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Introduction: Myxoid soft‑tissue tumors are a diverse group of tumors which have similar histomorphology but have varied geneticsequence and clinical outcome, hence differentiating and diagnosing them is a challenge for any pathologist. This study describes the varioushistomorphological spectrum and vascular pattern of various myxoid soft‑tissue tumors. Materials and Methods: This was a retrospective and prospective observational study of myxoid soft‑tissue tumors over a period of 13 years. A total of 224 cases with myxoid morphology were included and were examined morphologically with a special focus on the vascular pattern. SPSS v 24 was used for statistical analysis. Results: The predominant lesions were benign in 164 (73.21%) cases, followed by malignant lesions in 43 (19.19%) cases and intermediate lesions 17 (7.58%) cases. Both benign and malignant lesions showed a male preponderance and were seen to arise predominantly from the extremities. The most common benign myxoid lesions in this study were of neural origin with myxoid neurofibroma constituting 65 (29. 01%) cases, followed by schwannoma 38 (16.9%) cases. Myxoid dermatofibrosarcoma protuberans was the most common intermediatelesion. Tumors with adipocytic differentiation were the predominant lesions among the malignant group, i.e myxoid liposarcoma seen in 17 (7.5%) cases. Conclusions: Vascular pattern in the myxoid lesions are subtle yet crucial in arriving at a histo‑morphological diagnosis. Further studies correlating the vascular pattern with the genetic profile of these tumours can help arriving at a histo‑morphological diagnosisof myxoid lesions.
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Objective:To evaluate the efficacy and patients＇ satisfaction of the intense pulse light (IPL) and M22-Resur Fx non-ablative fractional laser (NAFL) for the treatment of lateral static crow＇s feet.Methods:A prospective split-face, randomized, controlled study of 60 consecutive patients with lateral static crow＇s feet was performed. The patients aged 30 to 55 years, who were enrolled in the Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University from January 2018 to January 2020. The two sides of each patient＇s face were randomized to receive different treatment, and according to their treatment, the patients were divided into 3 groups with 20 cases each: Group A, in which 20 patients＇ one side face was treated with IPL, and other side was treated with NAFL; Group B, in which one side face was treated with IPL, and another side was treated with IPL immediately followed by NAFL; Group C, in which one side face was treated with NAFL, and another side was treated with IPL immediately followed by NAFL. The improvements including the water content of stratum corneum of skin and the patients＇ satisfaction, as well as the improvement of the lateral static crow＇s feet were evaluated.Results:The IPL plus NAFL combined treatment group and the NAFL treatment group showed the effective rate of the improvement for lateral static crow＇s feet of patients on days 60 and 90 was statistically significant ( P<0.05) compared with that before the treatment. And the improvement for lateral static crow＇s feet of patients on days 60 and 90 in combined treatment side was significantly different from either NAFL side ( P<0.05). 60 days and 90 days after treatment, the satisfaction of combined treatment side was significantly higher than that of either NAFL side or IPL side ( P<0.05). Conclusions:The treatment with an optimized IPL immediately followed by a NAFL is clinically superior to those with the NAFL or IPL alone for improving the lateral static crow＇s feet of patients. The satisfaction treated by NAFL combined with IPL is higher than using the NAFL or IPL alone.
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Objective@#To observe the effect of the outer orbicularis muscle partial resection combined with orbital fat flap or orbicularis muscle flap transfer to block orbicularis muscle for improvement of crow′s feet.@*Methods@#From October 2010 to May 2015, 82 cases of females (aged from 27 to 54 years old) with crow′s feet were treated with new method(n=41) and traditional method(control, n=41). The new method included partial resection and orbital fat flap or orbicularis muscle flap transfer to block orbicularis muscle. The traditional method was performed to lift the skin and orbicularis oculi muscle to improve the crow′s feet. The operation time, the postoperative recovery time, eyes closing function and hematoma, nerve injury and other complications were recorded. 1, 3, 6 and 12 months after operation, the effect was assessed by one cosmetic surgeon who is unkown the groups. Completely correction was assed as 5 points and no improvement or even worse as 0 point. 12 months after operation, the patients satisfactory rate was recorded.@*Results@#75 cases were followed up, including 39 in new method group and 36 in control group. The operative time and postoperative recovery time were (50±5) min, (58±4) min and (5±1) d, (6.0±1.5) d in the new method group and control group respectively (P<0.05). The two groups both had good eyes closing function, no eyes closing fatigue or difficult or other serious complications such as hematoma, nerve injury. Visual analog scale were 3.2±0.6, 3.5±0.5, 4.2±0.8, 4.3±0.8 and 3.1±0.6, 3.4±0.9, 3.0±0.6, 2.8±0.5 in the new method group and control group at 1, 3, 6, 12 months after surgery respectively . Obviously, the effect in new method group was much better than that in control group after 6 and 12 months with statistical significance (P<0.05). 12 months after surgery, the satisfaction surveys showed satisfactory in 33 cases; fairly satisfactory in 4 cases; dissatisfactory in 2 cases in new method group, and satisfactory in 10 cases; fairly satisfactory in 15 cases; dissatisfactory in 11 cases in the control group, showing significant difference between the 2 groups (P<0.05).@*Conclusions@#The outer orbital orbicularis muscle partial resection combined with orbital fat flap or orbicularis muscle flap is reasonable and reliable to correct crow′s feet with short recovery and less complication. It is a worthy new method for recommendation.
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Objective The purpose of this study was to evaluate the efficacy of multipoint transfixion combined with filling of temporal fascia and the lateral orbicularis oculi muscle as an alternative rejuvenation technique on crow's feet wrinkles during face lift.Methods A retrospective review was conducted in 86 patients who underwent crow's feet wrinkles treatment during 2005 and 2009.During operation orbicularis' strength was broken down and blocked when we multi-pointly sutured and fixed the orbicularis oculi and deep tissue,temproal musculofascia was filled on the surface of multi-pointly sutured orbicularis oculi.By postoperative follow-up,complications,aesthetic outcome,and patient's satisfaction were recorded.Results In the group of 86 cases,50 cases were followed up from 3 to 28 months.The effect was lasting obviously and there was no any severe complications,such as hematoma or nerve injury.Patients were satisfied with their results.Among the total,2 patients appeared the temporary movement loss of the eyebrows in one side,but both recovered 3 months later.And 1 case appeared subcutaneous nodular inflammation and recovered after pulling out the suture.Conclusions The authors demonstrate that combination of filling with temporal fascia and the multipoint transfixion of lateral orbicularis oculi muscle is a safe technique,which may be a good alternative for periorbital rejuvenation and help in avoiding lower lid incisions or extensive dissections during face lifting in some cases.
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As people grow older, many aging phenomena occur in the facial skin and soft tissues, including crow's feet, glabellar frown lines, jowls, depression of malar fat pads, brow ptosis, Marionette lines, and more. Among these results, the authors focused on crow's feet(Lateral. periorbital wrinkles), which are one of the major causes of facial rejuvenation in the periorbital area. Upper & lower blepharoplasty do not always improve crow's feet to one's satisfaction, and above that, surgery sometimes accentuates rather than improves these wrinkles. Consequently, the authors proposed a new operative method for lateral. periorbital wrinkle correction, which could be summarized as dissection of the orbicularis oculi muscle, below the subcutaneous tissue above the temporal fascia, elevation of the muscle flap, advancement of the flap to the upper-lateral direction, and excision of redundant skin. After laying the patient down on the operation table and exposing both ears, the whole face was cleansed with an antiseptic solution. Incision lines were designed as temporal W-shaped. After dissecting through the subcutaneous fat layer and elevating the flap from the temporal fascia, the orbicularis oculi muscle was incised at the lateral margin of orbicularis muscle. The orbicularis oculi muscle flap was then elevated, and pulled into the upper- lateral direction with smooth forceps to find the point which would make the patient's eyes look the most natural. The lateral margin of orbicularis muscle was fixed to the deep temporal fascia of temporal hairline. with 4-0 Nylon suture. Redundant skin was excised and wound was closed with 6-0 Black silk by W- plasty technique. Between 2001 and 2006, 63 patients were operated on using the technique mentioned above, with favorable aesthetic and functional results. Several patients complained about the W-plasty scar but those were aesthetically accepted. Crow's feet are not always corrected with satisfactory results, and sometimes are accentuated, by upper & lower blepharoplasty. In order to solve these problems, an operative technique was conceived that dissects the orbicularis oculi muscle, elevates and advances the muscle flap, and then excises the redundant skin. This technique showed favorable patient satisfaction scores in both functional and aesthetic aspects, with satisfactory results even in long-term follow up, and also had the effect of a central- facial face lift.
Subject(s)
Humans , Adipose Tissue , Aging , Blepharoplasty , Cicatrix , Depression , Ear , Fascia , Follow-Up Studies , Foot , Nylons , Operating Tables , Patient Satisfaction , Rejuvenation , Rhytidoplasty , Silk , Skin , Subcutaneous Fat , Subcutaneous Tissue , Surgical Instruments , Sutures , Wounds and InjuriesABSTRACT
It is well known that crow's feet are caused by hyperkinetic facial muscles. Recently, rejuvenation in this area has been improved enormously by radical approach and various combined adjuvant surgery. And many articles regarding with the various applicable treatment modalities are published every year. Actually, there are various types of crow's feet, but treatment method of crow's feet doesn't have to be different according to their types. Therefore, we tried to analyze the pattern of crow's feet among Korean people and classified them by age and sex. Total of 256 volunteer people were inspected and photographed. We took pictures of oblique view of periorbital area showing primary gaze and smiling feature. Pictures which show poor quality or any disagreement of opinions from three plastic surgeons were excluded. Finally, 160 pictures were collected and classified. The crow's feet lines were classified as four patterns; i.e., central upper, central, central lower and combined pattern. The "central upper pattern" is shown among those with wrinkle lines only in the upper eyelid skin down to the lateral canthus. The "central pattern" is categorized in those who exibit wrinkles only in the lateral canthal area, and the "central-lower pattern" is recognized to have wrinkling on the lower lid and upper cheek area. The "combined pattern" is defined as patients exhibiting crinkling of their lateral canthal skin from the lower lateral brow across the upper eyelid, through the lateral canthus, and across the lower eyelid, upper cheek junction with horizontal and perpendicular wrinkles crossing over. In this study, the most common pattern of the wrinkle pattern was the combined type. In thirties and fourties, central- lower pattern was more common in men. In women, the type of central and central-upper pattern showed nearly equal frequency. However, over the age of 50-year's, combined pattern was common in both sex. For maintenance of a long-lasting and natural outcome we should recognize the diversity of facial expression among indivisuals and render the treatment accordingly. This observations could also be applied to the injection technique of botulinum toxin for the facial rejuvenation.
Subject(s)
Female , Humans , Male , Botulinum Toxins , Cheek , Crossing Over, Genetic , Eyelids , Facial Expression , Facial Muscles , Foot , Rejuvenation , Skin , Smiling , VolunteersABSTRACT
Most common signs of human aging often include skin fold and wrinkles in the lateral canthal area. It is called "crow's feet". The accordion-like activity of the orbicularis oculi muscle during movements of facial expression accentuates this phenomenon because the muscle shortens but the skin does not. The purpose of this study is to present the classification of the crow's feet and to look for it's clinical characteristics in Koreans. The pictures of lateral view of the crows feet in 105 patients taken with digital camera are classified by their age, sex, types and degree of direction. Results show that there are three types of crows feet such as upper, lower and bidirectional types. Bidirectional type is the most common type(85%), lower directional type is 15% and upper directional type is 5%. In thirties, bidirectional type is 50% but the rate of this type increases in older groups. So in over sixties, bidirectional type is almost 100%. There are no differences between the two sexes. The degree of the direction of wrinkles increases in thirties and forties, but in fifties or over no difference was seen. In summary, this study could be helpful to decide the procedure in correction of the crow's feet.