ABSTRACT
PURPOSE: To present three cases of chronic infraorbital nerve hyperesthesia relieved by surgical decompression of the infraorbital nerve. METHODS: Retrospective chart review. RESULTS: We identified three cases of chronic hyperesthesia of the infraorbital nerve. Two cases were related to previous blunt orbital trauma, whereas the third was associated with a long-standing anophthalmic socket with numerous previous surgeries. In each case, patients had dramatic relief of infraorbital nerve hyperesthesia and pain after surgical decompression of the infraorbital nerve. CONCLUSIONS: Surgical decompression of the infraorbital nerve can provide significant symptomatic improvement in patients with chronic infraorbital nerve hyperesthesia secondary to nerve compression.
Subject(s)
Cranial Nerve Diseases/surgery , Decompression, Surgical/methods , Hyperesthesia/surgery , Maxillary Nerve/surgery , Orbit/innervation , Adult , Chronic Disease , Cranial Nerve Diseases/diagnosis , Female , Humans , Hyperesthesia/diagnosis , Magnetic Resonance Imaging , Male , Maxillary Nerve/pathology , Middle Aged , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
The apocrine hidrocystoma is a benign adenomatous cystic proliferation derived from apocrine glands, which frequently occurs in periocular tissues. These cystadenomas may occur bilaterally, in multiple disfiguring confluent groups on both the upper and lower lids. Although these lesions have been treated successfully with meticulous surgical extirpation and electrosurgery, this report describes the successful treatment of two patients, each with multiple large (>7 mm) periocular apocrine hidrocystomas by either chemical ablation of the cystic epithelium with trichloroacetic acid (TCA) or surgical excision. Examination of the cysts at 1, 3, and 6 months after TCA treatment revealed well-healed lesions without cyst recurrence. Most of the TCA-treated cysts resolved completely, without leaving any trace to clinical examination. Treatment of cysts with TCA was technically simpler and much less time-consuming than surgical excision. The treatment of large apocrine hidrocystomas with TCA is an effective and expeditious method of treating these disfiguring and recalcitrant lesions.
Subject(s)
Apocrine Glands/drug effects , Eyelid Neoplasms/drug therapy , Hidrocystoma/drug therapy , Neoplasms, Multiple Primary/drug therapy , Sweat Gland Neoplasms/drug therapy , Trichloroacetic Acid/therapeutic use , Aged , Apocrine Glands/pathology , Eyelid Neoplasms/pathology , Hidrocystoma/pathology , Humans , Male , Middle Aged , Neoplasms, Multiple Primary/pathology , Sweat Gland Neoplasms/pathologyABSTRACT
PURPOSE OF REVIEW: In this text, we describe and compare the most current brow-lifting techniques, including endoscopic, coronal, and pretrichial approaches, as well as subperiosteal and subgaleal dissection planes, and we discuss the advantages and disadvantages of each. RECENT FINDINGS: Over the past decade, we have witnessed tremendous advances in the anatomic understanding of brow ptosis and in the procedures used to correct the resulting functional and aesthetic deformities.
Subject(s)
Eyebrows , Rhytidoplasty , Blepharoplasty , Blepharoptosis , Endoscopy , Forehead/surgery , Humans , Rhytidoplasty/methodsABSTRACT
PURPOSE: To study the effect of upper eyelid ptosis repair by Müller muscle-conjunctival resection on tear production. METHODS: The authors retrospectively reviewed the charts of 174 patients who underwent ptosis repair by Müller muscle-conjunctival resection at the Casey Eye Institute between October 1996 and August 2001. After exclusions for insufficient data and confounding ocular morbidities, the charts of 38 patients, consisting of 71 ptosis repair surgeries, were analyzed. A single surgeon performed the same procedure on all patients. All subjects underwent Schirmer testing before ptosis repair and again during the period between 6 weeks to 18 months after surgery. Patients responded to questions pertaining to dry eye symptoms during preoperative and postoperative visits. RESULTS: No statistically significant change in tear production (as measured by Schirmer strip testing) associated with ptosis correction by Müller muscle-conjunctival resection was observed. Before surgery, 34% (24 of 71) of eyes measured dry before ptosis repair. This ratio remained unchanged on long-term follow-up. A transient increase in dry-eye symptoms was reported in at least one eye of 29% (11 of 38) of patients in the immediate postoperative period (<2 weeks). On long-term follow-up, a persistent increase in dry-eye symptoms or new diagnosis of dry eye was observed in at least one eye of 16% (6/38) of patients, whereas 13% (5/38) of patients noticed diminution of their presurgical dry eye symptoms. CONCLUSIONS: Upper eyelid ptosis repair by Müller muscle-conjunctival resection had no significant effect on tear production as measured by Schirmer testing. Subjective dry-eye symptoms transiently increased in the immediate postoperative period but resolved frequently by the late follow-up period.