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Objective@#To investigate the lateral canthoplasty and canthopexy with bone drilling to correct lower eyelid malposition and its benefit.@*Methods@#From January 2014 to January 2019, lateral canthopexy with bone drilling technique was used to repair 56 patients with lower eyelid malposition in Department of Plastic and Reconstructive Surgery of Changhai Hospital. Forty-four patients with lower eyelid ectopic had multiple previous surgeries, and 12 patients had congenital lower eyelid retraction. For patients without lower palpebral margin extension, lateral canthopexy with bone drilling technique was applied. For patients with lower palpebral margin extension, the lateral canthus angle was exposed to shorten the lower eyelid margin. For congenital lower eyelid retraction, the lateral canthus tendon was completely cut off, and then fixed with double armed sutures.@*Results@#Operations were successfully performed on all 56 patients, and the patients were followed up for 1-38 months. Forty-nine patients achieved good eyelid shape and satisfied with the operative effects (87.5%). Malposition was ameliorated in 6 patients (10.7%). One remained uncorrected (1.8%).@*Conclusions@#Lateral canthopexy with bone drilling technique could obtain firm suspension force. For lower eyelid malposition, especially for patients with recurrent malposition or congenital lower eyelid retraction, satisfied function and appearance could be achieved.
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Objective: To investigate the effectiveness of modified kite flap in repair of soft tissue defect after divided nevus of lateral canthus excision. Methods: Between October 2010 and April 2018, 20 children (20 eyes) with divided nevus of lateral canthus were admitted. There were 13 boys and 7 girls, with an average age of 7.9 years (mean, 4-14 years). There were 11 cases of moderate range lesions (maximum diameter, 1.5-2.0 cm) and 9 cases of small range lesions (maximum diameter, <1.5 cm). After excising the divided nevus of lateral canthus, the area of soft tissue defect ranged from 0.72 to 3.23 cm2。The modified kite flap was used to reconstruct the structure and shape of lateral canthus. Results: There were 16 cases of mixed nevus and 4 cases of intradermal nevus. The flaps survived and the incisions healed by the first intention. The patients were followed up 12-22 months (mean, 13.6 months). There was no malformation, valgus, exposure keratitis, or obvious scar. No malignant transformation occurred or nevus recurred during follow-up. At last follow-up, the effectiveness was rated as excellent in 16 cases, good in 3 cases, and poor in 1 case. Conclusion: The modified kite flap can repair the soft tissue defect after excising the divided nevus of lateral canthus, and obtain the good appearance and function of lateral canthus.
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The lateral canthus is the junction of the upper and lower eyelids, which is located at the temporal side. The distance from the lateral orbit rim to the lateral canthal angle is 5-7 mm. Cosmetic lateral canthoplasty, as an important surgical method for the rejuvenation of the eyes, was developed in recent year. Along with the development of anatomic study of the lateral canthus, the cosmetic lateral canthoplasty was modified and improved. The purpose of this review is to summarize the anatomy of the lateral canthus, indications for cosmetic lateral canthoplasty and surgical procedures, so as to provide a useful reference for clinicians.
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Cosmetic lateral canthoplasty, in which the size of the eye is increased by extending the palpebral fissure and decreasing the degree of the eye slant, has become a prevalent procedure for East Asians. However, it is not uncommon for there to be complications or unfavorable results after the surgery. With this in mind, the authors have designed a surgical method to reduce complications in cosmetic lateral canthoplasty by preserving the lateral canthal angle. We discuss here the anatomy required for surgery, the surgical methods, and methods for reducing complications during cosmetic lateral canthoplasty.
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Humans , Asian People , Lacrimal Apparatus , MethodsABSTRACT
Objective To evaluate the application of the lateral tarsal strip procedure for lower eyelid lesions. Methods We retrospectively analyzed 64 eyelids of 48 patients with lower eyelid laxity, ectropion, retraction, lagophthalmus and lateral canthus displacement from February 2010 to August 2013. All the patients were treated with the lateral tarsal strip procedure as the main surgical style, of which some combined with the surgery of lower-eyelid tarsal constrictor,some implanted with high porous polyethylene lower eyelid spacers (Medpor LES), and few cases of eyelid ectropion underwent transplantation or transposition of flap. The effect of relocation of lower eyelid and appearance improvement were evaluated after surgery. The degree of the low eyelid retraction, lagophthalmus and the lateral canthus displacement were examined quantitatively before and after operation, while the change of the low eyelid ectropion and laxity were done qualitatively. Results After two weeks of operation, eyelids of all the patients were relocated well except two cases of ectropion under mild correction. The quantitative evaluation showed there was significant difference between pre and post operation ( <0.001),while the qualitative effect of correction was satisfied after operation. Conclusion The lateral tarsal strip procedure had positive effects in the treatment of most sorts of lower eyelid diseases.
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PURPOSE: To report a case of malignant fibrous histiocytoma of the lateral canthal area that was diagnosed clinically as a benign epidermal inclusion cyst. CASE SUMMARY: A 49 year-old man presented with a cutaneous mass involving the lateral canthal area. A 0.7-cm cystic lesion was freely movable and non-inflamed. After excisional biopsy, the results of immunohistochemical staining led to a final diagnosis of low-grade malignant fibrous histiocytoma. The specimen from excisional biopsy had margins positive for malignancy; the patient underwent a second procedure for complete resection, and that specimen had tumor-free margins. CONCLUSIONS: Fibrous histiocytoma is a rare disease but may occur in the eyelid. Therefore, when an eyelid tumor progresses rapidly, malignant fibrous histiocytoma should be considered as a diagnosis.
Subject(s)
Humans , Biopsy , Eyelids , Histiocytoma, Benign Fibrous , Histiocytoma, Malignant Fibrous , Rare DiseasesABSTRACT
PURPOSE: To report a rare case of primary mucinous adenocarcinoma arising from a sweat gland in the eyelid. CASE SUMMARY: A 68-year-old male presented to our hospital with a painless, superficial nodular lesion over the skin of the right lateral canthus that had slowly grown over the past two years. The patient had a history of surgical excision for three nodular lesions at the same site 5 years ago, and an excisional biopsy was mucinous adenocarcinoma with a positive margin. A systemic evaluation, including whole-body Positron Emission Tomography scan (PET), chest computerized tomography, gastrointestinal endoscopy, and colonoscopy, revealed no other abnormal lesions. Therefore, the eyelid lesion was considered a primary mucinous adenocarcinoma of the skin. CONCLUSIONS: Primary mucinous adenocarcinoma of the eyelid can rarely metastasize. Therefore, a systemic examination is warranted to discriminate primary and metastatic adenocarcinoma and also to monitor the long-term follow-up for the evaluation of local recurrence.
Subject(s)
Aged , Humans , Male , Adenocarcinoma , Adenocarcinoma, Mucinous , Biopsy , Colonoscopy , Endoscopy, Gastrointestinal , Eyelids , Mucins , Organothiophosphorus Compounds , Positron-Emission Tomography , Recurrence , Skin , Sweat Glands , ThoraxABSTRACT
Objective:To perform the rhytidectomy of the lateral canthus in combination with blepharoplasty for youth and middle-aged persons.Methods:The rhytidectomy of the lateral canthus with subdermal incision were used in 36 patients at the age of 28～45 years who underwent simultaneous blepharoplasty.The 36 cases were divided into four groups of 28～30,31～35,36～40,and 41～45 years old in order to observe and evaluate the changes of the lateral canthus before and after operation.The keys to operative technique were presented.Results:Postoperative and follow-up results demonstrated the effects were desirable in the cases lower than 40 years of age who showed slight-middle degree crow's feet wrinkles,but unsatisfactory results were showed in the cases above 40 years of age who showed rough-deep degree wrinkles at the lateral canthus preoperation.Conclusion:The rhytidectomy with subdermal incision is an excellent method to reconstruct the skin structure and to eliminate slight-middle degree wrinkles.