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This article describes a surgical technique using drill holes through the inferior orbital rim and fixation with permanent sutures as a functional subperiosteal midface lift and compares it to other standard midface elevation techniques. This was a retrospective, comparative, non-randomized study. Charts of all patients undergoing midface elevation between 2009 and 2013 were reviewed. Pre- and post-operative photos were graded on a scale 0 to 3 with 0 representing normal lower lid position and lid/cheek junction and 3 representing the most severe malposition. Twenty-seven patients (35 sides) underwent midface lift. Twelve sides had the subperiosteal drill hole midface lift; 9 preperiosteal with Vicryl suture fixation to periosteum; 14 subperiosteal with Endotine midface B device. All groups had similar demographics and indications for surgery. Average follow-up time was greater than 4 months in all groups. No significant complications were seen in any of the patients. The average post-operative grade of the drill hole group was 0.65 compared to 0.75 of the preperiosteal Vicryl group and 0.7 of the Endotine group. The drill hole group had the most severe pre-operative malposition. Overall, the drill hole group demonstrated the largest improvement score. The subperiosteal drill hole technique proved to be an effective method for functional midface elevation. This technique achieves adequate and durable vertical elevation without relying on the strength of the periosteum or use of a commercial device.  相似文献   
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目的探讨瘢痕性睑外翻的手术细节的改进及治疗效果。方法回顾我科收治的Ⅱ、Ⅲ度瘢痕性睑外翻患者46例,根据睑外翻的程度和局部情况,选择眼睑部正常皮肤与瘢痕组织交界处设计切口线,尽可能保留和恢复眼轮匝肌结构,松解区域分别超出内外眦处并达眼裂水平,采用全厚皮片游离移植术行睑外翻手术矫正并行睑缘融合,皮片于内外眦韧带处行皮内固定。结果随访6个月至2年,46例眼睑皮片完全存活,眼睑复位良好,无1例眼睑闭合不全。结论适当的选择手术切口线及松解范围,尽可能保留眼轮匝肌的结构完整并对移植皮片在内外眦处进行固定,可以有效预防睑外翻的复发,提升手术效果。  相似文献   
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Frontal osteomyelitis is a rare clinical entity that can occur as sequelae to frontal sinusitis, head trauma, as a postoperative complication following sinus surgery or due to haematogenous spread. It usually presents with a soft, fluctuant forehead swelling with pain and fever. Cicatricial ectropion is an extremely rare feature of frontal osteomyelitis. We present a young male patient presenting with cicatricial ectropion that occurred as the sole manifestation of an underlying frontal osteomyelitis. Extensive Medline search did not find any such reported case. We feel that frontal osteomyelitis should be kept in mind as a possible etiology when considering the differential diagnosis of cicatricial ectropion.  相似文献   
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Purpose: To evaluate the results from the correction of ectropion of the punctum lacrimale in lower eyelids with a new surgical clamp.

Design: Prospective study.

Methods: Eighty eight eyelids in 55 patients with mild and moderate ectropion were included in the study. An excision of a diamond of tarso-conjunctiva with retractor reattachment and concomitant correction of horizontal lid laxity, if present, was performed.

Results: Resolution of tearing was obtained in 77 eyes. In 11 eyes, persistent tearing was reported.

Conclusion: Conclusion:Conclusion: Repair of early to intermediate ectropion of the lacrimal punctum using the Raus–Garito clamp is associated with a good functional and cosmetic outcome.  相似文献   

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Purpose

It is vital that surgeons undertaking oculoplastic procedures are able to show that the surgery they perform is of benefit to their patients. Not only is this fundamental to patient-centred medicine but it is also important in demonstrating cost effectiveness. There are several ways in which benefit can be measured, including clinical scales, functional ability scales, and global quality-of-life scales. The Glasgow benefit inventory (GBI) is an example of a patient-reported, questionnaire-based, post-interventional quality-of-life scale that can be used to compare a range of different treatments for a variety of conditions.

Methods

A cross-sectional study was undertaken using the GBI to score patient benefit from four commonly performed oculoplastic procedures. It was completed for 66 entropion repairs, 50 ptosis repairs, 41 ectropion repairs, and 41 external dacryocystorhinostomies (DCR). The GBI generates a scale from −100 (maximal detriment) through zero (no change) to +100 (maximal benefit).

Results

The total GBI scores of patients undergoing surgery for entropion, ptosis, ectropion, and external DCR were: +25.25 (95% CI 20.00–30.50, P<0.001), +24.89 (95% CI 20.04–29.73, P<0.001), +17.68 (95% CI 9.46–25.91, P<0.001), and +32.25 (95% CI 21.47–43.03, P<0.001), respectively, demonstrating a statistically significant benefit from all procedures.

Conclusion

Patients derived significant quality-of-life benefits from the four most commonly performed oculoplastic procedures.  相似文献   
8.
Abstract

Context: Anthrax is a rare disease caused by Bacillus anthracis. Antrax is zoonotic disease and is often encountered in persons engaged in animal husbandry. Cutaneous anthrax is approximately 95% of anthrax in humans. Palbebral involvement is rare.

Objective: In this study, we aimed to evaluate the clinical presentation, diagnosis and treatment of cases with cutaneous palpebral anthrax.

Methods: In this study, the patients diagnosed of cutaneous palpebral anthrax between January 2000 and December 2012, were investigated and evaluated, retrospectively. Cutaneous palpebral anthrax was diagnosed by the presence of typical anthrax lesion and/or observation of gram-positive encapsulated bacilli in gram prepations and/or culture positive of samples taken from lesions. In the cases who were culture-negative and without bacilli in gram-staining, the diagnosis was based on the presence of characteristic clinical presentation with a history of severe scarring formation, swelling, black eschar and positive response to the treatment.

Results: A total of 21 patients with cutaneous palpebral anthrax admitted to the two hospitals between January 2000 and December 2012. Eight patients were male (38.1%) and 13 patients were female (61.9%), and the mean age was 31?±?21.2 (range 1–82 years). The most common symptoms on admission to the hospital were swelling and redness on the skin. Periorbital lesions were in the right eye in 14 cases and the most common eyelid involvement was seen in upper eyelid with 15 cases. The diagnosis was based on isolation of bacteria in five (23.8%) cases, detection of gram-positive bacilli in direct examination of characteristic lesion material in six (28.5%) cases. Ten (47.7%) cases were diagnosed by the characteristic appearance of the lesion. Malignant pustule was seen in all of our patients and seven cases (33.4%) had malignant edema. In the treatment, penicilin was used for 10 (47.7%) cases, ampicillin-sulbactam for five (23.8%) cases and, ciprofloxacin for three (14.3%) cases. Cicatricial ectropion was observed in 10 (47.7%) patients, lagophthalmos developed in four (19%) patients, and corneal scar in two (9.5%) patients. The distribution of the cases did not differ by the year but showed a density in the months from July to September (62.7%).

Conclusion: Early diagnosis and high dose antibiotic treatment can facilitate the treatment and prevent development of eyelid complications including cicatricial ectropion, corneal scars and palpebral symphysis. Prolonged follow-up is necessary in patients who develop complications and surgical intervention.  相似文献   
9.
目的探讨应用悬吊下睑睑板治疗各种下睑外翻或退缩的方法和疗效。方法对轻度下睑外翻或退缩采用尼龙线在一侧固定于内眦韧带后,向外侧“蛇形”缠绕下睑板,外侧端固定于外眦韧带外上方处悬吊下睑组织的方法修复;对重度下睑外翻或退缩,采用掌长肌腱游离移植辅助治疗瘢痕性下睑外翻的方法,下睑继发创面直接缝合或局部皮瓣转移修复。结果自2009年5月至2013年9月,共修复各种下睑外翻或退缩15例,其中轻度下睑外翻或退缩8例,重度下睑外翻或退缩7例;所有患者术后下睑外翻均得到矫正,随访6~36个月,均无睑外翻或退缩复发。结论根据患者下睑外翻或退缩的情况,采用合适的悬吊下睑板的方法辅助治疗下睑外翻或退缩,可取得较好的修复效果。  相似文献   
10.
目的:评价外侧睑板条悬吊术在各种下睑病变中的应用.方法回顾分析2010年2月至2013年8月间各种原因所致的下睑松弛、外翻、退缩、外眦移位,眼睑闭合不全共48人(64眼).所有患者均采用外侧睑板条悬吊术作为主要术式,部分患者联合了下睑缩肌的手术,或植入高密度多孔聚乙烯植片(Medpor LES)做为手术的补充;少数睑外翻还进行了皮瓣转位或移植.术后针对下睑复位及外观改善情况进行评价,定量分析下睑退缩、睑闭合不全、外眦下移;定性比较下睑松弛、下睑外翻.结果术后2周复诊,除2例下睑外翻仍轻度欠矫外,所有患者下睑均复位,外观满意;其中定量分析术后较术前差异有统计学意义(P<0.01),定性比较的效果理想.结论外侧睑板条悬吊术在各种下睑病变中疗效显著.  相似文献   
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