Minimally invasive temporalis tendon transposition and upper lid lipofilling for immediate and secondary facial reanimation in patients treated for malignant tumors of the parotid gland

Treatment for facial nerve-invading parotid malignancies usually results in complete facial palsy. The authors present a novel technique to treat facial palsy following radical parotid surgery and retrospectively evaluate results in terms of soft tissue symmetry at rest and during smiling and eyelid closure using the eFACE system.9 patients with facial palsy following parotid malignancies resection or undergoing parotidectomy with planned facial nerve resection for tumor invasion were treated with the association of mini-invasive temporalis flap rotation and upper lid lipofilling to restore symmetry of the middle facial third at rest and during smiling and eyelid closure. The technique was employed during the same surgical session as the tumor removal or for secondary facial reanimation.Systematic eFACE evaluation demonstrated significant improvement in static nasolabial fold depth orientation and oral commissure position, palpebral fissure narrowing during eye closure, and oral commissure movement and nasolabial fold depth and orientation with smile (p respectively .008, .011, 0.008, 0.035, 0.011, 0.008, and 0.011, Wilcoxon's test). Furthermore, all patients described subjective improvement of corneal discomfort.The presented technique appears promising in treating facial palsy in oncological patients, representing a potential alternative to other more complex reconstructive techniques.     

视神经炎的临床特征分析及早期视盘和黄斑的改变

目的　研究视神经炎患者的临床特征及早期视盘和黄斑的改变。方法　回顾性分析山西省眼科医院视神经炎患者67例85眼。分析患者基本情况、眼科检查结果及OCT检查结果。结果　67例85眼中，男24例，女43例；28例（41.8%）发生于冬季；49眼（57.6%）入院时最佳矫正视力小于1.7 logMAR。视神经脊髓炎抗体阳性者出院和入院时的最佳矫正视力均较髓鞘少突胶质糖蛋白抗体阳性者差。患眼较健眼视盘周围神经纤维层增厚，杯盘面积比、杯盘垂直比、杯盘水平比、杯容积减小，盘沿面积、视盘面积增大（均为P=0.000）；与健眼相比，患眼早期上方、下方和平均黄斑区神经节细胞层厚度及黄斑区神经节细胞复合体的局部丢失体积、整体丢失体积均未发生明显改变（均为P＞0.05）。视盘水肿与患眼平均视盘周围神经纤维层厚度存在正相关（r=0.728，P=0.000）。结论　视神经炎多发生于女性，早期视力损害严重，视神经脊髓炎抗体阳性者视力预后差。早期由于视盘水肿，视盘周围神经纤维层增厚，盘沿面积、视盘面积增大；杯容积、杯盘比减小，早期病变未累及黄斑区。     

Oropharyngeal shedding of herpesviruses before and after BNT162b2 mRNA vaccination against COVID-19

IntroductionConcerns were raised over an increase in Bell's palsy, herpes simplex and herpes zoster after BNT162b2 vaccination, all are manifestations of herpesviruses reactivation. As herpesviruses commonly reactivate in the oropharynx, we have hypothesized that oropharyngeal shedding of herpesviruses will increase after vaccination.MethodsImmune-competent Adults, excluding those using topical steroids or manifesting symptomatic herpesvirus infection, were sampled before BNT162b2 vaccination and one week after. Herpesviruses 1–7 shedding was tested with a multiplexed PCR.ResultsIn 103 paired samples the prevalence of herpesviruses was similar before and after vaccination: HSV1, 3.9% vs. 5.8% (p = 0.75); HSV2, 0% vs. 1% (p = not applicable, NA); VZV, 0% vs. 0% (p = NA); EBV, 14.6% vs. 17.5% (p = 0.63); CMV, 0% vs. 0% (p = NA); HHV6, 4.9% vs. 7.8% (p = 0.55); HHV7, 71.8% vs. 72.8% (p = 1); any herpesvirus, 73.8% vs. 74.8% (p = 1).DiscussionWe did not find evidence for increased oropharyngeal reactivation of herpesviruses one week after BNT162b2.