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 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hard palate mucosa grafts are an excellent replacement for tarsus and conjunctiva in eyelid reconstruction. Twenty-five eyelids from 18 patients underwent eyelid reconstruction using hard palate mucosa grafts. Patients were treated for a variety of disorders including postblepharoplasty lower eyelid retraction, cicatricial entropion, eyelid retraction secondary to thyroid eye disease, and lagophthalmos following surgery for paralytic ptosis. Surgical results were evaluated, grafts were measured for postoperative shrinkage, and donor site healing was recorded. Several patients had hard palate biopsy specimens evaluated. One of these patients also had a graft biopsied after it had been in place for 3 months. A review of hard palate anatomy and histology and a discussion of surgical technique are presented.
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PMID:Eyelid reconstruction with hard palate mucosa grafts. 819 78

Correction of ptosis in patients with chronic progressive ophthalmoplegia is problematic because the ptosis enlarges the palpebral fissure and aggravates the lagophthalmos. Additional lifting of the lower lids, which are often retracted, therefore seems advisable. Experience with various lower lid elongation techniques is reported.
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PMID:[Lower eyelid extension-plasty in patients with ptosis in chronic progressive external ophthalmoplegia]. 188 64

10 patients of congenital simple ptosis having 3 to 5 mm of ptosis with variable levator action were operated. All the patients showed a good response of lid lift after instillation of phenyl ephrine drops showing the activity of Muller's muscle. With this technique the lagophthalmos was minimal and good lid folds were formed in all cases. The skin muscle lamina was not excised and was utilized for formation of lid folds which were equal in depth and dynamic in nature. However, the lid lag which is an unavoidable complication of any ptosis surgery was present in the present technique also.
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PMID:Modified split level lid resection in ptosis. 208 69

Hemifacial spasm is characterized by unilateral, periodic, tonic contractions of facial muscles, thought to be caused by mechanical compression at the root-exit zone of the facial nerve. Electrophysiologic abnormalities such as ectopic excitation and synkinesis are typical. Although posterior fossa microsurgical nerve decompression is successful in bringing about relief of the spasm in most cases, it carries a risk to hearing. As an alternative treatment, 15 patients with hemifacial spasm were given a total of 41 sets of injections with botulinum A toxin, with a mean follow-up of 14.3 +/- 1.1 months. Relief of symptoms lasted a mean of 108.3 +/- 4.2 days. Mild transient lagophthalmos and ptosis were the only complications. Although the exact mechanism of its action and beneficial effect is speculative at this time, botulinum A toxin appears to offer an effective, safe alternative to more radical intracranial surgery for patients with hemifacial spasm.
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PMID:Treatment of hemifacial spasm with botulinum A toxin. Results and rationale. 315 54

Patients with chronic progressive external ophthalmoplegia (CPEO) are often disabled by ptosis; however, conventional ptosis surgery may induce lagophthalmos and exposure keratitis. Ten patients with CPEO underwent ptosis correction via bilateral frontalis suspensions, using monofilament synthetic material. Three of these patients were also treated with lower eyelid horizontal tightening. The frontalis sling was adjusted to provide a firm linkage between the eyebrow and eyelid, but was loose enough to allow eyelid closure when the frontalis muscle is relaxed. All patients experienced lessening of ptosis and relief from visual obstruction. One patient required reoperation of one eyelid for undercorrection. No lagophthalmos or corneal complications occurred. The rationale for treatment, preoperative evaluation, and operative procedure in CPEO is discussed herein.
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PMID:Management of ptosis in chronic progressive external ophthalmoplegia. 315 93

Of 650 patients who underwent various surgical procedures on the anterior segment in which 2% lidocaine hydrochloride plus 1:100,000 epinephrine was used as a local anesthetic, 5 experienced postoperative complications attributed to the anesthetic: ptosis (in 2 cases), horizontal rectus muscle palsy (in 2) and lagophthalmos (in 1). The cause of the complications may have been inadvertent direct infiltration of the anesthetic into the levator palpebrae superioris, the horizontal rectus muscles and the orbicularis oculi respectively. All the patients recovered spontaneously in 8 to 12 weeks. The clinical course was compatible with myotoxic effects of local anesthetics.
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PMID:Ocular myotoxic effects of local anesthetics. 339 20

Primary objective of multidirectional tractions of the facial muscles for protracted facial paralysis is to restore the facial symmetry. The facial suspension by multiple fascial strips in conjunction with other complemental minor surgical procedures realizes these complex tractions. Deformities requiring surgical procedures, regionally classified, are indicated for surgery as follows: 1) drooping of the eyebrow and upper eyelid, and loss of frontal creases, 2) lagophthalmos and ptosis of the lower eyelid, and 3) drooping of the cheeks and lips, and loss of the nasolabial fold. The multifascial suspension is a valuable adjunct to facial nerve surgery. It is capable of alleviating facial asymmetry due to paralysis and suppresses abnormal associated movements subsequent to surgical repair of facial nerves.
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PMID:Multiple facial suspensions in protracted facial palsy. 344 37

The surgical procedure using frontalis muscle and autogenous fascia lata suspension (Beard, Crawford) gives good results in the correction of severe blepharoptosis. Personal experience of 34 operations (23 patients) is reported. The level of the palpebral margin remains stable and there is no long-term undercorrection. The autogenous fascia lata is, in our experience, better than the other sling procedures. There is good tissular adhesion and less necrosis. The disadvantages are the constant lid lag in downward gaze and the scar on the thigh. The lagophthalmos is well tolerated and needs neither drops nor ointments 3 months post-operatively. Complications were infection (1 case) and corneal ulceration in a patient with traumatic ptosis and complete ophthalmoplegia. The sling must be deep and must support the suspensor ligament of Whitnall without perforating the conjunctiva. This step requires the use of a Reverdin needle, and is controlled by a finger applied in the superior fornix.
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PMID:[Treatment of severe ptosis by suspension of the upper eyelid using the autogenic frontal muscle and fascia lata. Analysis of 34 interventions]. 667 55

Four tarsorrhaphy sutures are placed through the lower eyelid and brow following ptosis surgery in a system designed for patients with external ophthalmoplegia, third nerve paralysis, and myashenia gravis. Three of the sutures connect the lower eyelid to the forehead, and the fourth suture is passed through the lower eyelid and taped to the cheek. The three lid-brow sutures are released during the first two postoperative weeks, one by one, and topical ointment instillations are gradually tapered. The tarsorrhaphy system allows the cornea to adapt gradually to the lagophthalmos that follows ptosis surgery. It also keeps the eyelids partially closed during the first two postoperative weeks in patients with frontalis sling surgery who have marked difficulty lowering their eyebrow and closing their eyelids because of early postoperative forehead edema and pain. The tarsorrhaphy system has prevented serious keratopathy in six patients with ptosis associated with abnormal ocular motility and in one patient with lagophthalmos following trauma. It also allowed the six ptosis patients to have full, rather than partial, correction of their ptosis.
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PMID:Suture tarsorrhaphy system to control keratopathy after ptosis surgery. 699 12

During the past 10 years, the authors have observed several cases of malfunction of the eyelids, such as congenital lid retraction, lagophthalmos accompanying facial nerve palsy, ocular myopathy, blepharochalasis, traumatic lid ptosis, and Horner's syndrome. Several operational techniques were utilized in these cases. Some operative cases are presented together with pre- and postoperative photographs. To obtain aesthetically pleasing results, the authors felt the most exacting techniques were necessary for even minor deformities.
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PMID:Operative experience with malfunction of the eyelid. 718 Jul 15


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