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

A 45-year-old man and a 21-year old man presented with palpable lacrimal gland fossa masses and mechanical ptosis and proptosis, respectively. Computed tomography demonstrated well-circumscribed, partially cystic tumors. Echography in one case showed a well-outlined, predominantly low-reflective lesion with cysts and moderate vascularity detected by Doppler flow and standardized A-scan studies. Histopathology of the excised tumors revealed them to be CD34 antigen-positive hemangiopericytomas, in one case associated with lacrimal gland ductal cysts (dacryops) and with cyst-like spaces containing proteinaceous exudate in the other. No recurrence was found at 14 and 30 months, respectively. Although uncommon, hemangiopericytomas should be included in the differential diagnosis of lacrimal gland tumors. Orbital ultrasound revealing vascularity may be a useful adjunct in this diagnosis. Cystic degeneration or dacryops due to tumor infiltration and compression of lacrimal gland ducts may occur.
Orbit 1998 Sep
PMID:Lacrimal gland hemangiopericytoma. 1204 26

The charts of 10 patients affected by myogenic ptosis who underwent surgical correction by means of a frontalis suspension sling using a silicone rod were reviewed. The patients included in the study were affected by ptosis secondary to myasthenia gravis (MG), chronic progressive external ophthalmoplegia (CPEO) or mitochondrial myopathy (MM). In every patient the ptosis was severe (MRD( 1) < 2 mm), with the eyelid partially or totally occluding the visual axis; levator function was poor (<5 mm), Bell's phenomenon was poor or absent and the orbicularis function was reduced. Final eyelid height, patient satisfaction and the presence of complications were our main outcome measures. Analysis of the results showed that the ptosis was corrected in every patient with a clear visual axis. One patient with absent Bell's and poor levator function had exposure keratopathy resistant to medical treatment and required surgical revision. We believe that the frontalis suspension sling is safe, effective and is the procedure of choice for patients affected by poor-function acquired ptosis. A silicone rod, because of its elasticity, is the material of choice in this selected category of patients.
Orbit 2002 Sep
PMID:Frontalis suspension sling using a silicone rod in patients affected by myogenic blepharoptosis. 1218 12

The authors report a family with familial Bell's palsy affecting seven individuals, six of whom are females. This is a distinct subtype of Bell's palsy with a predilection for juvenile females, previously reported only very rarely. In conjunction with a review of the literature, this case suggests that this phenotype carries with it a greater risk of serious complications affecting the eyelids and lacrimal gland. These carry significant functional and cosmetic implications owing to aberrant regeneration of the seventh, sixth and possibly third cranial nerves, chronicity and relapses. Clinical features include synkinesis of the eyelids with the orbicularis oris causing synkinetic ptosis, recurrent paralytic ectropion, paralysis of facial muscles of expression with dry eye, hyperlacrimation (crocodile tears), and transient strabismus. Clinically, the decision to offer surgery in place of conservative treatment should consider the natural history of chronicity and relapses often seen with this subtype of familial Bell's palsy. Botulinum toxin injections are especially versatile in managing the complications associated with this phenotype.
Orbit 2005 Jun
PMID:Familial Bell's palsy in females: a phenotype with a predilection for eyelids and lacrimal gland. 1619 1

Paediatric ptosis is routinely more challenging than adult ptosis with considerations such as amblyopia, difficulty of examination and at what age surgery should be performed. Unilateral severe congenital ptosis and jaw-winking ptosis raise additional questions of which surgical procedure and whether unilateral or bilateral surgery should be performed. A panel of international experts answer questions relating to two clinical scenarios.
Orbit 2006 Mar
PMID:Clinical controversy: congenital unilateral and jaw-winking ptosis. 1652 69

This paper examines the developmental substrate for congenital ptosis with particular emphasis on the transcription factors that are thought to be involved. We summarize my research findings and present a review of the relevant literature.
Orbit 2006 Sep
PMID:Towards an understanding of congenital ptosis. 1698 64

Brow ptosis occurs as part of the aging process, and as a complication of facial nerve paresis. The article addresses the options available for correction of brow ptosis. The direct brow lift is effective for medial and central brow ptosis, and additional lift laterally may occasionally be needed. This is achieved with either a temporal external lift or an internal lift combined with blepharoplasty. The direct brow lift is suitable for any degree and pattern of brow ptosis, usually in males. It is also suitable for older females as well as male patients with facial paresis or marked involutional brow ptosis. The trans-blepharoplasty brow lift is suitable for relatively small degrees of brow ptosis affecting mainly the lateral two-thirds of the brow in any age group. It is often combined with upper lid blepharoplasty and is performed through the same incision. Complications associated with the direct brow lift include a cosmetically disturbing scar, granuloma formation due to the use of braided absorbable sutures rather than monofilament sutures, and the brow descending again. There may be temporary patches of reduced sensation in the forehead which normally recover in a few months. Complications associated with the trans-blepharoplasty brow lift include less lift than desired, and sutures causing dimpling of the skin. These two techniques are useful additions to the approaches for patients with brow ptosis.
Orbit 2006 Dec
PMID:Brow lift via the direct and trans-blepharoplasty approaches. 1718 3

Innumerable approaches to the ptotic brow and forehead have been described in the past. Over the last twenty-five years, we have used all these techniques in cosmetic and reconstructive patients. We have used the endoscopic brow lift technique since 1995. While no one technique is applicable to all patients, the endoscopic brow lift, with appropriate modifications for individual patients, can be used effectively for most patients with brow ptosis. We present the nuances of this technique and show several different fixation methods we have found useful.
Orbit 2006 Dec
PMID:Endoscopic brow lifts uber alles. 1718 4

The complications of blepharoplasty are infrequent, most often minor and transient, and rarely major and permanent with functional or aesthetic consequences. Treatment is above all preventive with screening of "at risk" patients in whom blepharoplasty would be contra-indicated. Patients must be informed of possible risks through informative booklets stressing the most important points. The complications may affect vision. Partial or complete visual loss due to ischemic optic neuropathy, or rarely to compression of the ocular globe by intraorbital hemorrhage, is the most serious complication. Other visual complications include oculomotor disorders, keratoconjunctivitis sicca, epiphora, and chemosis of lymphatic origin. Eyelid complications are more frequent: ptosis of the upper eyelid or lagophthalmia caused by incorrect resection of the skin, scarring, and eyelid fold anomalies. The most severe aesthetic complication is the malposition of the lower eyelid resulting in retraction, lagophthalmia, ectropion, deformation of the external canthus, or lower eyelid tissue relaxation. These malpositions are often minor, sometimes reversible, but they can be major, with psychological, aesthetic, and functional consequences. Other local complications include enophthalmia and hypo- or hypercorrection. General complications may include pigmentation anomalies or infections extending as far as the orbital fat tissue. Finally, complications observed after the newer procedures of laser surgery include ectropion, burns and residual redness. Complications related to periocular injections of filling material are also mentioned. The discussion of these complications is followed by a comprehensive review of the prevention, diagnosis and management of the complications after blepharoplasty.
Orbit 2006 Dec
PMID:Complications of blepharoplasty. 1718 5

The authors describe the case of 49-year-old female teacher who had sustained severe facial lacerations following a minor fall on the kerb. The severe shearing force by which the flap was ripped off the forehead caused complete ptosis and complete failure of elevation of the left eye, which was presumed to be due to mechanical damage to the superior rectus and levator complex. The management by a multidisciplinary approach and clinical course of the patient are described with documentary photographs. This presentation is meant to highlight an unusual case of severe facial trauma resulting from a minor injury, and its successful management with gratifying results for both patient and the surgeon.
Orbit 2007 Dec
PMID:An unusual case of complete ptosis and failure of elevation due to severe facial trauma. 1809 78

During a series of 101 levator procedures to correct acquired ptosis we measured the motility of the aponeurosis, the necessary advancement of the aponeurosis to adjust the eyelid height and the motility of Whitnall's ligament. We compared these intraoperative data with the data of the preoperative examination and did not find any correlation. The necessary amount of advancement of the aponeurosis to adjust the height of the eyelid was not related to the motility of the aponeurosis, the levator function or the amount of ptosis. However, we did find that the motility of Whitnall's ligament is closely related to the motility of the aponeurosis. Therefore connecting both structures is useful in ptosis adjustment without risking limited eyelid motility.
Orbit 2008
PMID:The significance of intraoperative measurements in acquired ptosis surgery. 1830 41


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