ABSTRACT
OBJECTIVES: With the effect of advancing age and environmental factors, excess skin and muscle start to weigh on the eyelids and cause a tired facial expression. The prevailing opinion is that by partially excising muscle in surgical treatment, this load on the eyelid will be reduced, and more successful results will be obtained. Using a classic strip orbicularis oculi excision, the integrity of the muscle is disrupted, and morbidities such as lagophthalmos and edema increase. In this paper, we share our clinical experiences regarding the split excision of the palpebral part of the orbicularis oculi muscle and the subsequent process. METHODS: Twenty-seven patients who applied to our clinic to undergo blepharoplasty were operated on under local anesthesia. The orbicularis oculi muscle was split-excised together with the skin from the marked areas. RESULTS: The split excision of the orbicularis oculi muscle did not cause prolonged edema. The general appearance of the eyelid and face of the patients was observed to have significantly improved in the third month after surgery compared with the preoperative period. No complications such as wound healing, hypertrophic scar, asymmetry, or infection were observed during the follow-up period. CONCLUSIONS: The split excision of the orbicularis oculi muscle can be considered a new and effective method in cases in which a muscle excision is planned as part of blepharoplasty. Prolonged edema due to the strip muscle excision is not observed clinically. This technique can eliminate the negative effects of excess muscle tissue on the eyelid without disrupting the integrity of the muscle. LEVEL OF EVIDENCE: Evidence Based Medicine Level V.
ABSTRACT
Background and objectives: Neuropathic pain is defined as pain caused by damage to the nerve as a result of a lesion or disease. It has been shown that ischemic preconditioning exerts a protective role in various tissue injuries; however, the effect of transplantation of remote ischemic preconditioning serum (RIPCs) on neuropathic pain symptoms has not been studied. The aim of this project is to investigate the effect of RIPCs transfusion by different routes of administration on neuropathic pain symptoms. Our secondary aim was to demonstrate the role of Schwann cells in the regeneration of sciatic nerve injury and to evaluate the change in the number of glial cells in the spinal cord dorsal horn. Methods: The sciatic nerve partial ligation method was used to induce neuropathic pain. Changes in neuropathic pain symptoms were assessed by measuring thermal hyperalgesia and mechanical allodynia. To determine the possible therapeutic site, alterations in the number of spinal cord lumbar posterior horn microglia and astrocytes were evaluated by ionized calcium-binding adapter molecule 1 (iba1) and glial fibrillary acidic protein (GFAP) immunostaining. Myelin basic protein immunohistochemistry was also used to assess Schwann cell immunoreactivity in the sciatic nerve. Results: In rats that underwent partial sciatic nerve ligation, neuropathic pain symptoms developed on average on day 12 and persisted up to day 21 (p < 0.0001). RIPCs administered intravenously for five days reduced thermal hyperalgesia more than intraperitoneal and subcutaneous administration (p < 0.05). Both central glial cells appear to play a role in the effect of RIPCs. RIPCs treatment increases Schwann cell remyelination. Conclusions: Our results showed that intravenously administered RIPCs remarkably improved the neuropathic pain symptoms, thermal hyperalgesia and mechanical allodynia. Further studies are needed to evaluate the role of RIPCs transfusion on glial cells.
