ABSTRACT
Full?thickness deficiency of eyelid tissues can result in coloboma or retraction or both. Here we report our initial experience on the use of auricular skin?cartilage sandwich graft technique for full?thickness eyelid deformities. Five patients (4� years) underwent the procedure. Patients with full?thickness eyelid deformity were included. Three patients were operated for large?sized coloboma and two for eyelid retraction. One patient had congenital, and four patients had acquired etiology. The following parameters were specifically assessed: correction of deformity, ocular surface problems, graft status, and epithelization of skin?cartilage graft. All the patients had a good correction of eyelid position, except one patient who had severe eyelid retraction (8 mm) at presentation. None of our patients had corneal erosion/defect, persistent ocular surface redness, or graft loss. The auricular skin?cartilage sandwich graft technique produces optimal results with no graft loss. Advancement of orbicularis muscle in between the auricular skin and cartilage grafts (sandwich technique) is an imperative step that leads to the survival of both grafts.
ABSTRACT
@#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.
ABSTRACT
RESUMO Objetivo pesquisar a atividade elétrica do músculo orbicular da boca em quatro diferentes tarefas isométricas e indicar a mais apropriada para utilização como referência na normalização do sinal elétrico do músculo orbicular da boca pela contração voluntária máxima. Métodos participaram do estudo 22 indivíduos, sendo dez do sexo masculino e 12 do feminino, com idades entre 20 e 33 anos. A atividade elétrica das porções superior e inferior do músculo orbicular da boca foi registrada durante a realização das seguintes tarefas isométricas: protrusão labial com fechamento, protrusão labial sem fechamento, contrarresistência com a placa de resistência labial e preensão de lábios. A ordem de realização das tarefas foi randomizada entre os participantes. Os dados foram comparados entre as tarefas, para cada seguimento labial. Resultados no segmento marginal superior, a tarefa com maior média e mediana de amplitude foi preensão labial, embora sem diferença significativa entre tarefas. O menor coeficiente de variação foi obtido na tarefa de contrarresistência com a placa de resistência labial. No segmento marginal inferior, a tarefa com maior média e mediana de amplitude foi protrusão labial com fechamento, que também teve o menor coeficiente de variação e diferença significativa entre as tarefas protrusão labial com fechamento e preensão, sendo os maiores valores obtidos na primeira. Conclusão indica-se como referência para a normalização do sinal elétrico do músculo orbicular da boca, pela contração voluntária máxima, a tarefa de protrusão labial com fechamento.
ABSTRACT Purpose To verify the electrical activity of the orbicularis oris in four different isometric tasks and to indicate the most appropriate task for use as a reference in the normalization of the electrical signal of the orbicularis oris muscle by maximum voluntary contraction. Methods Twenty-two individuals participated in the study, of which 10 were male and 12 were female, with ages ranging from 20 to 33 years. The electrical activity of the upper and lower parts of orbicularis oris muscle was recorded during the following isometric tasks: lip protrusion with bilabial closure; lip protrusion without bilabial closure; the counter resistance using the plate of labial resistance and lips prehension. The order of the tasks was randomized among participants. Data were compared between tasks for each lip part. Results in the upper marginal segment, the task with the highest mean and median amplitude was lip prehension, although there was no significant difference between tasks. The lowest coefficient of variation was obtained in the counter resistance task with the plate of labial resistance. In the lower marginal segment, the task with the highest mean and median amplitude was labial protrusion with lips closure, which also had the lowest coefficient of variation. In this segment, there was a significant difference between labial protrusion with lips closure and prehension, with the highest values obtained in the first task. Conclusion lip protrusion with bilabial closure is suggested as reference for the normalization of the electrical signal of the orbicularis oris muscle, by maximum voluntary contraction.
Subject(s)
Humans , Male , Female , Adult , Electromyography , Facial Muscles , Isometric Contraction , Masticatory Muscles/physiopathologyABSTRACT
Objective To develop a new technique of upper eyelid blepharoplasty for reducing surgical complications and improving cosmetic results.Methods In this study,721 cases (9 males and 712 females,range in age 17-32 years) with single eyelid were performed with double eyelid blepharoplasty using this method (dermis orbicularis muscle flap technique,DOMF),698 cases of which were simultaneously operated with epicanthoplastic surgery.In the operation,DOMF was harvested in the dermis edge in lower incision margin.The flap was sutured to levatoraponeuros at the superior border of the tarsus.Patients were followed up for three months to three years.Results It was concluded that unfavorable results included low fold in 12 cases,relapse in 3 cases,asymmetric crease in 4 cases,puffy eyelids in 5 cases,and sunken appearance in 4 cases.The physicians and patients were satified with the results.The eyelid appeared smooth without fold depression on downward gaze or eyes closed,and it was gentle and not overly puff as eyes opening.Conclusions The DOMF technique mimics the movement of congenital crease fold,which is easy to perform,creating a delicate,firm and smooth upper lid orientation.
ABSTRACT
Objective@#To observe the clinic effect of autologous orbicularis muscle filling combined with eyelid gray line incisionin treating scar upper eyelid entropion.@*Methods@#The clinic data of 36case (58eyes) were analyzed from March 2015 to October 2016. All adopted the autologous orbicularis muscle filling combined with eyelid gray line incision method, and the efficacy of treatment was observed.@*Results@#All of 36 case (58eyes) had success surgery, and all cases had no complications. The cure rate was 91.67%(33/36) and the total effective rate was 100.00%(36/36).@*Conclusions@#The method of autologous orbicularis muscle filling combined with eyelid gray line incision can get good treatment effect and worth popularizing.
ABSTRACT
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.
ABSTRACT
@#AIM:To compare the clinical effect of the lower eyelid retractor muscle transposition and eyelid orbicularis muscle folding shorten combined with lower eyelid retractor muscle transposition in the treatment of senile lower eyelid entropion. <p>METHODS: Sixty-four cases(85 eyes)with senile lower entropion were divided into Group A(31 cases 42 eyes)and Group B(33 cases 43 eyes)according to the different ways of operation from January 2013 to October 2014 in our hospital. Patients in Group A were treated by eyelid retractor muscle transposition while patients in Group B treated by eyelid orbicularis muscle folding shortening combined with lower eyelid retractor muscle transposition. The short-term and long-term therapeutic efficacy and two-year recurrence rates after operation were compared between the two groups. <p>RESULTS: The short-term effective rate of patients in Group B was higher than that of Group A while the difference was not statistically significant(98% <i>vs</i> 95%, <i>P</i>>0.05). The long-term effective rate of patients in Group B was higher than that of Group A and the difference was statistically significant(95% <i>vs </i>83%)and two-year recurrence rate of patients in Group B was lower than that of Group A(5% <i>vs</i> 17%)and the difference was statistically significant(<i>P</i><0.05). <p>CONCLUSION:The clinical curative effect of eyelid orbicularis muscle folding shortening combined with lower eyelid retractor muscle transposition is better than single retractor muscle transposition in the treatment of senile lower eyelid entropion.
ABSTRACT
AIM: To observe and compare efficacy of the lower eyelid twitch shift joint outer canthal ligament shortening surgery and orbicularis muscle resection surgery to treat degenerative entropion. METHODS: Patients with degenerative entropion in our hospital were selected. The test group was 40 cases ( 70 eyes), of which double eyes with attack (30 cases), and lower eyelid twitch shift joint outer canthal ligament shortening surgery was applied to the test group. Control group was 20 cases (26 eyes), of which double eyes with attack ( 6 cases ) , and the control group was used by orbicularis muscle resection surgery. The correction rate, double eyelid symmetry and overcorrection rate were observed in two groups at postoperative 1wk. The long-term recurrence rate, double eyelid symmetry and overcorrection rate with follow-up 6mo were observed. RESULTS: After 1wk, the correction rate of experimental group 98. 6%, undercorrection rate of that was 1. 4%, all the eyelid was symmetry, only one eye with a slight overcorrection. Correction rate of control group was 92. 3%; all the eyelid was symmetry, and the poor rate of this group was 7. 7%. After 6mo, correction rate of experimental group was 95. 2%; undercorrection rate of experimental group was 3. 2%, and overcorrection rate was 1. 6%. Correction rate of control group was 87%, and 2 eyes of recurrence, 1 eye with a poor overcorrection. Double eyelid was symmetry, overcorrection rate difference was not statistically significant ( P > 0. 05 ), and the correction rate were significantly different (PCONCLUSION: Compared toorbicularis muscle resection surgery, postoperative recurrence rate of lower eyelid twitch shift joint outer canthal ligament shortening surgery is significantly lowered.
ABSTRACT
AlM:To explore treatment efficacy of the lower eyelid twitch muscle transposition surgery in senile entropion.METHODS:Fifty cases (86 eyes) of senile lower eyelid entropion patients underwent lower eyelid twitch muscle transposition correction surgery as the experimental group, and the other 42 cases (68 eyes) of senile lower eyelid entropion patients received orbicularis muscle shortening correction as controls group. The correction rate, double eyelid symmetry and overcorrection rate of patients were observed one week after surgery. The patients were followed up for 6~12mo to be observed the long-term recurrence rate, double eyelid symmetry and overcorrection rate.RESULTS: One week after operation, eyelid symmetry, overcorrection rate of experimental group and control group had significant difference (P<0. 05); After followed up for 6 ~12mo, eyelid symmetry, overcorrection rate of experimental group and control group had significant difference (P<0. 05). CONCLUSlON: Folding and orbicularis muscle shortening treatment of senile entropion was compared with the lower eyelid twitch muscle transposition surgery treatment of senile entropion, We can find that clinical results in double eyelid surgery symmetry and overcorrection rate are of obvious advantage.
ABSTRACT
To analyze the clinical results of orbicularis muscle shortening surgery and eyelid skin orbicularis muscle resection for senile entropion. ●METHODS: From January 01, 2006 to December 31, 2012, senile patients with lower eyelid were divided into two groups according to different surgical methods. Group A with the orbicularis muscle shortening improved operation in 20 cases (38 eyes), group B used the eyelid skin orbicularis muscle resection in 21 cases (36 eyes). The effects of surgery were followed-up postoperatively. ●RESULTS: Patients were followed up for 1 - 2a, 20 patients ( 38 eyes ) in group A were cured without recurrence; 7 eyes recurred in group B, the recurrence rate was 19%, the recurrence rate after surgery both groups were statistically significant (P ●CONCLUSlON: The effect of orbicularis muscle shortening improved operation for senile entropion is good and stable.
ABSTRACT
Objective To explore the methodology of suturing the upper margin of the orbicularis muscle in pretarsal orbicularis myocutaneous flap to the levator aponeurosis,simulating the mechanism of fibers from the levator aponeurosis to the dermis in natural double-eyelid in blepharoplasty.Methods Pretarsal orbicularis myocutaneous flap was harvested.Dissection between the orbital septum and the levator aponeurosis was performed originating from the upper margin of the tarsi until to the levator muscle.The upper margin of the orbicularis muscle in pretarsal orbicularis myocutaneous flap was sutured to the levator aponeurosis.The lower skin margin to the orbital septum to the upper skin margin was sutured interruptedly.Patients with medial epicanthus were performed epicanthoplasty at the same time.Results 136 eyes in 68 patients were performed with double-eyelid blepharoplasty using this method.62 patients were followed-up for 1 month and 53 patients were followed-up for 3 months.They all reported satisfactory aesthetic results.Conclusions Double-eyelid blepharoplasty using this method accords with the physiological mechanism in natural double-eyelid.Postoperative double-eyelid is natural with little tumefaction.This method can avoid double-eyelid fold retraction and multi-fold occurrence.
ABSTRACT
Objective To investigate a myocutaneous flap method for eyelid baggy plasty conforming to the medical aesthetic requirements. Methods Before operation the amount of the lower eyelid skin excised should be determined. Asking the patient to look upward at supine position, the operator lifted properly the lower eyelid skin using fine forceps without teeth at the results of smooth superficialness at this region and slight ectropion. The incision lines were marked along the print pinched by forceps and the trace 2 to 3 mm below the ciliary margin. Intra-operatively severing soft issues to the inferior orbital fringe just on the sub-orbicularis level, the skin-muscle flap was made. Then the excessive muscle was removed in the light of the incision lines. The orbital fat teased out resected or filled up the concavity along the lower orbital edge. Results The tense and smooth appearance of lower eyelid was archived in 900 cases received in our hospital except 2 temporary ectropion cases and 2 temporary double vision cases. We repaired the 15 ectropions using adjacent skin flap, tarsal reduction, skin soft tissue expansion, or superficial temporary fascia sling suspension, eliminated 28 haematomaes and made the excision of scar and wound suture for a hypertrophic scar case in the 150 complications from other hospitals. The crow wrinkles were improved apparently. Conclusion The amount of skin excision determined pre-operatively, which not only successfully refrains interfering elements from blooding and swelling but also avoids giving rise to ectropion, is accurate than that performed during operation. Natural appearance after operation becomes better and lasting because of orbicularis raised which strengthens the anterior wall of orbital septum.