ABSTRACT
Propranolol has been used successfully in a limited number of children with infantile hemangiomas (IHs). This study describes the efficacy and adverse effects of propranolol in IH. Seventy-one infants with IHs were treated with oral propranolol, administered at a dose of 2 mg/kg/day, for at least 12 weeks. A photograph-based severity scoring assessment was performed by five observers to evaluate efficacy, utilizing a score of 10 as the original IHs before treatment and 0 as completely normal skin. The mean of the five independent measurements was used in the analysis. Propranolol was a rapid and effective treatment for IHs at 4 weeks (P<0.001), at 8 weeks (P<0.001 compared with the value at 4 weeks), at 12 weeks (P<0.05 compared with the value at 8 weeks), and thereafter up to 32 weeks (P<0.01 compared with the value at 16 weeks). The response of IHs to propranolol was similar regardless of gender, age at the onset of treatment, type of involvement (local and extended), facial segments affected, special locations (eyelid, nasal tip, and parotid regions), ulceration, and depth of IHs. In the series of patients in this study, oral propranolol at a dosage of 2 mg/kg/day was a well-tolerated and effective treatment for IHs.
Subject(s)
Adrenergic beta-Antagonists/therapeutic use , Hemangioma/drug therapy , Propranolol/therapeutic use , Skin Neoplasms/drug therapy , Administration, Oral , Adrenergic beta-Antagonists/adverse effects , Child, Preschool , Face , Female , Humans , Infant , Male , Propranolol/adverse effects , Severity of Illness Index , Treatment OutcomeABSTRACT
In the subject of this case report, a self-inflating hydrogel expander was implanted as a treatment for posttraumatic enophthalmos in a fully sighted eye. The intervention caused hypertropia with diplopia, restriction of eye movements, visual field defects, and colour desaturation as a result of excessive swelling of the expander. Once the expander volume was adjusted, clinical signs regressed, and the aesthetic results were excellent. Following the implantation of self-inflating orbit expanders, it is advisable to carry out immediate follow-up during the expander's swelling period, and long-term follow-up is also advised to rule out late sequelae, as a position-dependent secondary glaucoma could occur.
Subject(s)
Diplopia/etiology , Diplopia/prevention & control , Enophthalmos/therapy , Hydrogels , Oculomotor Nerve Diseases/etiology , Oculomotor Nerve Diseases/prevention & control , Orbital Implants/adverse effects , Female , Humans , Young AdultABSTRACT
AIMS: The aim of this study was to determine the indication for endoscopic-assisted forehead and brow lift and to present the surgical technique and evaluate clinical outcome. PATIENTS AND METHODS: A total of 61 female patients between 36 and 64 years (s=49.64) were operated from 1999 through 2002 with the endoscopic-assisted forehead and brow lift and were observed pre- and postoperatively and 6 months after surgery. The galea aponeurotic flap was fixed through a bone tunnel (tabula externa) with nonabsorbable sutures in all patients. We measured the distance between the middle of the pupil and the most cranial point of the eyebrow as well as the largest distance between the eyebrow and the hairline intraoperatively and 6 months after surgery. The patients' satisfaction with the outcome of these surgical procedures was determined on a scale from 1 to 10 with 1 as the worst and 10 as the best mark. RESULTS: We found a brow lift of 8.03 mm (s=1.622) on average. The endoscopic forehead and brow lift was indicated up to the maximal distance of 12 cm between the eyebrow and the hairline. The patients' satisfaction with the outcome was registered on average at 6.98 (s=1.36) on our scale. A temporary unilateral weakness of the frontal branch of the facial nerve was the severest complication found postoperatively. CONCLUSION: The endoscopic-assisted forehead and brow lift is a safe and effective method to improve upper face aesthetics. A high grade of patient satisfaction is obtainable. The advantage in using this method is the invisible scar formation. The indication is limited by a high hairline.
Subject(s)
Endoscopy/methods , Eyebrows , Forehead/surgery , Rhytidoplasty/methods , Adult , Esthetics , Facial Expression , Female , Follow-Up Studies , Humans , Middle Aged , Outcome Assessment, Health Care , Patient SatisfactionABSTRACT
In cases of stab and bite injuries to the face there is a risk of general infection and the necessity for an active and/or passive immunization must be considered by the first treating physician. In Central Europe tetanus, rabies, hepatitis B and C as well as HIV must be taken into account as possible consequences of such injuries. With regard to a tetanus immunization the indication for the post-exposition prophylaxis (PEP) should generally be as wide as possible. For other protective vaccinations a differentiated decision in co-operation with other fields of activity and public health authorities should be realized. The current recommendations for the systemic infections relevant in Central Europe are described.
