[Sonographic imaging of upper eyelid tarsal radii when changing the direction of vision]. / Sonographische Darstellung der Oberlidtarsalradien bei Blickrichtungsänderung.

AIM: Aesthetic and reconstructive surgery of the upper eyelid attempts to restore aesthetic or functional deficits. Knowing of the anatomic relationships in these structures is very important. The aim of our study was to assess by ultrasound the upper eye lid tarsal curvature changes depending on movement of the bulbus. METHODS: In 50 people with healthy eyes we measured the diameter of the upper eyelid tarsal plate, the cornea, the bulbus and additionally the intraocular pressure. In measuring the upper eyelid tarsal plate we used transpalpebral ultrasound in a non contact mode with a 7.5 MHz linear array scanner, with the bulbus in median and in abduction position. RESULTS: In healthy eyes the diameter of the upper eye lid tarsal plate changes depend on movement of the bulbus. The mean diameter of the upper eye lid tarsal plate over the bulbus in medium position was 19.3 +/- 3.8 mm versus 30.1 +/- 6.3 mm in abduction position. This difference is statistically significant (p < 0.05). CONCLUSIONS: The results of the study indicate, that using ultrasound with a 7.5 MHz linear array scanner is appropriate for objective evaluation of relative changings of the upper eye lid tarsal plate diameter. The obtained data showed significant differences and must be taken into account when considering cosmetic and functional surgery of the upper eye lid, f. e. lidloading in facial palsy with gold or platinum implants.

[Atypical course in (eosinophilic) fasciitis]. / Atypischer Verlauf einer (eosinophilen) Fasziitis.

A 22-year old male patient developed--following a short phase of monarthritis--the symptoms of a symmetric, polysynoviatic, discrete erosive rheumatoid arthritis, thus fulfilling five of seven ACR criteria. Initially as well as persisting during the course of the disease the palpable swelling of synovitis showed a coarse character. The radiological progression at the hands during an interval of eight years being only minimal the loss of functions, up to contraction of joints (left hip) augmented considerably during that time. Neither rheumatoid factor or antinuclear antibodies nor evident eosinophilia or hypergammaglobulinaemia could be proved or verified. In 1994 muscle biopsy led to the diagnosis "fasciitis with low-graded eosinophilia". Anamnestic, clinical and radiological signs and data as well as the course of the disease and assessing of differential diagnoses are presented and discussed.