular lacerations admitted for primary repair in the Department of Ocular Trauma of Hebei Eye Hospital from January 2015 to June 2018. The patients were divided into two groups according to the treatment of method: Group A(25 patients, the conventional silicone tube), Group B(23 patients, the RS-1 silicone tube). The management of pediatric canalicular lacerations were performed under general anesthesia. The silicone tube was removed about 3mo after surgery. The surgical time, clinical efficacy and complications were compared.<p>RESULTS: The mean surgical time between the two groups was 44.92±14.45min in Group A and 31.78±7.40min in Group B, which was statistically significant difference(<i>t</i>=4.02, <i>P</i><0.01). The clinical efficacy of the two groups was compared. Group A: 20 patients were cured(80%), 2 patients were improved(8%), 3 patients were failed(12%), and the functional success rate was 88%. Group B: 19 patients were cured(82%), 2 patients were improved(9%), 2 patients were failed(9%), the functional success rate was 91%, which was not statistically significant difference(χ2=0.14, <i>P</i>>0.05). The incidence of complications(32% <i>vs</i> 9%)including lower lacrimal point and mild eyelid eversion(1 patient 4% <i>vs</i> 1 patient 4%), slit canaliculus(2 patients 8% <i>vs</i> 1 patient 4%), early tube extrusion(3 patients 12% <i>vs</i> 0%), and nasal mucosal injury(3 patients 12% <i>vs</i> 0%)in Groups A and B, respectively, were comparable. There was statistically significant difference in the incidence of complications between the groups(χ2=3.94, <i>P</i><0.05).<p>CONCLUSION: There is no statistically significant difference with the two different types of silicone tube, which have good clinical efficacy, in the management of pediatric canalicular lacerations. But the RS-1 silicone tube is easier to operate, shorter surgical time, less complications and easier to removed.

The Trans-Scale Conduction Behavior of Fluid Stimulation in Loaded Bone / 医用生物力学

Objective To investigate the conduction behavior of fluid flow induced by physiological loads at different scales of bone. Method sThe multiscale bone models were established by using the COMSOL Multiphysics software, and the fluid behaviors were investigated at macro-, meso- and micro-scale. Results At macro-meso scale，the distribution of pore pressure and fluid velocity of osteon near the periosteum and endoosteum were different from that in other parts. Due to the different structure and material parameters at different layers, the loading and fluid pressure caused different biomechanical responses in the process of transferring from macro-scale to micro-scale. Conclusions The multi-scale layered modeling of bone structure-osteon-lacunae-bone canaliculi was established, which provided the theoretical reference for deeper understanding of fluid stimulation and mechanotransduction.

Trauma palpebral severo / Severe palpebral trauma

RESUMEN La ubicación anatómica de los párpados los predispone a ser dañados frecuentemente por causas traumáticas. Se informa la evolución de un paciente masculino, de 22 años de edad, remitido a la Consulta de Urgencia del Instituto Cubano de Oftalmología "Ramón Pando Ferrer" por presentar trauma palpebral grave en su ojo izquierdo producido por un alambre. Al examen oftalmológico se constató colgajo extenso del párpado superior, que colgaba fijado de la porción temporal. Se comprobó herida horizontal de la aponeurosis del elevador del párpado superior, de bordes anfractuosos, que se extendía a todo el párpado, así como sección del canalículo superior. Se confirmó el diagnóstico de herida avulsiva grave, con afectación del borde libre palpebral y sección del canalículo superior. Se decidió la conducta quirúrgica: reconstrucción palpebral, que incluyó aponeurosis del músculo elevador del párpado superior, canalículo superior con sonda bicanalicular y borde libre palpebral. Durante el seguimiento se constataron buenos resultados estéticos y funcionales. El conocimiento de la anatomía palpebral y una reconstrucción minuciosa de los tejidos palpebrales permiten resultados posquirúrgicos excelentes en un trauma palpebral grave(AU)

ABSTRACT The anatomical location of the eyelids predisposes them to be frequently damaged by traumatic causes. The evolution of a patient aged 22 years is reported, who was referred at Ramón Pando Ferrer Cuban Institute of Ophthalmology for presenting severe eyelid trauma in his left eye caused by a wire. The ophthalmological examination showed a large flap of the upper eyelid, which hung fixed from the temporal portion. Horizontal wound of the aponeurosis of the upper eyelid elevator, with an abnormal fracture, which extended to the entire eyelid, as well as section of the upper canaliculus, was found. The diagnosis of severe avulsive wound was confirmed, with involvement of the palpebral free edge and section of the upper canaliculus. Surgical behavior was decided: eyelid reconstruction, which included aponeurosis of the upper eyelid lift muscle, upper canaliculus with bicanalicular probe and palpebral free edge. During the follow-up, good aesthetic and functional results were observed. The knowledge of the eyelid anatomy and a thorough reconstruction of the eyelid tissues allow excellent post-surgical results in severe eyelid trauma(AU)

Clinical observation of two surgical methods based on a new type of lacrimal canalicular anastomosis device / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To evaluate the clinical effect of two surgical methods based on a new type of lacrimal canalicular anastomosis device.<p>METHODS:In this research, we observed eighty relative cases(80 eyes)of traumatic lower canalicular laceration and all clinical assessments were performed during and after operation. Two kinds of probes were used for lacrimal canalicular anastomosis. The elastic pigtail probe was used for double lacrimal canalicular intubation(experience group)and the straight probe was used for single lacrimal canalicular intubation(control group).<p>RESULTS: The average time of intubation was 12.1±3.7min in experience group and 21.2±5.5min in control group(<i>t</i>=8.68, <i>P</i><0.05), and the average time of total operations was 28.9±5.6min in experience group and 34.4±6.8min in control group(<i>t</i>=3.95, <i>P</i><0.05). The rates of anatomic and functional success were 88%(35 cases)and 90%(36 cases)in experience group and 82%(33 cases)and 90%(36 cases)in control group at 12mo after operation(<i>P</i>>0.05). There were 4 cases of epiphora and 5 cases of lacrimal stenosis in the experience group, and 4 cases of epiphora, 7 cases of lacrimal stenosis, 5 cases of skin scar, 2 cases of catheter displacement and 1 case of eyelid relaxation in the control group(<i>P</i>>0.05). The intraoperative penetration rate was 100% in both groups, and the false path was not observed in this study.<p>CONCLUSION: The two methods of lacrimal canalicular anastomosis have different advantages, and they are both effective and feasible therapies in clinic.

Clinical application of locational partition of the nasal endsin lacerated lacrimal canaliculi / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the positional relationship between the nasal ends of the lacerated lacrimal canaliculi, lacrimal caruncle, and medial canthal ligament, as well as its application in the lacrimal canalicular anastomosis.<p>METHODS: Sixty-five patients with traumatic lower canalicular laceration were selected. The distance from the lacrimal punctum to the temporal end was measured. The nasal ends were found under direct vision, and the positional relationship between the nasal ends, lacrimal caruncle and medial canthal ligament were quantitatively analyzed.<p>RESULTS: Totally 65 patients with canaliculus laceration, 39 patients had a distance of less than 6mm from the lacrimal punctum to the temporal end, where the nasal ends of 35 patients were located in the lacrimal caruncle area. There were 26 cases in which the distance from the lacrimal punctum to the temporal end was greater than 6mm, where the nasal ends of 24 cases were located in the medial canthal ligament area. The vertical distance between the nasal ends in the lacrimal caruncle area and the lacrimal mucosa was 2.1±0.7mm, and the vertical distance between the nasal ends in the medial canthal ligament area and the skin edge was 3.5±1.2mm.<p>CONCLUSION: The positions of nasal ends can be divided into the lacrimal caruncle area and the medial canthal ligament area, providing a basis for finding the nasal ends of the lacerated lacrimal canaliculi in the clinical practice.

A Case of Canalicular Adenoma Arising on the Upper Lip / 대한피부과학회지

Canalicular adenoma is a rare benign tumor that arises in the minor salivary gland. Clinically, it usually presents as an asymptomatic nodule on the upper lip or buccal mucosa. It is necessary to histopathologically differentiate canalicular adenoma from basal cell adenoma and adenoid cystic carcinoma. Canalicular adenoma shows tubular structures composed of 1 or 2 layers of columnar cells and intraluminal hemorrhage. Squamous morules, which seem to represent metaplasia, are a unique finding for this tumor. Immunohistochemical staining is often helpful for the diagnosis of canalicular adenoma, which is positive for S-100 and CK (AE1/3). Herein, we report a case of canalicular adenoma in a 71-year-old man who presented with an asymptomatic nodule on the upper lip. As far as we know, this is the first report of canalicular in Korean Dermatology Journal.

A newly designed silicone tube for the treatment of canalicular laceration / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the clinical efficacy of a newly designed silicone tube for the repair of canalicular lacerations.<p>METHODS: This was a prospective clinical study. Data were analyzed from 47 eyes of 47 patients presenting with traumatic canalicular laceration in our hospital from January 2013 to October 2015. The newly designed silicone tubes were inserted through the lacrimal punctum and left in the bicanaliculi for 3mo. Data of the lacrimal duct patency, epiphora, and eyelid shape were recorded.<p>RESULTS: Surgery was performed successfully in all cases. No complications associated with the silicone tubes occurred. In total, 41 patients(87.23%)achieved complete success, 4 patients(8.51%)achieved partial success, and 2 patients(4.26%)had surgical failure.<p>CONCLUSION: The newly designed silicone tube is an effective and atraumatic tool for the management of canalicular lacerations. The operation process is simple, and is easy to grasp for the surgeon.

Retrospective study on the influencing factors of lacrimal canalicular rupture repair / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To analyze and compare the influence of different injury sites and injury types on surgical repair of canalicular laceration.<p>METHODS: A retrospective study was conducted on 87 cases(87 eyes)of traumatic canalicular laceration from January 2016 to August 2017, who were treated with silicone lacrimal drainage tube implantation. Lacrimal irrigation were performed 3mo and 6mo after surgery, and their respective operation results were evaluated. 3mo after surgery, lacrimal drainage tube were removed. Statisical analysis was proceeded on injury types, distances as well as the success rate of lacrimal passage irrigation.<p>RESULTS: Among the 87 cases of canalicular laceration, 29 eyes(33%)were in the PCL(proximal canalicular laceration)group, 41 eyes(47%)were in the MCL(medial canalicular laceration)group, and 17 eyes(20%)were in the DCL(distal canalicular laceration)group. There were 22 eyes(25%)of lacrimal canaliculi fracture caused by sharp instrument injury, including 18 eyes in the PCL group, 2 eyes in the MCL group and 2 eyes in the DCL group. There were 65 eyes(75%)of lacrimal canaliculi fracture caused by blunt trauma or collision, including 11 eyes in the PCL group, 39 eyes in the MCL group and 15 eyes in the DCL group. Six months after surgery, 72 eyes of lacrimal passage irrigation were successful, including 20 eyes in the PCL group, 36 eyes in the MCL group, and 16 eyes in the DCL group. The success rate of postoperative anatomic reduction in the three groups was 69%、88%、94%, respectively(<i>P</i>=0.047). There were 19 eyes of acute injury and 53 eyes of blunt injury with successful lacrimal duct irrigation respectively. The success rate of anatomical reduction was 86%、82%(<i>P</i>=0.605), respectively.<p>CONCLUSION: The canalicular laceration closed to lacrimal punctum is more vulnerable to cutting injury, while the canalicular laceration, which is near the lacrimal sac or between the lacrimal sac and center part of lacrimal punctum, can be more likely caused by lacerated wound. The success rate after operation is higher for patients with distal or medial canalicular laceration, and lower for those who with blunt wound location near the lacrimal punctum.

Diagnostic utility of CD10 immunohistochemical staining on cellblock in differentiating hepatocellular carcinoma from secondary malignancies of liver

Background: Differentiation of hepatocellular carcinoma (HCC) from metastatic malignancy in liver may be difficult at times on fine-needle aspiration cytology, especially in case of moderate-to-poorly differentiated tumors. The benefit of cell-block technique is the recognition of histologic pattern of diseases along with application of a wide variety of immunohistochemical (IHC) stains to differentiate hepatic malignancies. In this study, CD10 IHC staining was done on cellblocks prepared from aspirates of clinicoradiologically/cytologically suspected malignant liver neoplasms to differentiate HCC from malignancies metastasizing to liver. Objective: The objective of the study was to assess the diagnostic utility of CD10 IHC stain on cell-block preparation for differentiating primary from Secondary malignancies of liver. Materials and Methods: Formalin-fixed, paraffin-embedded cellblocks of 61 cases (25 cases of HCC and 36 cases of metastatic carcinoma) were prepared from a fine-needle aspirate of the suspected malignant liver neoplasm and immunostained using monoclonal antibody against CD10. Results: Twenty-two (88%) of 25 cases of HCC were positive for CD10 with a canalicular staining pattern. Two (8%) were positive for CD10 with membranous and one (4%) with cytoplasmic staining pattern. Conclusion: CD10 immunostaining on cellblock is useful in discriminating HCC and metastatic carcinoma of the liver with a diagnostic accuracy of 88.52%.

Long-term results of mini-monoka® monocanalicular intubation in the repair of canalicular lacerations

Objective@#To report the epidemiology of canalicular lacerations and surgical outcomes of canalicular laceration repair with Mini-Monoka® (FCI Ophthalmics, Issy-les-Moulineaux, Cedex, France) intubation.@*Methods@#This is a retrospective interventional case series of patients who underwent Mini-Monoka® intubation in the repair of canalicular laceration from 2010 to 2015 at a tertiary state-owned hospital in Manila, Philippines. Patient demographics, surgical outcomes, and complications were analyzed.@*Results@#Fourteen patients (12 males and 2 females) underwent Mini-Monoka® intubation for monocanalicular laceration. The mean age at presentation was 27 years (range, 16-47 years). The mean duration of follow-up was 2.92 years (range, 1.28-6.15 years). Canalicular patency was achieved in 12 out of the 14 patients (86%). None of the 12 patients experienced epiphora following stent removal resulting in a functional success rate of 100%. Two patients had punctal slitting (14%). Premature stent loss occurred in 2 out of the 14 patients (14%).@*Conclusion@#Mini-Monoka® intubation is effective in maintaining the long-term anatomical patency of the lacerated canaliculus. It is a simple and minimally invasive procedure making it a safe and reasonable alternative to the traditional methods of canalicular repair.

Effects of medial canthus ligament relaxation suture in anastomosis of lacrimal canaliculus laceration / 眼科新进展

Objective To investigate the effects of preset medial canthus ligament relaxation sutures in traumatic inferior canalicular laceration anastomosis.Methods A retrospective study was conducted in 32 patients (32 eyes) with inferior lacrimal canaliculus laceration who admitted to the Department of Ophthalmology from September 2014 to September 2016.In the procedures,after the broken end of the lower lacrimal canaliculus was found,4-0 suture was immediately placed between the ends of medial canthus ligament.After ensuring the satisfaction of the broken ends of the duct,the preset suture was released and the lacrimal stents were implanted.Anastomosis of lacrimal canaliculus laceration was performed with 8-0 absorbable suture,and subcutaneous tissue and skin were sutured with 6-0 absorbable suture.Then the lacrimal stents were removed 2-3 months after the operation.The patients were followed up 6-12 months for analysis of success rate and complications.Results Totally 29 patients were cured,2 patients improved,and 1 patient did not get better,with cure rate of 90.62％ and the effective rate of 96.88％.After surgery,lacrimal point tear presented in 2 eyes (6.25％),and notch within medial canthus was found in 1 eye (3.12％).Conclusion Medial canthus ligament relaxation suture can create a low tension healing environment for lacrimal canalicular laceration and improve the cure rate of canalicular laceration anastomosis.

Sialoadenitis por sialolito inusual de la glándula submaxilar derecha en un adulto / Sialadenitis due to uncommon sialolith of the right submaxillary gland in an adult patient

Se presenta el caso clínico de un paciente de 45 años de edad, atendido en el Departamento de Cirugía Maxilofacial del Hospital Provincial Docente Clinicoquirúrgico Saturnino Lora Torres por presentar molestias en el suelo de la boca con 3 años de evolución. Después de un estudio minucioso se comprobó que se trataba de una sialoadenitis por sialolitiasis de la glándula submaxilar derecha. Se realizó sialolectomía canalicular intrabucal. El cálculo extraído tenía forma cónica, más ancho en su porción posterior, de 3,8 cm de largo y 4,2 cm de circunferencia externa, color amarillo-verdoso y consistencia dura friable

The case report of a 45 years patient was presented. He was assisted in the Maxillofacial Surgery Department of Saturnino Lora Torres Clinical Surgical Provincial Hospital in Santiago de Cuba due to discomfort in the floor of the mouth with a course of 3 years. After a detailed study it was confirmed that it was a sialadenitis due to sialolithiasis of the right submaxillary gland. An intraoral canalicular sialolectomy was carried out. The stone removed had a conic form, wider in its posterior portion, 3.8 cm long and 4.2 cm in the external circumference, yellow-green color and friable hard consistency

Injection of sodium hyaluronate gel to upper lacrimal puncta in locating the broken end of inferior canalicular laceration / 眼科新进展

Objective To investigate the feasibility of injection of sodium hyaluronate gel to upper lacrimal puncta in locating the nasal broken end of inferior canalicular laceration.Methods Together 52 patients(52 eyes) with inferior canalicular laceration who collected from March 2013 to March 2016 in the Third Affiliated Hospital of Nanchang University underwent canaliculax laceration anastomosis combined with silicone tube.Injection of sodium hyaluronate gel to the upper lacrimal puncta was introduced in group A (n =32/32 eyes) for locating the nasal broken end of lower canaliculax laceration,while microscope for searching the nasal broken end served as group B (n =20/20 eyes).In both groups,the silicone tubes were implanted in the lacrimal passage for more than 3 months after locating the broken end successfully.All patients were followed up from 6 months to 12 months,with mean follow-up of (8.2 ± 1.6) months,and then clinical data of the distance of lower canalicular laceration between lacrimal canal,time consuming for locating the nasal broken end,effective rate and postoperative comphcations were compared between two groups.Results The procedures in all patients were successfully.In group A,23 patients were cured and 5 improved,but the operation was failed in 4 patients,of which 3 patients occurred upper or lower lacrimal punctas teax;while in group B,13 patients were cured and 4 improved,but the operation was failed in 3 patients,of which 2 patients occurred upper or lower lacrimal punctas tear.There was no significant difference in the the distance of between lower canalicular laceration and lacrimal canal in group A [6.5-8.3 (7.3 ± 0.6) mm] and group B [6.6-8.2 (7.2 ± 0.5) mm] (P =0.40).The time consuming for locating the nasal broken end in group A [1.5-5.5 (3.3 ± 1.3) min] was shorter than that in group B [5.0-26.0 (17.0 ± 6.0) min],with significant difference (P ＜ 0.001).Conclusion It is an easy and accurate method of injection of sodium hyaluronate gel to upper lacrimal puncta for locating the nasal broken end of lower canalicular laceration with less time.

Clinical application of modified probe synchronous intubation in treating canalicular laceration / 重庆医学

Objective To evaluate the intraoperative and postoperative effects of new type and modified probe in fractured lacrimal duct anastomosis.Methods Forty-nine patients with lower canalicular laceration were included in this study.The operation comparison was performed between the modified probe in a manner of synchronousintubation and the traditional pigtail probe.The differences of intraoperative effects were observed,and the clinical effects were assessed at postoperative 3,12 months.Results The average intubation time was (10.05±1.51) min in the observation group and (32.30±4.70) min in the control group,the difference was statistically significant (t=23.63,P＜0.01),the average whole operation time was (32.91 ± 3.98) min in the Observation group and (53.74± 5.48) min in the control group,the difference was staustically significant (t=15.71,P＜0.01).The rates of anatomic and functional success were 100.0％ (22 cases) and 90.9％ (20 cases) in the observation group,which were significantly higher than 70.4％ (19 cased) and 59.3％ (16 cases) in the control group,the difference was statistically significant (x2 =5.77,P＜0.05;x2 =6.23,P＜0.05).The punctal dilator was used by 18 times in the observation group and by 13 times in the control group,the difference was statistically significant (x2=5.91,P＜0.05),nevertheless no punctal incision was used.The rates of anatomic and functional success detected at 3 postoperative months,intraoperative once success and final success rates and postoperative complications showed no statistically significant differences(P＞0.05).Conclusion The modified probe provides a synchronous intubation new type operation mode,which simplifies the operation procedure,increases the operative success rate and partially reduces the occurrence of postoperative complications.