Blink Lagophthalmos in Graves Orbitopathy.

PURPOSE: To investigate the relationship between the kinematics of spontaneous blinks and the anterior area of the levator palpebrae superioris muscle in patients with Graves orbitopathy (GO). METHODS: This is a case-control study. The authors measured the margin reflex distance of the upper eyelid (margin reflex distance 1), the kinematics of spontaneous blinks, and the anterior area of levator palpebrae superioris muscle in CT coronal scans of patients with Graves upper eyelid retraction (GO) and a control group. The eye with the greatest margin reflex distance 1 was selected for analysis in each group. RESULTS: A total of 68 participants were included, with 36 in the GO group and 32 in the control group. In the GO group, the mean margin reflex distance 1 measured 6.5 mm, while in the control group, it was 3.9 mm. Almost all parameters related to the closing phase of spontaneous blinking activity, including amplitude, velocity, blinking rate, and interblink time, did not differ between the two groups. However, the effectiveness of the blink's amplitude (ratio of blink amplitude to margin reflex distance 1) and the main sequence (relationship between amplitude and velocity) were significantly reduced in the GO group compared with the control group. The area of the levator palpebrae superioris muscle was significantly larger in GO than in controls, with 71.4% of patients' muscles outside of the maximum range of the controls. CONCLUSIONS: In patients with GO, there is a reduction in blinking effectiveness, also known as blink lagophthalmos, which is a factor in the common occurrence of ocular surface symptoms. The increase in velocity with amplitude is also reduced in GO.

Cerclage sling technique using temporalis muscle fascia to manage paralytic lagophthalmos: A preliminary study.

PURPOSE: Despite various existing surgical techniques, treatment of facial nerve palsy remains difficult. The purpose of this report is to present the cerclage sling technique using temporalis fascia to manage paralytic lagophthalmos. METHODS: A series of six patients underwent a cerclage sling technique using temporalis muscle fascia to treat paralytic lagophthalmos. The technique is presented in detail. Symptoms, palpebral fissures, and lagophthalmos were assessed pre- and postoperatively. Data were submitted for statistical analysis. RESULTS: After surgery, all patients achieved a reduction in clinical symptoms. The upper eyelids had lowered, and the inferior eyelids had elevated, reducing ocular exposure even if mild residual lagophthalmos was present. CONCLUSION: Cerclage using the temporalis muscle fascia sling technique is a safe and effective procedure to treat facial nerve paralytic lagophthalmos. A reduction in ocular exposure and lagophthalmos provides improvement in clinical symptoms and eyelid function.

Auricular Cartilage Graft for Lengthening Levator Muscle Aponeurosis With Ectropion Correction for Paralytic Lagophthalmos.

BACKGROUND: Paralytic lagophthalmos can have devastating consequences for vision if left untreated. Several surgical techniques have been described, including the utilization of alloplastic and autologous materials. OBJECTIVES: The authors sought to evaluate the effectiveness of the surgical treatment of paralytic lagophthalmos with combined techniques employing autologous material and involving the upper and lower eyelids. METHODS: Patients with paralytic lagophthalmos underwent stretching of the levator aponeurosis with interposition of conchal cartilage in the upper eyelid associated with sectioning of the orbitomalar ligament and lateral canthoplasty in the lower eyelid. The effectiveness of the technique was evaluated employing subjective (symptomatology) and objective parameters (ophthalmologic evaluation and measurements of lagophthalmos and marginal reflex distances 1 and 2). RESULTS: Eight patients with paralytic lagophthalmos were subjected to the proposed technique. In the postoperative period, 85.7% reported complete improvement of symptoms and 62.5% presented a normal eye examination. The mean lagophthalmos measurement was reduced by 5.93 mm, the mean marginal reflex distance 2 was reduced by 2.61 mm, and the mean marginal reflex distance 1 was reduced by 0.69 mm. CONCLUSIONS: The technique presented herein, employing autologous material associated with sectioning of the orbitomalar ligament and lateral canthoplasty, was effective in the treatment of paralytic lagophthalmos and did not present significant complications, such as extrusion.

Estimación poblacional y sanitaria de Canis lupus familiaris en zonas rurales y urbanas de Huancarama, Perú / Population and health estimate of Canis lupus familiaris in rural and urban areas of Huancarama, Peru

RESUMEN El objetivo de la investigación fue estimar la población de canes con propietario y evaluar algunos aspectos de su estado sanitario en el distrito de Huancarama. El estudio fue cuantitativo, observacional, descriptivo y transversal. Se efectuó en noviembre de 2020. Las viviendas se seleccionaron mediante un muestreo estratificado aleatorio proporcional que contemplaba a los centros poblados como estratos. Se realizó una encuesta a los jefes de familia en las viviendas utilizando como instrumento una guía de entrevista validada por expertos. La información recolectada se transfirió a una hoja de Excel® para ser procesada con el software Epidat 4.2. El 70% (IC95% = 65,8-74,2%) de las viviendas tuvo canes. Los centros poblados con mayor tenencia de canes fueron Tunyabamba y Mateclla (100%, respectivamente). La mayoría de viviendas tuvo un solo can (51,3%), con predominio del sexo macho (68,8%) y edades entre 2 y 8 años (77,6%). Pocas familias tuvieron en confinamiento a sus canes (19%) y los han esterilizado (2%). Sin embargo, aunque la mayoría de los canes fueron vacunados contra la rabia (81,9%), son pocos los que tuvieron control veterinario (16%). Todos los centros poblados, a excepción de California, tuvieron en promedio un can por vivienda. En el distrito existen 1.717 canes con propietario y una razón de tres personas por cada can. Los centros poblados de Llactabamba, Acco, Tunyabamba, Lambraspata, Los Ángeles, Sotapa Pararani y otros tuvieron una razón de dos personas por can. En conclusión, existe excesiva cantidad de canes en el distrito de Huancarama, constituyendo una proporción elevada en relación con la de personas.

ABSTRACT The objective of the research was to estimate the population of dogs with an owner and to evaluate some aspects of their sanitary status in the district of Huancarama. The study was quantitative, observational, descriptive and cross-sectional. It was carried out in November 2020. The dwellings were selected through a proportional random stratified sampling considering the populated centers as strata. A survey of household heads was conducted using an interview guide validated by experts as an instrument. The information collected was transferred to an Excel* sheet to be processed later with the Epidat 4.2 software. 70% (95% CI = 65, 8-74, 2%) of the dwellings had dogs. The populated centers with the highest proportion of dog ownership were Tunyabamba and Mateclla (100%, respectively). Most of the dwellings had only one dog (51, 3%), with a predominance of the male sex (68, 8%) and ages between 2-8 years (77, 6%). Few families have their dogs confined (19%) and have them sterilized (2%). However, although the majority of the dogs were vaccinated against rabies (81,9%), few had veterinary control (16%). All populated centers, with the exception of California, had an average of one can per dwelling. In the district there are 1.717 dogs with owners and a ratio of three people to each dog. The population centers of Llactabamba, Acco, Tunyabamba, Lambraspata, Los Angeles, Sotapa Pararani, and others had a ratio of two people per dog. In conclusion, there is an excessive number of dogs in the district of Huancarama, constituting a high proportion in relation to that of people.