• Archives of Plastic Surgery
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• 제33권1호
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• pp.95-100
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• 2006

The challenge of accurately predicting eyelid height after blepharoptosis surgery is well-known problem even in complete hands. From May, 1988 to December, 2004, authors reviewed 182 cases(240 eyes) of blepharoptosis corrected by frontalis muscle transfer or levator resection and had experienced 10 cases(15 eyelids) of early reoperation around 1 week. The period from initial operation to reoperation are between six to eight days and mean period is seven days. Initial operative procedures were frontalis muscle transfer in 3 cases(4 eyelids) and levator resection in 7 cases(11 eyelids). Follow up period ranged from 6 months to 16 years. Early adjusting surgery was performed in accordance with the preoperative and postoperative degree of ptosis of patient and considering previous operative technique. The results are evaluated according to the criteria of an ideal correction by Souther and Jordan. Seven patients have good or satisfactory results(less than 1 mm asymmetry, good in 5 cases and satisfactory in 2 cases). Three patients(5 eyelids) recorded as poor results(more than 2 mm asymmetry). Even if early or late reoperation can be effective in correcting unsatisfactory results after correction of blepharoptosis, early reoperation is better than later reoperation because early reoperation can offer a reduction in time to final result, the ease with which it is performed, potential cost savings. The experience of surgeon is also important factor for the reatment of recurred blepharoptosis

• Archives of Plastic Surgery
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• 제33권1호
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• pp.80-86
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• 2006

The challenge of accurately predicting eyelid height after blepharoptosis surgery is well-known problem even in complete hands. From May 1988 to December 2004, authors reviewed 182 cases(240 eyes) of blepharoptosis corrected by frontalis muscle transfer or levator resection and had experienced 10 cases(15 eyelids) of early reoperation around the first week. The period from initial operation to reoperation are between six to eight days and mean period is seven days. Initial operative procedures were frontalis muscle transfer in 3 cases(4 eyelids) and levator resection in 7 cases(11 eyelids). Follow up period ranged from 6 months to 16 years. Early adjusting surgery was performed in accordance with the preoperative and postoperative degree of ptosis of patient and by previous operative technique. The results are evaluated according to the criteria of an ideal correction by Souther and Jordan. Seven patients have good or satisfactory results(less than 1 mm asymmetry, good in 5 cases and satisfactory in 2 cases). Three patients(5 eyelids) recorded as poor results(more than 2 mm asymmetry). Even if early or late reoperation can be effective in correcting unsatisfactory results after correction of blepharoptosis, early reoperation may lead to better results than late reoperation because early reoperation can offer a reduction in time to final result, the ease with which it is performed and potential cost savings. The experience of surgeon is also important factor for the treat ment of recurred blepharoptosis.

• Archives of Plastic Surgery
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• 제39권1호
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• pp.31-35
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• 2012

Background : Orbital roof fractures are frequently associated with a high energy impact to the craniofacial region, and displaced orbital roof fractures can cause ophthalmic and neurologic complications and occasionally require open surgical intervention. The purpose of this article was to investigate the clinical features and treatment outcomes of orbital root fractures combined with neurologic injuries after early reconstruction. Methods : Between January 2006 and December 2008, 45 patients with orbital roof fractures were admitted; among them, 37 patients were treated conservatively and 8 patients underwent early surgical intervention for orbital roof fractures. The type of injuries that caused the fractures, patient characteristics, associated fractures, ocular and neurological injuries, patient management, and treatment outcomes were investigated. Results : The patients underwent frontal craniotomy and free bone fragment removal, their orbital roofs were reconstructed with titanium micromesh, and associated fractures were repaired. The mean follow up period was 11 months. There were no postoperative neurologic sequelae. Postoperative computed tomography scans showed anatomically reconstructed orbital roofs. Two of the five patients with traumatic optic neuropathy achieved full visual acuity recovery, one patient showed decreased visual acuity, and the other two patients completely lost their vision due to traumatic optic neuropathy. Preoperative ophthalmic symptoms, such as proptosis, diplopia, upper eyelid ptosis, and enophthalmos were corrected. Conclusions : Early recognition and treatment of orbital roof fractures can reduce intracranial and ocular complications. A coronal flap with frontal craniotomy and orbital roof reconstruction using titanium mesh provides a versatile method and provides good functional and cosmetic results.

• 한국임상수의학회지
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• 제24권3호
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• pp.441-443
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• 2007

Horner's syndrome is a group of clinical signs that results from interference with the sympathetic innervation of the globe and adnexa. Three dogs were presented with unilateral ptosis, miosis, enophthalmos and protrusion of the third eyelid. There were no other clinical signs on physical and neurological examination. On ophthalmic examination, the symptomatic eyes were diagnosed as Horner's syndrome. In order to localize the site of the lesion, pharmacological testing was performed through assessment of ocular response to the topical administration of 10% phenylephrine and clinical signs were resolved within 20 minutes. The pharmacological testing suggested that the deficit could be at the postganglionic neuron. Total resolution of clinical signs was observed within 6 months after their initial appearance without any treatment.

• Archives of Plastic Surgery
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• 제37권3호
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• pp.265-270
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• 2010

Purpose: Most of the bilateral structures in our body are not perfectly balanced, such that one side is preferred than the other or it has physiological superiority. Eyes also have an imbalance; the eye with sensory and motional superiority compared to the other is called dominant eye. Authors of this study focused on analyzing the correlation between the dominant eye and levator palpebrae superioris muscle. Methods: The subject of this study was 42 patients with no ptosis and with no past history of blepharoplasty. Hand dominance was identified through questionnaire and dominant eye was identified by hole-in-the-card dominance test (Dolman's test) in all patients. The function of levator palpebrae superioris muscle was measured by MLD (marginal limbal distance). During the measuring procedure, frontalis muscle was not inhibited to avoid the eyelid skin hooding. Results: Out of 42 patients, 27 patients (64.3%) were right ocular dominant, 15 patients (35.7%) were left ocular dominant, 36 patients (85.7%) were right hand dominant and 4 patients (9.5%) were left hand dominant. Out of 27 right ocular dominant patients, right MLD was larger than the left in 26 patients (96.3%). It was larger in average of 0.47 mm (p<0.001) in 27 right ocular dominant patients. Also, left MLD was larger than the right in 11 patients (73.3%) out of 15 left ocular dominant patients. It was larger in average of 0.57 mm (p=0.003) in 27 left ocular dominant patients. MLD on the side of the dominant eye was larger in average of 0.50 mm (p<0.001) than the MLD of non-dominant eye side. Right MLD was larger than the left in average of 0.28mm (p=0.010) in right hand dominant patients, and left MLD was larger than the right in average of 1.15 mm (p=0.025) in left hand dominant patients. Conclusion: The function of levator palpebrae muscle differs in right and left, and the difference correlates with the dominant eye. Also, the function of levator palpebrae muscle is stronger in the dominant eye. We were able to present statistical evidence regarding the difference of the function in right and left levator palpebrae muscle. This may be a factor worth consideration in terms of balancing the eyes during the blepharoplasty.

• Journal of Oral Medicine and Pain
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• 제24권2호
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• pp.171-179
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• 1999

최근 저자들은 좌측 안검하수, 안면마비, 좌측 협궁부의 부종 및 안모비대칭을 호소하는 49세 한국 여성 환자로부터, 임상적으로 우측 하악지 부위에서의 융기성 경결성 병소를 발견하고, 이에 대한 진단 및 감별진단을 위해 (1) 문진상 직장 선암(直腸 腺癌)에 대한 과거 수술병력 소견, (2) 두부 전산화단층촬영사진상 우측 하악지 전내방에서의 비교적 균질한 괴(塊)의 존재와 이것에 의한 우측 하악지 내측 피질골의 파괴, 또한 경사대(傾斜臺)를 중심으로 뇌실질 조직에 비해 약간 고밀도를 보이는 불규칙한 괴(塊)의 존재와 이것에 의한 접형동(蝶形洞)과 주변 골 및 좌측 상악골의 파괴, 그리고 전신 골스캔상 비강 부위와 좌측 상악골 부위에서의 hot spot의 존재, 그리고 후전방 흉부 일반방사선촬영사진상 전폐야에 걸친 다양한 크기의 수 많은 결절의 산재를 나타낸 영상화 검사 소견, (3) 과거 전신병력 추적 소견상 간 우엽에서의 중심부에 hyperechoic focus를 가진 과녁 모양의 경계가 양호한 괴(塊)의 존재를 나타낸 간부위 초음파 검사 소견을 채득한 후 이들 자료를 종합, 분석, 평가한 결과, 과거 전신병력상의 원발성 직장 선암의 원격 전이에 의해 발생된 것으로 판단되었으며, 또한 영상화 검사에서 관찰된 우측 하악지 내측 피질골의 파괴상 및 좌측 상악골의 파괴상 역시 원발성 직장 선암의 원격 전이에 의해 발생된 것으로 판단되었다.