Influence of exophthalmos on design of double eyelid incision / 中华医学美学美容杂志

Objective:To compare the postoperative effects of double eyelid surgery with different exophthalmos to find its influence on the surgery and necessary changes in preoperative design and during operation.Methods:A total of 50 female patients with single eyelid seeking beauty from June 2021 to March 2022 were selected from the Department of Plastic Surgery, Affiliated Hospital of Qingdao University. The ocular protrusion was measured by HETEL ophthalmostatometer before surgery. Both eyes at 12-15 mm were taken as normal group ( n=26), both eyes at 16-18 mm as mild protrusion group ( n=14) and both eyes at 19-22 mm as severe protrusion group ( n=10). All the patients were treated with double-eyelid surgery by orbital septum and unified postoperative nursing. Results:After six months of follow-up, there was no difference in eyelid width with closed eyes (all P>0.05). The width of double eyelid with open eyes in normal group was smaller than that in mild protrusion group ( F=23.23, all P<0.05), and the width of double eyelid with open eyes in mild protrusion group was smaller than that in severe protrusion group ( F=47.70, all P<0.05). There was no difference in the improvement rate of facial aesthetics among the three groups ( P>0.05). The " feeling of meet" and scar formation in the normal group were less than those in the mild protrusion group ( F=16.92, F=33.45, all P<0.05), and the " feeling of meet" and scar formation in the mild protrusion group were less than those in the severe protrusion group ( F=27.93, F=28.53, all P<0.05). The improvement rate of normal group was higher than that of mild and severe protrusion group (χ 2=7.25, 7.89, all P<0.05). There was no difference in the improvement rate between the mild and severe protrusion groups ( P>0.05). Conclusions:In clinical practice, it is necessary to make corresponding changes in the preoperative design and operation of double eyelid surgery for patients with high eyeball protrusion.

The electromyographic analysis of orbicularis oculi muscle in epiphora

Purpose: Functional epiphora is a clinical condition that presents with the complaint of watery eyes, but without anatomical stenosis in the lacrimal drainage system. Although the mechanism is not clear, there are various possibilities involving the movement of the orbicularis oculi muscle, especially its deeper segment (Horner’s muscle). We aimed to evaluate the function of the orbicularis oculi muscle in patients with patent, but dysfunctional lacrimal drainage system using a quantitative motor unit potential (MUP) analysis. Methods: Twenty?eight patients with functional epiphora (mean age = 59 years) and a control group of 28 volunteers were included in the study. Inclusion criteria were persistent and symptomatic epiphora or wiping >10 times per day and diagnosis confirmation by lacrimal irrigation test. Electromyography (EMG) was performed on the deeper segment of the orbicularis oculi muscle (medial and lateral parts). MUP parameters (duration time, amplitude, number of phases, number of turns, area, rise time, and thickness) were evaluated in both groups. Any increase in amplitude, prolongation time (>14 ms), number of turns, and satellite potential was taken as characteristic of the neurogenic type of epiphora, whereas shortened motor unit duration time, increased phase number, and low amplitude are the features of myopathic type. Results: Upon MUP analysis of the medial and lateral orbicularis oculi muscle, the increase in duration and thickness values in the medial part and the increase in duration, amplitude, area, and thickness values of the lateral part were found to be statistically significant in the patient group compared to the control group (P < 0.001). In the evaluation of the patients’ medial and lateral orbicularis oculi muscle, the increase in phase values and decrease in amplitude, area, and rise time values were found to be statistically significant (P = 0.024, P < 0.001, P < 0.001, and P = 0.010, respectively). Conclusion: These data show that functional epiphora is due to neurogenic damage of the orbicularis oculi muscle and should be investigated in more detail

Application of orbicularis oculi muscle shaping in lower blepharoplasty / 中华医学美学美容杂志

Objective:To investigate the clinical application and effect of orbicularis oculi muscle shaping in lower blepharoplasty.Methods:A retrospective analysis was performed on the clinical data of 32 cases of flabby blepharoplasty patients admitted to the Orthopedic Surgery Clinic of Sichuan people＇s Hospital from October 2018 to September 2019. At the same time of transcutaneous blepharoplasty, 32 patients were treated with orbicularis oculi muscle shaping to remove the relaxed orbicularis oculi muscle, to reconstruct the annular strength and shape of the orbicularis oculi muscle, to strengthen the supporting structure of the lower eyelid, to reset the relationship between the external canthus orbicularis muscle and the skin, and then to reconstruct the soft tissue filling degree of the lower eyelid margin. The safety, efficacy and stability of the operation were evaluated by Barton grading, postoperative complications and scoring before and after operation and satisfactory analysis based on patients＇ satisfaction scale after operation.Results:All the patients were free of postoperative infection and healed at stage I. There were 2 cases of ecchymosis, 3 cases of ocular foreign body sensation, and no cases of infection, lower eyelid retraction, lower eyelid ectropion, or retrobulbous hematoma. The mean Barton score of all patients before surgery was 1.88±0.49, and the mean Barton score after surgery was 0.53±0.51. The t-test showed that the difference was statistically significant ( t=15.75, P<0.05), and the postoperative lacrimal groove deformity was improved. According to the score of satisfaction scale, 7 people were basically satisfied (21.88%) and 25 people were very satisfied (78.12%). Conclusions:Forming in the orbicularis oculi muscle relaxation eyelid bag type of prosthesis, in addition to the part of the orbicularis oculi muscle relaxation, deformation, and widely shed canthus outside skin and orbicularis connection, make the next eyelid edge to reproduce the full shape, obviously the bulging under the eyelid relaxation, the shape of the degree of repair, lateral canthus wrinkles tail department have also improven, restoring the full eyelid platform. The operation has strong pertinence, simple procedures, less complications and better long-term effect.

Orbicularis oculi muscle resection combined with orbicularis oculi muscle shortening and lower eyelid retractor reduction in the treatment of elderly lower eyelid entropion / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the efficacy of orbicularis oculi muscle resection combined with orbicularis oculi muscle shortening and lower eyelid retractor reduction in the treatment of elderly lower eyelid entropion.METHODS:A retrospective study was conducted among 97 elderly patients(175 eyes)with lower eyelid entropion who admitted to the hospital from June 2019 to June 2021. According to the treatment method, the patients were divided into control group(47 patients of 82 eyes treated with orbicularis oculi muscle resection)and combination group(50 patients of 93 eyes treated with orbicularis oculi muscle resection combined with orbicularis oculi muscle shortening and lower eyelid retractor reduction). The two groups were compared in terms of short-term curative effect, perioperative indexes, scores of symptoms and signs before and after surgery, width of palpebral fissure before and after surgery, direction of eyelashes, exposure rate of lacrimal caruncle, complications, and patient satisfaction.RESULTS: The total response rate in the combination group was significantly higher than that in the control group(95% vs 80%, P=0.004). The intraoperative blood loss, operation time and hospital stay of the combination group were significantly more/longer than those of the control group(P&#x003C;0.001). The scores of symptoms and signs such as lacrimation, foreign body sensation, photophobia and irritation in the combination group after the surgery were significantly lower than those in the control group(all P&#x003C;0.001). After surgery, the width of palpebral fissure, direction of eyelashes and exposure rate of lacrimal caruncle in the combination group were higher than those in the control group(P&#x003C;0.001). The incidence of postoperative complications in the combination group was lower than that in the control group(8% vs 18%, P=0.032). The patient satisfaction scores of comfort level, trichiasis correction, scar appearance, eyes symmetry and appearance in the combination group were higher than those in the control group(all P&#x003C;0.001).CONCLUSION: Orbicularis oculi muscle resection combined with orbicularis oculi muscle shortening and lower eyelid retractor reduction is effective and safe in the treatment of elderly lower eyelid entropion, which can meet the requirements of the patients.

Effects of lower eyelid blepharoplasty on palpebral bags with different etiology / 中华医学美学美容杂志

Objective:To address a new classification method in term of the three-dimensional space of orbit and to present the different surgical approaches correspondingly.Methods:In a retrospect study from April of 2015 to June of 2018, 102 patients were performed lower eyelid blepharoplasty, including 20 males and 82 females, aged 21-65 years, with an average of 45.2 years. These patients were divided into five groups, which were described in term of three-dimensional structure of orbit, based on the following points: the presence and extent of herniated orbital fat, the presence of inferior orbitopalpebral sulcus, amount of excess skin, and the skin wrinkles in the lower eyelid. And then patients in different group were treated with different kinds of blepharoplasty. All patients in this study ranged in follow-up from 1 month to 12 months. With patients＇ permit, photographs and clinical information were taken to evaluate the preoperative and postoperative outcome.Results:In type 1, all the 32 cases healed well, no complications such as hematoma, infection and ectropion occurred. During the follow-up of more than 1 months, the overall effect was good, and the pouch-shaped appearance of lower eyelid pouch was significantly improved. In types 2, 8 cases had no complications, and the incision healed well; the patients were followed up for more than 3 months, the lower eyelid bag and lower eyelid skin relaxation were significantly improved, and the lower eyelid skin was tighter than before. In types 3, there were no complications in these 19 cases, and the incision was healed well. The patients were followed up for more than 3 months, the deformity of lower eyelid bag was improved obviously, and no obvious local bulge was found under static and dynamic expression. In type 4, there were no complications in all 34 cases, and the incision healed well; during the follow-up of more than 3 months, the lower eyelid pouch deformity and lower eyelid skin relaxation were greatly improved, except for 1 case with mild bulge (untreated). In type 5, 9 cases had no complications, and the incision healed well; during the follow-up of more than 3 months, the fold of the lower eyelid skin disappeared.Conclusions:Little information is available about classification of lower eyelid bags. And the exact surgical approach remains controversial and largely dependent upon surgeon preference and a patient＇s stated cosmetic desire. In this study, an objective classification based on clinical appearance combined with forming reasons of lower eye bags is little available, and the appropriate surgical approach remains controversial as well.

Influence on orbicularis oculi muscle in the patients with facial neuritis treated with the penetra-ting needling at Cuanzhu (BL2) and Yuyao (EX-HN4) combined with the perpendicular needling at Shenmai (BL62) / 针刺研究

OBJECTIVE: To explore the therapeutic effect on incomplete eyelid in the patients with facial neuritis treated with the penetrating needling at Cuanzhu (BL2) and Yuyao (EX-HN4) combined with the perpendicular needling at Shenmai (BL62). METHODS: A total of 64 patients with facial neuritis, in compliance with the inclusion criteria, were randomized into a treatment group and a control group, with 32 cases in each. In the treatment group, the penetrating needling was applied to BL2 and EX-HN4 on the affected side, combined with the perpendicular needling at bilateral BL62. Besides, on the affected side, the penetrating needling was applied from Yangbai (GB14) toward four directions, named Shangxing (GV23), Touwei (ST8), Cuanzu (BL2) and Sizukong (TE23), the mutual penetrating needling was adopted between Dicang (ST4) and Jiache (ST6). Between Yingxiang (LI20) and Xiaguan (ST7), a row-arranged needling technique was applied. All of the needles were retained for 10 to 30 min in each treatment. The treatment was given once daily and the treatment for 10 days was as 1 course. A total of 2 courses of treatment were required. In the control group, prednisone acetate （30 mg/d）, was administered consecutively for 5 days. Afterward, the dose was reduced to be 10 mg/d and the medication stopped after taking consecutively for 1 week. Muscular injection with vitamin B12 （0.5 mg） and B1 （0.1 mg） was given, once daily. 10 days later, vitamin B1 was taken for oral administration, 10 mg each time, three times a day, for 10 days totally. Before and after the treatment, the clinical effect was compared between the two groups in terms of the analysis on the Hourse-Brackman (H-B) grade of facial nerve function, the distance between the upper and the lower eyelids, muscle strength, degree of eyelid closure and electromyogram (EMG). RESULTS: The total effective rate of treatment group was 96.9 % (31/32), better than 84.4%（27/32） in the control group (P<0.05). After treatment, in the treatment group, the distance between the upper and lower eyelids, the muscle strength, the degree of eyelid closure, the wave amplitude of motor nerve conduction and the latent period, as well as the blink reflex were all improved as compared with those before the treatment (P<0.01, P<0.05). In the control group, the distance between the upper and lower eyelids, the muscle strength, the degree of eyelid closure, the latent period of motor nerve conduction and the blink reflex were all improved as compared with those before the treatment (P<0.01, P<0.05). After the treatment, the results of the distance between the upper and lower eyelids, the muscle strength, the degree of eyelid closure, the wave amplitude of motor nerve conduction and the latent period, as well as the blink reflex in the treatment group were all better than those in the control group (P<0.05，P<0.01). CONCLUSION: The treatment with the penetrating needling at Cuanzhu (BL2) and Yuyao (EX-HN4) combined with the perpendicular needling at Shenmai (BL62) greatly promotes the recovery of orbicularis oculi muscle in the patients with facial neuritis, reduces the complications and presents the satisfactory clinical effect.

Combination of orbicularis oculi muscular myolemma release and orbital septum reset to create double eyelid / 中华整形外科杂志

Objective@#To explore a surgical method for the reconstruction of naturally dynamic double eyelid by fully reserving orbicularis oculi muscle.@*Methods@#Incisional double eyelid blepharoplasty were performed on 352 patients. Orbicularis oculi muscle in incisional and pretarsal area were completely preserved. Muscle was elevated from plate by resecting deep muscular myolemma and muscles to form pretarsal myocutaneous flap. Thereafter, the orbital septum was completely exposed. The free end of muscle flap was fixed to a higher position of the levator aponeurosis. The orbital septum was repaired at the same time.@*Results@#From June 2009 to December 2017, 352 patients were performed double eyelid blepharoplasty using above technique. They are 337 females and 15 males. Fifty-two patients were followed up for 6-60 months, with the mean time of 27 months. All the incisions were uneventfully healed. The new double eyelid presented smooth appearance, and the so-called " sausage" phenomena were not noticed. There was no concave groove or step-like deformity when eyes closed. Forty-five patients were satisfied with the outcomes. Two patients had shallower supratarsal folds on one side, and 1 patient underwent secondary repair. Two patients complained about asymmetry. Two patients suffered from mild unilateral eyelash eversion (without need of reparation).@*Conclusions@#The combined application of deep and superficial myolemma release of the orbicularis oculi muscle, and orbital septum reset, could create a double eyelid with natural and dynamic appearance.

Combination of orbicularis oculi muscular myolemma release and orbital septum reset to create double eyelid / 中华整形外科杂志

Objective@#To explore a surgical method for the reconstruction of naturally dynamic double eyelid by fully reserving orbicularis oculi muscle.@*Methods@#Incisional double eyelid blepharoplasty were performed on 352 patients. Orbicularis oculi muscle in incisional and pretarsal area were completely preserved. Muscle was elevated from plate by resecting deep muscular myolemma and muscles to form pretarsal myocutaneous flap. Thereafter, the orbital septum was completely exposed. The free end of muscle flap was fixed to a higher position of the levator aponeurosis. The orbital septum was repaired at the same time.@*Results@#From June 2009 to December 2017, 352 patients were performed double eyelid blepharoplasty using above technique. They are 337 females and 15 males. Fifty-two patients were followed up for 6-60 months, with the mean time of 27 months. All the incisions were uneventfully healed. The new double eyelid presented smooth appearance, and the so-called " sausage" phenomena were not noticed. There was no concave groove or step-like deformity when eyes closed. Forty-five patients were satisfied with the outcomes. Two patients had shallower supratarsal folds on one side, and 1 patient underwent secondary repair. Two patients complained about asymmetry. Two patients suffered from mild unilateral eyelash eversion (without need of reparation).@*Conclusions@#The combined application of deep and superficial myolemma release of the orbicularis oculi muscle, and orbital septum reset, could create a double eyelid with natural and dynamic appearance.

Isolation, cultivation and identification of skeletal muscle stem cells derived from human orbicularis oculi muscle / 中华整形外科杂志

Objective@#To establish the isolation and culture methods of skeletal muscle stem cells, derived from human orbicularis oculi muscle (OOMSCs), and to identify their multi-directional differentiation potential in vitro.@*Methods@#The cellswere isolated from pretarsal orbicularis oculi muscle (OOM), obtained in routine blepharoplasty surgery.The tissue was digested using collagenase type I combined with re-plating methods. Specific cell surface antigen markers were detected using flow cytometry analysis. OOMSCs were cultured under different inductive conditions, to identify their pluripotent differentiation ability.@*Results@#OOMSCs exhibited similar fibroblast-like morphology as mesenchymal stem cells with high expression of skeletal muscle-derived stem cell surface markers. OOMSCs were able to differentiate into adipocytes, osteoblasts and chondrocytes in vitro, in the presence of lineage-specific inductive media. Moreover, after myogenic induction, the differentiated cells were fused into multinucleated myotube-like structure, and positive for myogenic-related marks, Pax3, Pax7, Myf5 and MyoD.@*Conclusions@#Muscle-derived stem cells can be isolated from human OOM with myogenic differentiation properties, showing further applications potential intissue regeneration and medical therapies of muscle diseases.

Utility of single fiber electromyography in the differential diagnosis of hyperthyroidism associated with ocular myasthenia gravis and Graves ophthalmopathy / 临床神经病学杂志

Objective To assess the utility of single fiber EMG (SFEMG)in the differential diagnosis of hyperthyroidism associated with ocular myasthenia gravis (OMG)and Graves ophthalmopathy.Methods SFEMG was performed in orbicularis oculi muscle of 2 groups of patients.including 32 patients with hyperthyroidism associated with OMG,and 35 patients with Graves ophthalmopathy.The parameters of SFEMG between different groups were compared.Results The mean jitter was (96.2 ± 23.7),(42.8 ± 12.6)μs in hyperthyroidism associated with OMG and patients with Graves Orbitopathy. M50of the percentage of jitter ＞55 μs was 92% and 5% in the 2 groups respectively.M50of the percentage of block was 25% and 0 in the 2 groups respectively.Fiber density was (1.9 ± 0.4)and (1.7 ± 0.5)in the 2 groups respectively.There was significant difference in those parameters of SFEMG between the patients in 2 groups(t＝15.56,Z＝9.26,Z＝7.35,all P＜0.01).Conclusion SFEMG of orbicularis oculi muscle shows significantly increased jitter and block in hyperthyroidism associated with OMG,which can help to differentiate hyperthyroidism associated with OMG from Graves ophthalmopathy.

Comparison of two surgical treatments for involutional entropion of lower eyelid with blepharochalasis / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze and compare the clinical effect in treatment of degenerative entropion of lower eyelid with blepharochalasis between the modified orbicularis oculi muscle shortening procedure and orbicularis muscle shortening procedure.?METHODS:From January 2012 to August 2014, ninety-three cases ( 108 eyes ) diagnosed as involutional entropion of lower eyelid with blepharochalasis were enrolled in our study. According to different surgical methods, patients were divided into observation group (52 eyes in 47 cases) and control group (56 eyes in 46 cases ) . The observation group was performed on the modified orbicularis muscle shortening procedure, and the control group was using a simple orbicularis muscle shortening method. The general datum, short - term clinical effect and long-term clinical effect were collected to compared between two groups.?RESULTS:The age, gender and the course of disease were no significance differences between the observation group and the control group (P>0. 05). There was no statistical significance on the short-term effective rate ( P>0. 05 ) between the observation group and the control group ( 98％ vs 95％, respectively ) . The long - term recurrence rate of the observation group was 2％, while the control group was 14％. It had a significance statistical difference between two groups (P=0. 033).?CONCLUSION: The clinical curative effect of modified orbicularis oculi muscle shortening procedure, in the treatment of lower eyelid entropion with blepharochalasis, is better than the orbicularis muscle shortening procedure's.

Clinical effect of orbital fat replacement combined with orbicularis oculi muscle flap folding for correction of severe upper eyelid depression with multiple eyelid / 中华医学美学美容杂志

Objective To explore the method and effect of orbital lateral fat replacement combined with orbicularis oculi muscle flap for correction of severe upper eyelid depression with multiple eyelid.Methods From January 2014 to January 2017,26 patients with severe upper eyelid sag with multiple eyelid were treated in Department of Plastic Surgery,Huai'an Second People's Hospital,including 18 cases of multiple physiological sag eyelid,improper operation on the formation of 8 cases of multiple eyelid eyelid sag.All the patients adopt outside orbital fat reset with the orbicularis muscle flap folded for the treatment.Results The follow-up time was 6 months to 1 year,with an average of 8.5 months.23 patients with upper eyelid sag with multiple eyelid were rectified,3 cases of upper eyelid depression associated with multiple eyelid depression alleviated,multiple eyelid disappeared,including 5 cases of preoperative patients with mild ptosis,and symptoms improved after surgery.Conclusions The orbital lateral fat replacement combined with orbicularis oculi muscle flap folding is a safe and effective treatment for upper eyelid depression with multiple eyelid.

Clinical efficacy of Fox surgery, improved Fox surgery and modified orbicularis oculi muscle fold surgery for the patients of entropion / 中华医学美学美容杂志

Objective To analyze the clinical efficacy of patients with lower eyelid entropion after the treatment of Fox surgery,modified Fox surgery and modified orbicularis oculi muscle fold surgery.Methods 250 patients with lower eyelid entropion were retrospectively analyzed.The modified orbicularis oculi muscle fold surgery (group A),Fox surgery (group B),and modified Fox surgery (group C) were used for lower eyelid entropion.Results Postoperatively,No skin redness and swelling occured in group A,and mild skin redness appeared in 8 and 2 cases in groups B and C,respectively;the difference was statistically significant between the three groups (P＜0.05);No eyelid hyperemia was found in groups A and C,but 6 cases presented with eyelid margin hyperemia in group B;the difference was statistically significant between the three groups (P ＜ 0.05).Long term follow-up showed that the satisfaction score of group A was (8.23±1.08),B group was (7.54±1.09),C group was (9.26± 1.94),and the difference between three groups was statistically significant (P＜0.05).In addition,the long-term recurrence rate showed that the recurrence rate in group C was the lowest,followed by group A,and the recurrence rate in group B was the highest,and the differences between various groups were statistically significant (P＜0.05).Conclusions The improved Fox surgery has better satisfaction and lower recurrence rate in patients with lower eyelid entropion,and especially the long-term effect is more definite.

Clinical effects of small-incision orbicularis-levator fixation technique for monocular double-eyelid blepharoplasty / 中华医学美学美容杂志

Objective To evaluate the clinical effects of small-incision orbicularis-levator fixation technique for monocular double-eyelid blepharoplasty.Methods Data were collected in 56 patients (5 males and 51 females) with monocular double eyelid from January 2013 to January 2014.All patients underwent small-incision orbicularis-levator fixation blepharoplasty.To ensure the symmetry between the two eyelids,extensive study and design might be done before the surgery,including the positon of incisions,the amount of tissue removed,the tightness of sutures fixation during surgery,and so on.Results All patients were successfully operated and were performed postoperative follow-up for 19.3±3.4 months.MRI was taken on their upper eyelids preoperatively and 6 months postoperatively.Before the surgery,the MRI orbicularis oculi muscle thickness were 4.08±0.74 U in the left side and 4.81±1.05 U in the right (t=2.66,P＜0.05);the areas of orbit fat were 84.26±9.75 U2 in the left and 93.85±12.15 U2 in the right (t =3.21,P＜0.05).As for 6 months postoperatively,the MRI orbicularis oculi muscle thickness were 4.07±0.69 U in the left side and 4.37±0.99 U in the right (t=1.46,P=0.15);the areas of orbit fat were 82.88±8.81 U2 in the left and 85.30±11.94 U2 in the right (t =1.21,P=0.23).Fifty-four patients were satisfied with surgery,the eyelid's crease turned narrow in 1 case and disappeared in 1 case.Those 2 cases were adjusted by secondary surgery using the same method.Conclusions Small-incision orbicularis-levator fixation blepharoplasty has a high success rate,with acceptable bilateral symmetry and slight scar.

In Vitro and In Vivo Osteogenesis of Human Orbicularis Oculi Muscle-Derived Stem Cells

BACKGROUND: Cell-based therapies for treating bone defects require a source of stem cells with osteogenic potential. There is evidence from pathologic ossification within muscles that human skeletal muscles contain osteogenic progenitor cells. However, muscle samples are usually acquired through a traumatic biopsy procedure which causes pain and morbidity to the donor. Herein, we identified a new alternative source of skeletal muscle stem cells (SMSCs) without conferring morbidity to donors. METHODS: Adherent cells isolated from human orbicularis oculi muscle (OOM) fragments, which are currently discarded during ophthalmic cosmetic surgeries, were obtained using a two-step plating method. The cell growth kinetics, immunophenotype and capabilities of in vitro multilineage differentiation were evaluated respectively. Moreover, the osteogenically-induced cells were transduced with GFP gene, loaded onto the porous β-tricalcium phosphate (β-TCP) bioceramics, and transplanted into the subcutaneous site of athymic mice. Ectopic bone formation was assessed and the cell fate in vivo was detected. RESULTS: OOM-derived cells were fibroblastic in shape, clonogenic in growth, and displayed phenotypic and behavioral characteristics similar to SMSCs. In particular, these cells could be induced into osteoblasts in vitro evidenced by the extracellular matrix calcification and enhanced alkaline phosphatase (ALP) activity and osteocalcin (OCN) production. New bone formation was found in the cell-loaded bioceramics 6 weeks after implantation. By using the GFP-labeling technique, these muscle cells were detected to participate in the process of ectopic osteogenesis in vivo. CONCLUSION: Our data suggest that human OOM tissue is a valuable and noninvasive resource for osteoprogenitor cells to be used in bone repair and regeneration.

Therapeutic Observation of Acupuncture for Hemifacial Spasm / 上海针灸杂志

Objective To observe the clinical efficacy of acupuncture in treating hemifacial spasm and its effect on the surface electromyogram signal of orbicularis oculi muscle under contraction state.Method Seventy-six patients with hemifacial spasm were randomized into a treatment group and a control group, 38 cases in each group. The control group was intervened by conventional medications, while the treatment group was by acupuncture in addition to the intervention given to the control group. The surface electromyogram signal of orbicularis oculi muscle under contraction before and after intervention, clinical efficacies, and side effects were compared between the two groups.Result The MF and MPF values were significantly changed after intervention in both groups (P<0.05). After intervention, the MPF value in the treatment group was significantly different from that in the control group (P<0.05). The total effective rate was 92.1% in the treatment group versus 63.2% in the control group, and the difference was statistically significant (P<0.05). The TESS scores after intervention were significantly different from that before intervention in both groups (P<0.05). After intervention, the TESS score in the treatment group was significantly different from that in the control group (P<0.05).Conclusion Acupuncture is an effective method in treating hemifacial spasm, and it can release muscle fatigue.

Clinical efficacy comparison of flabby skin excision combined orbicularis oculi muscle shortening surgery in patients with senile entropion / 国际眼科杂志(Guoji Yanke Zazhi)

AlM:To observe the clinical effect of slack skin excision combined with orbicularis oculi muscle shortening and orbicularis muscle shortening in the treatment of elderly patients with lower eyelid entropion, and provide the reference for the clinical treatment.METHODS: Eighty-two ( 126 eyes ) clinical diagnosis’s elderly patients with lower eyelid entropion were collected from our department, then randomly divided into excised relaxing skin and orbicularis oculi muscle shortening treatment group and the orbicularis muscle shortening treatment group. The general data of the two groups, long term curative effect and short-term curative effect were compared.RESULTS:The age, sex, proportion of patients with the first time operation, course of disease were no statistical significance between the observation group and the control group (P>0. 05). The short-term effective rate of the observation group was 95. 2%, while the short-term effective rate of the control group was 77. 8%, the short-term efficiency differences between the two groups was statistical significance (χ2=4. 100, P=0. 043). The long-term cure rate of the observation group was 82. 5% ( 34 cases, 52 eyes), recurrence rate was 17. 5% (7 cases, 11 eyes), while the cure rate of the control group was 60. 3%(25 cases, 38 eyes), recurrence rate was 39. 7% (16 cases, 25 eyes) , the difference of long term cure rate was statistical significance between the two groups (P<0. 05).CONCLUSlON: The clinical curative effect of slack skin excision combined with orbicularis oculi muscle shortening in the treatment of senile inferior entropion is better than orbicularis muscle shortening operation, recommending application in the clinical.

Inversão da porção lateral do músculo orbicular para tratamento das rítides perioculares (pés-de-galinha) / Inversion of the lateral portion of the orbicularis oculi muscle for the treatment of periocular rhytides (crow's feet)

INTRODUÇÃO: A cirurgia plástica, sempre em busca de resultados cada vez mais expressivo, vem associando às técnicas já consagradas aos novos tempos intraoperatórios. Este trabalho descreve uma técnica cirúrgica para ser associada às ritidoplastias baseada na ressecção da porção lateral do músculo orbicular, seguida pela enxertia do próprio músculo, porém invertido, sobre a área ressecada. MÉTODO: Em um período de 5 anos, foram realizadas 54 ritidoplastias associadas a técnica descrita. RESULTADOS: O seguimento no pós-operatório tardio (5 anos) mostrou-se satisfatório com permanente desaparecimento das ritides perioculares por neutralizar as forças exercidas pelo músculo nesta área. Não houve insatisfação por parte dos pacientes. Logo, trata-se de um procedimento com excelentes resultados na resolução das ritides perioculares e na elevação da porção caudal da sobrancelha em relação a orbita. CONCLUSÃO: A técnica descrita gera resultados permanentes e satisfatórios.

INTRODUCTION:In the continued search for increasingly expressive results, plastic surgeons are combining established techniques with new intraoperative times. This article describes a surgical technique associated with rhytidoplasties based on the resection of the lateral portion of the orbicularis oculi muscle, followed by grafting the muscle itself, however inverted, on the resected area. METHOD: In a 5-year period, 54 rhytidoplasties associated with the described technique were performed. RESULTS: The follow-up in the late postoperative period (5 years) was satisfactory, with the permanent disappearance of periocular rhytides due to the neutralization of the forces exerted by the muscle in this area. There was no dissatisfaction on the part of the patients. Consequently, the procedure had excellent results in the resolution of periocular rhytides and in lifting the caudal part of the eyebrow in relation to the orbit. CONCLUSION: The technique described generates permanent and satisfactory results.

Rhytidectomy by multi-point suture of musculi dormitator with temporalis fascia graft / 中华医学美学美容杂志

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.

Study on blepharoplasty stripping arcuate margin of orbicularis oculi muscle used in patients with tear trough and palpbromalar groove / 中国基层医药

Objective To explore divest arcuate edge orbicularis muscle surgery reconstructive treatment of the symptoms of clinical efficacy and recovery.Methods 80 patients with tear trough and palphromalar groove pouch,according to the operation method,were divided into group A and group B.The patients received stripped arcuate margin of orbicularis oculi muscle operation and true orbital fat too much fat operation,operation treatment,respectively.The satisfaction and revisit the rebound rate of the two groups after surgery were compared.Results Of 40 patients in A group,37 cases (92.5％)were satisfied with the treatment,general satisfaction in 3 cases (7.5％),0 case (0.0％) was not satisfactory.In B group,28 cases (62.5％)were satisfied with the treatment,general satisfaction in 9 cases (22.5％),3 cases (15.0％)were not satisfactory.The clinical efficacy between the two groups was significantly different(Z =18.481,P ＜ 0.01).During follow-up,in A group,one case (2.5％)relapsed.In B group,7 cases (17.5％) relapsed after 2 years.The postoperative recurrence rate between the two groups had significant difference (Z =7.314,P ＜ 0.05).Conclusion For patients with tear trough and palpbromalar groove pouch,treatment by stripping arcuate margin of orbicularis oculi muscle operation method can effectively correct the tear trough and palabromalar groove deformity postoperative reduction performance,has high degree of satisfaction,the recurrence rate is low,the clinical effect is significant,it is worthy of further clinical application and research.