透明质酸联合A型肉毒素注射在眼周年轻化治疗中的应用效果

目的 探究在眼周年轻化治疗中应用透明质酸联合A型肉毒素注射的效果及安全性。方法 选择 2023年1月-12月于我院整形外科行眼周年轻化治疗的100例患者为研究对象,按随机数字表法分为对照组 和观察组,每组50例。对照组给予常规整形手术治疗,观察组在对照组基础上给予透明质酸联合A型肉毒 素注射治疗,比较两组临床疗效、手术满意度、康复时间及不良反应发生情况。结果 观察组治疗总有效 率为96.00%,高于对照组的78.00%（P ＜0.05）;观察组手术满意度评分高于对照组（P＜0.05）;观察组康 复时间短于对照组（P ＜0.05）;两组不良反应发生率比较,差异无统计学意义（P＞0.05）。结论 透明质 酸联合A型肉毒素注射在眼周年轻化治疗中的应用效果确切,可提升治疗效果,提高手术满意度,有利于 缩短术后康复时间,且不会增加不良反应发生几率。     

球旁注射与球结膜下注射法治疗虹膜睫状体炎的比较研究

目的 探讨球旁注射与球结膜下注射2种注射方法对治疗虹膜睫状体炎的不同效果.方法 将80例虹膜睫状体炎患者按来院顺序随机分为A组与B组各40例,A组患者行球旁注射,B组患者行球结膜下注射.比较2组注射后并发症发生情况.结果 2组患者在实施治疗后的并发症及相关因素比较差异显著,球旁注射法优于球结膜下注射法.结论 球旁注射法是治疗虹膜睫状体炎理想的用药途径,操作简便、安全、快捷、痛苦小,值得推广.     

Cytogenetic analysis of rare orbital tumors: further evidence for diagnostic implication

INTRODUCTION . The pathologic diagnosis, and hence the management, of rare tumors of the orbit can represent a challenge. An increasing number of tumors have been shown to display specific chromosomal abnormalities detectable by cytogenetic analysis. MATERIALS AND METHODS . Two examples of rare primary orbital tumors are presented in which the correct pathologic diagnosis was either established or confirmed by cytogenetic analysis. Small pieces of the tumor were obtained at the time of biopsy and placed immediately, in a sterile fashion, in fresh culture medium. The cells were Giemsa stained and processed for chromosome analysis. RESULTS . In the first case, a 12-year-old boy was diagnosed with a sino-orbital mass after sustaining minor trauma. On biopsy, the pathologic examination was at first consistent with a Burkitt-like lymphoma, until cytogenetic analysis showed a t(8;21)(q22;q22) translocation, specific for granulocytic sarcoma, which corresponds to the localized solid form of acute myeloblastic leukemia. Consequently, proper chemotherapy was re-oriented and remission was achieved. In the second case, a 2-year-old boy presented with a well-vascularized orbital tumor. The histopathologic diagnosis of alveolar soft-part sarcoma of the orbit was confirmed by the finding of a specific t(X;17)(p11;q25) translocation. After two unsuccessful courses of chemotherapy, wide excision surgery with primary reconstruction brought remission. CONCLUSIONS . Cytogenetic analysis should be considered in the diagnosis of any orbital tumor which is suspected of malignancy.     

Sevoflurane versus propofol sedation during periocular anesthetic injections in oculoplastic procedures: An open-label randomized comparison

Purpose

The purpose of the current investigation was to make an objective controlled comparison of pain tolerance, patient satisfaction and potential complications during the injection of local anesthesia in oculoplastic procedures under short-term sedation using inhalational versus parenteral sedatives.

Methods

This was an open-label, randomized clinical trial where patients were randomized to 3 groups. Group I: Sedation with intravenous propofol. Group II: Sedation with inhaled sevoflurane. Group 3: Control group receiving no sedation.

Results

A total of 396 patients were randomly assigned, and 375 were included in the final analysis. Study groups were similar in age, gender, and distribution of operative procedures performed. There was no statistically significant difference in the adjusted primary composite outcome measure between propofol and sevoflurane (pain scores and patient satisfaction). Significantly more patients in group I required restraining during periocular injections than group II or III (p < 0.001). Significantly more patients sneezed in group I than group II (p < 0.001) and none in the control group. Three patients in group II suffered severe excitation–disinhibition during emergence from sedation which was rapidly reversible, and 3 more suffered a severe bout of postoperative nausea and vomiting (PONV).

Conclusion

Sevoflurane and propofol during periocular anesthetic injections produce an equally favorable experience. Sevoflurane is introduced painlessly, and offers better patient control with less induction of the sneezing reflex which may provide a higher safety profile, however short-term aggression/disinhibition and PONV may be an issue in some patients.     

Dermatography as a treatment after periocular surgery

Dermatography is the application of tattooing techniques in medicine. In the past, several techniques have been tried but none of these led to reproducible results. Over the last 17 years, dermatography has been developed into a technique that is both generally applicable and reproducible. It is a suitable treatment modality for disturbing skin discolorations and scars. With dermatography these can be permanently camouflaged. In this paper, the use of dermatography as a treatment after periocular interventions is discussed.     

Outcome of Periocular Basal Cell Carcinoma Managed by Overnight Paraffin Section

Background: Surgical excision of periocular skin cancer allows for optimum control in terms of tumour recurrence. Although Mohs' technique gives the best outcome, it is not widely available. Processing paraffin sections is slower but histologically superior to Mohs' frozen sections. We report the results of using a standard paraffin section (non-Mohs') technique to confirm histological clearance. Method: A retrospective study between 1/6/95 and 1/6/99 of all consecutive patients who had excision of periocular cancer was performed. All patients had surgical excision of the tumour with a 3-mm margin. Rapid (24-hour) paraffin sections were done and reconstruction performed if histological clearance was confirmed. If tumour was still present, a further 3-mm margin was excised at the appropriate edge(s) before reconstruction took place. Results: This study yielded 93 basal cell carcinomas (BCCs) of which 86 were of primary origin and 7 were recurrent tumours. The tumour characteristics were as follows: 88% nodular BCCs, 82% had a maximum surface measurement less than or equal to 10 mm, 39.8% were inner canthal and 49.5% were localised to the lower lid. In the 30 (35.4%) cases that required further excision based on the initial histological reports, tumour was seen in only four (11.4%) cases. Overall histological clearance for primary BCCs was achieved in 81/86 (94.2%) cases. There was only one late recurrence at 4 years and 5 months. Among recurrent BCCs, there was one recurrence (12.5%) and this was despite histological clearance having been reported. Conclusion: For primary BCCs the recurrence rate in this study was low and comparable to that following Mohs' technique. This approach, using routine pathological facilities, therefore offers a viable technique for managing periocular BCCs.