Blefaroplastia realizada con láser de CO2 versus radiocirugía en pacientes con dermatochalasis / Blepharoplasty performed with CO2 laser versus radiosurgery in patients with dermatochalasis

Objetivo: Describir los resultados de las blefaroplastias con láser de CO2 y radiocirugía realizada a pacientes con dermatochalasis del párpado superior en el Hospital "Hermanos Ameijeiras". Métodos: Se realizó un estudio descriptivo longitudinal en pacientes del servicio de Oftalmología. Después de aplicar los criterios de selección la muestra quedó conformada por los primeros 100 pacientes que asistieron de forma consecutiva y se dividieron al azar en dos grupos de 50 casos cada uno, al grupo A se le realizó blefaroplastia superior transcutánea con radiofrecuencia y al grupo B se le realizó blefaroplastia superior transcutánea con láser de CO2. Resultados: En ambos predominaron los pacientes entre los 60 a 79 años, el sexo femenino y los de color de piel blanca (p>0,05); se logró una reducción completa de la piel redundante en más de un 50 pr ciento. El tiempo quirúrgico promedio con el láser de CO2 fue de 31.5 min y con radiofrecuencia de 35,9 min. El sangrado intraoperatorio fue menor en operados con el láser de CO2. La satisfacción de los pacientes fue buena en ambos grupos. Complicaciones posoperatorias: el 16 del grupo A y el 11% del B, presentaron alguna complicación. Conclusiones: Se observó que con el uso del láser de CO2 el tiempo quirúrgico, el sangrado intraoperatorio y las complicaciones disminuyeron; con lo cual mejoró el aprovechamiento del salón. Ambas técnicas mostraron un elevado grado de satisfacción y mejoría de la estética palpebral por lo que son efectivas y seguras(AU)

Objective: To describe the results of CO2 laser blepharoplasty and radiosurgery performed in patients with upper eyelid dermatochalasis. Methods: A descriptive longitudinal study was carried out in patients of the Ophthalmology Service of the Clinical Surgical Hospital "Hermanos Ameijeiras". After applying the selection criteria, the sample consisted of the first 100 patients who attended consecutively and were randomly divided into two groups of 50 cases each. Group A underwent transcutaneous upper blepharoplasty with radiofrequency and group B underwent transcutaneous upper blepharoplasty with CO2 laser. Results: In both groups, patients between 60 and 79 years of age, female gender and white skin color predominated (p>0.05); a complete reduction of redundant skin was achieved in more than 50 percnt. The average surgical time with CO2 laser was 31.5 min and with radiofrequency 35.9 min. Intraoperative bleeding was lower in those operated with the CO2 laser. Patient satisfaction was good in both groups. Postoperative complications: 16 por ciento of group A and 11 percent of group B presented some complication. Conclusions: It was observed that with the use of CO2 laser the surgical time, intraoperative bleeding and complications decreased; thus improving room utilization. Both techniques showed a high degree of satisfaction and improvement of palpebral aesthetics, so they are effective and safe(AU)

Split cricoídeo posterior endoscópico con injerto de cartílago costal / Endoscopic posterior cricoid split with costal cartilage graft

RESUMEN A pesar de los avances en cirugía de vía aérea, tanto abierta como endoscópica, la inmovilidad bilateral de cuerdas vocales continúa representando un desafio significativo para los cirujanos de vía aérea. Entre las alternativas quirúrgicas existen tanto abordajes endoscópicos como transcervicales, no obstante, la mayoría de estas técnicas modifican estructuralmente regiones de la cuerda vocal y/o aritenoides de manera permanente. La traqueostomía ha sido el tratamiento de elección en niños con inmovilidad bilateral de cuerdas vocales severamente sintomática, sin embargo, el procedimiento ideal debiese establecer una vía aérea adecuada evitando la necesidad de realizar una traqueostomía, y a la vez no generar un deterioro de la función fonatoria. La capacidad de expandir el aspecto glótico posterior sin modificación estructural de aritenoides y/o ligamento vocal ha convertido a la sección cricoidea posterior endoscópica con injerto de cartílago costal en una alternativa quirúrgica atractiva para estos casos. En este trabajo se realiza una revisión de la literatura y presenta un caso tratado mediante esta técnica en el Hospital Guillermo Grant Benavente de Concepción, Chile.

ABSTRACT Despite advances in both open and endoscopic airway surgery, bilateral vocal cord immobility still poses a significant challenge for airway surgeons. Among the surgical alternatives there are both endoscopic and transcervical approaches. However, most of these techniques structurally modify certain regions of the vocal cord and/or arytenoids permanently. Tracheostomy has been the treatment of choice in severely symptomatic children with bilateral immobility of vocal cords. Nevertheless, the ideal procedure should establish an adequate airway, avoiding the need to perform a tracheostomy, and at the same time not causing a deterioration of the phonatory function. The ability to expand the posterior glottis without structural modification of the arytenoids and/or vocal ligament has converted the posterior endoscopic cricoid split with costal cartilage graft into an attractive surgical alternative for these cases. In this article we review the literature and present a case treated by this technique in the Guillermo Grant Benavente Hospital in Concepción, Chile.

Blefaroplastia: resultados del empleo de dos técnicas en el Centro Oftalmológico de Santiago de Cuba / Blepharoplasty: results of using two techniques in the Ophthalmologic Center from Santiago de Cuba

Introducción: La blefaroplastia produce resultados clínicos y estéticos favorables en los pacientes aquejados por dermatocalasis. Objetivo: Evaluar los resultados de los procedimientos quirúrgicos convencional y con láser de CO2 en estos afectados. Métodos: Se realizó un estudio descriptivo, prospectivo y trasversal de 300 pacientes con dermatocalasis, atendidos en el Servicio de Oculoplastia del Centro Oftalmológico del Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba, desde enero de 2015 hasta diciembre de 2016. Resultados: Predominaron el grupo etario de 40 a 59 años, el sexo femenino y la afectación en los párpados superiores, sin diferencias significativas en cuanto a las técnicas quirúrgicas empleadas; se observó un mayor número de complicaciones en los pacientes operados de manera convencional, con más frecuencia del sangrado. En general los pacientes evolucionaron satisfactoriamente y los que presentaron limitaciones del campo visual superior se recuperaron sin dificultad luego de la intervención quirúrgica. Conclusiones: La blefaroplastia con láser de CO2 constituye una mejor y más calificada opción terapéutica para la corrección de la dermatocalasis

Introduction: Blepharoplasty produces favorable clinical and cosmetic results in the patients that are suffering from dermatochalasis. Objective: To evaluate the results of the conventional and CO2 laser surgical procedures in these affected patients. Methods: A descriptive, prospective and cross-sectional study of 300 patients with dermatochalasis, assisted in the Oculoplasty Service of Dr Juan Bruno Zayas Alfonso Teaching General Hospital Ophthalmologic Center was carried out in Santiago de Cuba, from January, 2015 to December, 2016. Results: There was a prevalence of the 40 to 59 age group, female sex and upper lids disorder, without significant differences concerning the surgical techniques that were used; a higher number of complications in patients operated with a conventional way was observed, with more frequency of bleeding. In general the patients had a favorable clinical course and those that presented limitations of the upper visual field recovered without difficulty after the surgical intervention. Conclusions: Blepharoplasty with CO2 laser constitutes a better and more qualified therapeutic option for the correction of dermatochalasis

Aplicación del láser de CO2 en pacientes con dermatochálasis / Use of CO2 laser in patients with dermatochalasis

Objetivo: describir los resultados del tratamiento quirúrgico de la dermatochálasis con láser de CO2.Métodos: se realizó un estudio descriptivo, longitudinal y prospectivo en 54 pacientes atendidos en el Servicio de Oculoplastia del Instituto Cubano de Oftalmología Ramón Pando Ferrer de enero a noviembre de 2007. Se analizaron las variables: edad, sexo, color de la piel, localización y resultado quirúrgico...

Objective: to describe the results of surgical treatment with CO2 laser dermatochalasis.Methods: a prospective, longitudinal and descriptive study of 54 patients, who were treated at the Oculoplasty service from January to November 2007, was carried out. The following variables were used: age, sex, race, location and surgical outcome...

Avaliação de uma técnica simplificada para tratamento de rítides da região perioral e periorbicular com laser de CO2 / Evaluation of a simplified technique for the treatment of rhytids in the perioral and periorbicular regions with CO2 laser

Introdução: O avanço alcançado pelo conceito de fracionamento para lasers ablativos otimizou os resultados dos tratamentos para fotorrejuvenescimento diminuindo as complicações e o tempo de recuperação pós-procedimento. Métodos: Avaliamos uma modificação da técnica clássica de resurfacing ablativo com laser de CO2 que não possui a opção de fracionamento, em que o operador faz controle visual do fracionamento deixando áreas de pele sã entre as áreas tratadas. Nove voluntárias entre 38 e 73 anos, apresentando fotoenvelhecimento moderado ou grave foram submetidas à técnica nas regiões perioral e periocular. O laser foi aplicado com fracionamento visual em três sessões para a região periocular e duas sessões para a região perioral. Os resultados, avaliados através de fotografia por dois profissionais não médicos, pelo médico operador e pela opinião do paciente, foram classificados em: nenhuma melhora, melhora discreta, melhora moderada e grande melhora. Resultados: As nove pacientes realizaram tratamento completo da região periorbicular e relataram: quatro (44%) grande melhora, e cinco (56%) melhora moderada. Das quatro pacientes que realizaram tratamento da região perioral três (75%) relataram grande melhora, e uma (25%), melhora moderada. A avaliação fotográfica dos profissionais não médicos foi idêntica à percepção das pacientes. Na avaliação do médico para região perioral três (33%) tiveram grande melhora, e seis (67%), melhora moderada; e para região perioral duas melhora moderada, e duas melhora discreta. A recuperação total da pele ocorreu entre 15 e 30 dias, sendo o eritema o sinal mais persistente. Conclusão: A técnica mostrou-se boa opção para a melhora das rugas periorais e periorbiculares.

Introduction: The use of fractional ablative lasers has optimized the results of photorejuvenation treatments by decreasing the number of complications and reducing the post-procedure recovery time.Methods: The authors evaluated a modification in the classic ablative resurfacing technique with CO2 laser, in which the operator has visual control of the fractioning, allowing healthy skin to be left alone between treated areas. Nine volunteers (aged 38-73), with moderate to severe photodamage, received visual fractioning in the perioral (three sessions) and periocular regions (two sessions). Photographic evaluations were conducted by two non-medical professionals, the operator physician, and the patients.Results: In the periorbicular region, four patients (44%) presented considerable improvement, and five (56%) moderate improvement. Of the four patients who underwent treatment of the perioral region, three (75%) reported considerable improvement and one (25%) reported moderate improvement. The photographic evaluation of the non-medical professionals was identical to patient-reported outcomes. In the physician's assessment for the perioral region, three (33%) presented considerable improvement and six (67%) had moderate improvement. For the perioral region, two presented moderate improvement and two had slight improvement. The skin fully recovered within 15-30 days, with erythema the most persistent symptom.Conclusion: The technique is a good option for the improvement of perioral and periorbicular wrinkles

O emprego do laser de CO2 no controle da cárie dentária / The use of CO2 laser on dental caries control

O laser de dióxido de carbono atua na inibição da desmineralização do esmalte, reduzindo sua solubilidade aos ácidos e, este efeito pode ser potencializado quando associado a agentes fluoretados. Assim, o objetivo deste trabalho foi descrever as características do laser de CO2, discutir os mecanismos de ação do laser na inibição da desmineralização do esmalte e ainda, revisar a literatura a respeito de seus efeitos quando combinado ao íon flúor.

Carbon dioxide laser acts on the enamel demineralization inhibition by reducing its acid solubility and this effect can be enhanced when associated with fluoridated agents. Therefore, the aim of this paper was to describe CO2 laser characteristics, discuss its action mechanisms on the inhibition of enamel demineralization and also to review the literature concerning the laser effects when combined with fluoride ion.