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.

A Case of Periorbital Necrotizing Fasciitis Occurred in Patient with Fungal Sinusitis / 대한이비인후과학회지

Orbital complications due to sinusitis usually occur in children and spread from the ethmoid or frontal sinusitis. Periorbital necrotizing fasciitis, which is an aggressive infection characterized by extensive necrosis and gas formation in the fascia and subcutaneous tissue, is uncommon as an orbital complication due to sinusitis. Because most of orbital complications of the fungal sinusitis occur from invasive fungal infection in immunocompromised patients, orbital complications due to non-invasive maxillary fungal ball in healthy patients are extremely rare, especially if the complication is periorbital necrotizing fasciitis. We report a case of periorbital necrotizing fasciitis that occurred in a healthy 44-year-old male patient with non-invasive fungal sinusitis, which was treated with a combination of intravenous antibiotics and endoscopic sinus surgery and ophthalmologic surgical treatment.

A Case of Periorbital Necrotizing Fasciitis Occurred in a Diabetes Mellitus Patient Accompanied with Chronic Sinusitis with Nasal Polyp / 대한이비인후과학회지

Necrotizing fasciitis is a soft tissue infection characterized by necrosis of fascia and subcutaneous tissue. It rarely occurs in the craniocervical area but when it does, it can be fatal. Early recognition and prompt intervention are important in minimizing morbidity and mortality rates. We report on a diabetes mellitus patient with periorbital necrotizing fasciitis, which was treated with a combination of intravenous antibiotics and debridement of necrotic tissue and meticulous local wound management.