• 제목/요약/키워드: Blepharoptosis

검색결과 35건 처리시간 0.016초

Tarsal switch using an anterior approach to correct severe ptosis

  • Meneghim, Roberta Lilian Fernandes de Sousa;Ferraz, Lucieni Barbarini;Galindo-Ferreiro, Alicia;Khandekar, Rajiv;Sanchez-Tocino, Hortensia;Schellini, Silvana
    • Archives of Plastic Surgery
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    • 제45권2호
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    • pp.165-170
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    • 2018
  • Background To present the outcomes of the tarsal switch procedure using an anterior approach to correct severe ptosis with poor levator muscle function (<4 mm) with absent or poor Bell's phenomenon. Methods This retrospective case series included 11 patients with severe neurogenic or acquired myogenic palpebral ptosis. All patients underwent the tarsal switch procedure through an anterior approach from 2012 to 2015. Margin reflex distance (MRD1 and MRD2) and the palpebral fissure were evaluated preoperatively and postoperatively. Data were compared using the Wilcoxon signed-rank test. P-values <0.05 were considered to indicate statistical significance. Results Surgery was performed on 18 eyelids (11 patients). The median age at surgery was 57 years (range, 29-86 years). Four patients had unilateral ptosis and seven had bilateral ptosis. Nine patients had myogenic ptosis and two had neurogenic ptosis. Postoperatively, the chin-up position improved in all patients. The MRD1 increased statistically significantly, from 0 mm preoperatively to 1.0 mm postoperatively (P=0.001). The MRD2 decreased statistically significantly, from 4.5 mm preoperatively to 3.0 mm postoperatively (P=0.001). The palpebral fissure did not change (4.0 mm preoperatively to 4.0 mm postoperatively) (P=0.13). Conclusions The tarsal switch procedure through an anterior approach is an effective alternative for correcting severe ptosis, especially neurogenic or acquired myogenic ptosis. This procedure can be performed with minimal risk of ocular surface exposure and provides stable outcomes.

上胞下垂에 關한 文獻的 考察 (A literatual studies on the Ptosis(上胞下垂))

  • 박수연;최정화
    • 한방안이비인후피부과학회지
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    • 제13권2호
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    • pp.76-111
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    • 2000
  • I examined and referred to literatures of every generations on the nicknames, causes, herb medications and acupucture treatments of ptosis(上胞下垂) And then the results were obtained as follows. 1. The nicknames of ptosis(上胞下垂) are hyumok(휴목), chimpung(侵風), geompye(瞼廢), geompisubok(瞼皮垂覆), posu(胞垂) and bigwon(脾倦) which corresponds to blepharoptosis in Western Medicine. 2. The congenital ptosis(上胞下垂) is mostly caused by innate disposition(稟賦不足). The acquired ptosis(上胞下垂) is mostly caused by Qi sinking of Tri-energizer(中氣下陷). And besides this, there are Blood stasis due to Qi stagnancy(氣滯血瘀), invasion of the eyelid by wind(風邪入絡), Qi and Blood deficiency(氣血不足), Phlegm syndrome due to wind(風痰阻絡), Wind syndrome due to Yang hypertrophy(陽亢動風) and Stagnation of Liver Qi(肝氣鬱結). 3. In herb medication of ptosis(上胞下垂), Bojungikgitang(補中益氣湯) was used 14 times most and its effects are nourishing the spleen to promote the flow of Qi(健脾益氣) and elevating the YangQi and activation the meridian(升陽活絡). In the following, Insamyangyeongtang(人蔘養榮湯) was done 6 times and has effects of promoting the Qi and activating the blood(益氣養血) and of promoting blood circulation and restoring flow(活血通絡). The next, Jungyongtang(正容湯) appeared 5 times and this can expel wind, resolve phlegm and restore flow(祛風滌痰通絡). As single herb, Radix glycyrrhizae(甘草) was used 66 times most. Besides this, there are a few herbs used many times like Rhizoma atractylodis macrocephalae(白朮), Radix angelicae gogantis(當歸), Radix ginseng(人蔘). Radix astragali(황기) and Rhizoma cimicifugae(升麻). 4. In acupunture treatment, Chanzhu(撰竹) was used 19 times most. Besides this acupoint, there are some points choson frequently like Zusanli(足三里), Sanyinjiao(三飮交), Yangbai(陽白), Taiyang(太陽), Tongziliao(瞳子 ), Jingming(晴明), Hegu(合谷) and Fengchi(風池).

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부분절개 쌍꺼풀성형술의 결과로 유추한 가성 안검하수의 새로운 해석 (A New Interpretation of Ptosis-like Eyes through the Results of Small-Incision Double-Eyelid Operation)

  • 박성규;이승국;백롱민
    • Archives of Plastic Surgery
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    • 제33권4호
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    • pp.449-453
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    • 2006
  • Purpose: Perceiving the experience that $MRD_1$ is increased after small-incision double-eyelid operation, it has been statistically verified the improvement of $MRD_1$ retrospectively. Therefore, we suggest new interpretation for Korean-specific small eye and more definite classification for ptosis. Methods: In operation, we made 3 small incisions according to the line designed on upper eyelid and removed some soft tissues including connective tissues. Then, figure-of-8 continuous buried ligation was performed through the incision windows. This study is a retrospective study, measures $MRD_1$ changes and excursion distance change of eyelid margine and eyebrow using pre-and post-operative photos of 14 patients. Results: Postoperative photos were taken on the 4th day and all of 14 patients had an improvement in $MRD_1$ statistically. The excursion distance of upper eyelid was improved in half of patients, though not in the range of statistical verification. It was statistically confirmed that the movement of eyebrow was reduced after operation. Conclusion: It is thought that $MRD_1$ improvement without any operation on levator complex means that soft tissue including connective tissue eliminated in operation restricts the movement of upper eyelid. It is defined such factors as burden factors and such phenomenon as burdened eyelid. It is thougt that Korean's small eye is mainly burdened eyelid and cosmetic improvement may be obtaind even by removing such burden factors.

Tarsodermal Suture Fixation Preceding Redundant Skin Excision: A Modified Non-Incisional Upper Blepharoplasty Method for Elderly Patients

  • Yoon, Hong Sang;Park, Bo Young;Oh, Kap Sung
    • Archives of Plastic Surgery
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    • 제41권4호
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    • pp.398-402
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    • 2014
  • Background Non-incisional blepharoplasty is a simple, less invasive method for creating a more natural-appearing double eyelid than classical incisional blepharoplasty. However, in aging patients, non-incisional blepharoplasty is not effective due to more severe blepharochalasis. Traditionally, incisional blepharoplasty is a common surgical method used for older patients, but blepharoplasty in elderly patients typically results in prolonged recovery times, and final blepharoplasty lines may be located in unintended or asymmetrical positions. Here, we introduce a new modified combination technique for geriatric blepharoplasty. Methods A total of ten patients were treated from July 2010 through July 2012 using the combination method. First, we performed non-incisional blepharoplasty using tarsodermal fixation. Then, incisional blepharoplasty with additional elliptical excision of the upper eyelid skin was performed. We removed pretarsal tissue, fat, the orbicularis oculi muscle, and orbital fat. Telephone surveys were administered to all patients for follow-up. The questionnaire was composed of eight questions that addressed recurrence and satisfaction with aesthetics and the procedure. Results A total of nine patients (90%) responded to the telephone survey. All cases of moderate to severe blepharochalasia were corrected and there were no major complications. Patients who underwent blepharoplasty had higher satisfaction scores. All patients were satisfied with the postoperative shapes of their eyelids. Conclusions The advantages of the proposed technique include: ease of obtaining a natural-looking fold with symmetry at the desired point; reproducible methods that require short operation times; fast postoperative recovery that results in a natural-appearing double-eyelid line; and high patient satisfaction.

중증근무력증(重症筋無力症)에 대(對) 임상적(臨床的) 연구(硏究) (The clinical study of Myasthenia Gravis)

  • 채병윤
    • 대한한의학회지
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    • 제17권1호
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    • pp.190-211
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    • 1996
  • Generally the Myasthenia Gravis is classified into two of hereditary factor and acquement. Aquired Myasthenia Gravis was Quite well known to be caused by the autoimmune mechanism. Not in accurateness, on the hereditary, acetylcholine receptor antibody was to be analyzed very high in their parents and brothers. Also Myasthenia Gravis is a chronic disease characterized by voluntary muscle weakness and fatigue. above all, ocular Myasthenia Gravis is characterized clinically by blepharoptosis and external ophthalmoplegia and to be showed abut 90% cases and so oriental medicine can not but deal with myasthenia gravis at blepharoptosis. Accordinglv 20 out patients with Myasthenia Gravis were clinical study and observation as to the sex, age, progress state of MG, blood type, history, main symptom, liking for warm and cool food and tepidity, state of pulse, treatment of acupuncture and administration of oriental medicine etc. The results were as follows. 1. There was investigaed on the frequency of attack for sex, age, oculus dexter, oculus sinister, oculus uterque. Among the 20 patients, the number of female were 60% with 12 cases and male were 40% with 8 cases, therefore it was the rate of 6 : 4. the patients under 10 ages and 40 ages were 20% with 4 cases, 10 ages and 50 ages were 15% with 3 cases, 20, 30, 60 ages were 10% with 2 cases. And then oculus uterque was 90% with 18 cases, oculus sinister was 10% with 2 cases and oculus dexter were none of them. 2. Stage I were 50% with 10 patients, stage $II_A$ were 30% with 6 patients and stage $II_B$ were 20% with 4 patients, on the clinical stage and too class I were 20% with 4, class II were 45% with 9, class III were 35% with 7, in the functional activity the patients with chest heavy were 15% with 3 and hyperthyroidism were 10% with 2. 3. Hospital which patients had used to before came to this hospital were 10 university hospital and 6 local clinic. 4. The duration of disease was from 3 months to 30 years, the patients suffering between 3 months and within 1 year were 25% with 5 cases, 1-2 years were 30% with 6 cases, therefore within 2 years were 55%. 4-5 years were 15%, over 7 years were appeared less than 10%. 5. In the main symptom, all of patients were appeared to be heavy in opening their eyes the patients with blephroptosis were 70% with 14 cases on the oculus uterque, oculus sinisterf and oculus dexter, there were 20% with 4 eases each other in the oculogyation incomplete. visual failing, ophthalmoxerosis, strabismus etc and indigetion, frequency of urine(feel hurt), mild stools(or diarrea), oversensitiveness etc. but in addition, all of the other were 10%. 6. In the distribution of blood type, 0 types were 45% with 9 cases, A types were 25% with 5 cases, B and AB types were 15% each other. 7. For the rates of patients of liking for warm and cool food or tepidity, patients of liking for warm food possess 45% with 9 cases, and cool food possess 35% with 7 and tepidity possess 20% with 4, and then most of patients liking for warm food were females and cool food were much more males than females. 8. Hyunsae(弦細) were 40% with 8 cases, Buhurl(浮滑) were 20% with 4 cases, Hyunsak(弦數) were 15% with 3 cases, and in addition, the others were 10%, among 7 types of pulses. 9. The patients with less than 1 week were 40% with 8 cases, and there were female most of them and over 4 weeks were 20% and 1-2weeks were 15%, in the duration acupuncture treatment. 10. 15 kinds of prescriptions were administrated with oriental medicine from 1 week to 20weeks 1_2 weeks were 25.71% with 9 cases, 3 weeks were 17.14% with 6 cases and 6 weeks were 11.42% with 4 cases and also Gamibaetaugunbitang(加味培土健脾湯) were 28.57% with 10 cases, Gamijeounyongtang(加味正容湯) were 14.28% with 5 cases, Gamibojoongyigitung (加味補中益氣湯), Gamiyinsamyangyoungtung (加味人蔘養榮湯) were 8.57% with 3 cases each other and also Gamisamgitung (加味蔘?湯), Gamisamuloajatung(加味四物五子湯) Gamigoudungum (加味鉤藤飮), etc were applied.

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