Modified retractor plication technique in lower lid entropion repair: a 4-year follow-up study

BACKGROUND: Lower eyelid entropion is an eyelid malposition characterized by inward rotation of the eyelid margin associated with potentially significant discomfort and, occasionally, keratopathy. In this study we evaluated and compared the efficacy of two surgical techniques of retractor plication for involutional lower lid entropion repair. METHODS: Sixty-two consecutive patients (62 eyes) with involutional lower lid entropion were included. Of the 62, 34 underwent the Jones retractor plication technique, and 28 underwent a modification of this technique that simplifies the procedure. We evaluated horizontal lid laxity, medial canthal tendon laxity and lower lid excursion before and after surgery, and determined the rate of entropion recurrence in the two groups. All measures were obtained before and 1 month, 6 months, 1 year, 2 years, 3 years and 4 years after surgery. RESULTS: Preoperatively, there was no statistically significant difference between the two groups in any of the measures studied. Postoperatively, the mean amount of horizontal lid laxity was significantly less in the modified technique group than in the Jones technique group (6.86 mm [standard deviation (SD) 0.41 mm] vs. 7.30 mm [SD 0.64 mm]) (p < 0.05). Similarly, the mean amount of medial canthal tendon laxity in the resting position was significantly less in the modified technique group than in the Jones technique group (1.90 mm [SD 0.56 mm] vs. 1.25 mm [SD 0.43 mm]) (p < 0.05). The rate of entropion recurrence was significantly lower in the modified technique group (7.1%) than in the Jones technique group (14.7%) (p < 0.05). INTERPRETATION: The modified retractor plication technique showed encouraging results in terms of successful and long-lasting lower lid entropion repair.     

Idiopathic hypoplasia of the masseter muscle: A case report

Objective and importance: Hypoplasia of the masseter muscle is a rare condition, described as partial or total, associated with congenital malformations or pathologies. Rare cases are those with no genetic alterations in their familiar picture. The authors present a case of an idiopathic masseter muscle hypoplasia in the absence of other pathologies.

Clinical presentation: The case report involved a patient who presented to the consultant clinic complaining of facial asymmetry. The patient underwent several exams to confirm the diagnosis of masseter muscle hypoplasia, which included an X-ray, magnetic resonance of the temporomandibular articulation, and electromyography.

Intervention: The patient was treated with a customized functional appliance and fixed orthodontic treatment with satisfactory functional and esthetic results.

Conclusion: The case presented highlights the possibility of finding a hypoplasia of the masseter muscle even in the absence of other pathologies and without specific clinical symptoms, and how to plan an appropriate treatment with functional appliance and fixed orthodontic therapy.     

In Vivo Study of the Kinetics of Thiamine and its Phosphoesters in the Deafferented Rat Cerebellum

The effects of chemical (CD) and surgical (SD) deafferentation of the cerebellum on different steps of the metabolism of thiamine (Th), thiamine monophosphate (ThMP) and thiamine pyrophosphate (ThPP) were evaluatedin vivo in rats. CD was carried out by i.p. injection of 3-acetylpyridine, followed by harmaline and niacinamide. SD was carried out by complete dissection of the peduncles of the left cerebellar hemisphere. Under steady state condition the radioactivity of Th and its phosphoesters was determined in plasma and whole cerebellum after an i.p. injection of thiazole-[2¹⁴C]-thiamine (30 μg: 1.25 μCi). Analytical data were processed by using an improved mathematical comparmental model, which allowed the calculation of fractional rate constants (FRC), turnover rates (TR) and turnover times (TT). Both CD and SD caused a significant reduction of TR values for Th phosphorylation to ThPP, dephosphorylation of ThPP to ThMP and Th, and ThMP, but not Th, release. TT for all Th compounds were increased compared to controls, indicating a general slowing of thiamine metabolism in the deafferented cerebellum. These results indicate an imbalance in the thiamine metabolism resulting from the impaired activity of cerebellar neurons. The possible implications of the changes in rate of Th compound turnover with respect to biochemical changes in cerebellar ataxia are discussed.