• Archives of Plastic Surgery
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• v.44 no.1
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• pp.65-71
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• 2017

Background This study evaluated dynamic changes in eyebrow position related to aging. Methods Female participants were recruited and separated into two groups aged 20-30 years (the younger group, n=20; mean age, 24.8 years) and 50-70 years (the older group, n=20; mean age, 55.8 years). Photogrammetry was used to determine the eyebrow position at the medial canthus (MC), lateral limbus, lateral canthus, and lateral end point (EP) for 6 actions: smooth opening (the reference action) and closing of the eye, forward gaze, maximum opening and closing of the eye, and maximum frown. Videos were also recorded. Results No differences in eyebrow position were detected at the MC when opening or closing the eyes smoothly, gazing straight ahead, or closing the eyes maximally. For all 6 actions, the position of the lateral EP in the older group was significantly lower than in the younger group (P=0.003), and the smallest degree of vertical movement at this point was found in both age groups (P<0.001). Vertical movement at the 4 landmarks of the eyebrows decreased with aging. Conclusions Eyebrow position was unchanged at the MC with aging, except at maximal eye opening and maximal frown. No differences in eyebrow position were observed between the younger and older groups when eyes were maximally closed, except at the EP. It is important to focus on correction of the lateral EP for periorbital rejuvenation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.4
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• pp.366-369
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• 1999

The nasal and zygoma bone are parts of frequently fracturing of facial bones because of anatomically protrusion. Of facial bone fractures, nasal bone is at the high level of incidence rate. But zygoma fracture that anatomical characteristics increase the incidence rate also is occupied considerable part of the facial bone fracture. The outline of face is decided by form of underlying skeletal structure, of that, zygoma plays an important role in. Zygoma is closely attached to surrounding anatomic structure as orbit, maxillary sinus. Aesthetic and functional disturbance are developed by zygoma fracture from trauma, complications, as facial asymmetry, trismus, sensory disturbance, epistaxis, periorbital hemorrhage, diplopia etc, are developed. The patterns of complications following displacement of fractured fragment of zygoma by trauma are slightly different.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.524-527
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• 2007

Purpose: Globe displacement due to a blowout fracture is a rare clinical phenomenon. The authors present reduction of a globe displacement to the maxillary sinus due to trauma suffered in a fall and the reconstruction of a large defect left in the medial and inferior orbit. Methods: A 39-year-old male patient was unable to open his left eye after being struck on the periorbital area by a metal edge. Laceration was not noted in that area but we were unable to observe the intraorbital globe. A facial computed tomography (CT) scan showed that the globe was displaced through the maxillary sinus. A transconjunctival approach was used to access the infraorbital margin and the globe entrapped in the inferior margin of the orbit was successfully reduced. A large defect in the medial and inferior orbit was reconstructed using a graft from the iliac bone. Results: In 5 months after the operation, no atrophy of the globe was seen. Both sides retained a similar shape. A satisfactory functionality outcome in terms of improved extraocular muscle movement, and a satisfactory aesthetical outcome were achieved. Conclusion: The authors report the reduction of a globe displaced to the maxillary sinus following a fall and the reconstruction of the large defect left in the medial and inferior orbit.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.543-546
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• 2011

Purpose: LASIK, one of the currently popular ophthalmic procedures, can sometimes result in dry eye symptoms. In the patient who had underwent LASIK operation, the periorbital surgery may be more likely to lead to such a complication as dry eye symptom. We would like to report a case of corneal abrasion occurred after transconjunctival blepharoplasty in post-LASIK state and suggest the method about preventing the complication. Methods: A 30-year-old female patient underwent transconjunctival blepharoplasty and microfat graft into the face. She had history of LASIK operation 2 years ago. Corneal protector was applied to both eye during transconjunctival operation. After the surgery, she complained of visual blurring at left side. Ophthalmic examination revealed corneal abrasion of left eye. Results: Cornea protecting lens was applied to left eye for 2 weeks. Steroid and antibiotic eye drops were applied for relieving the symptoms and the prevention from progressing of complication. After 1 week, visual power and acuity was recovered to preoperative state. No other specific complications happened. Conclusion: Post-LASIK patient may have possibility of decreased corneal sensation and tear production. Preoperative ophthalmic examination is recommended for the prevention of complication. When corneal protector is applied, we suggest Optagel$^{(R)}$ as a useful lubricant.

• Korean Journal of Head & Neck Oncology
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• v.32 no.2
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• pp.61-64
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• 2016

There are various types of malignancy in eyelid, such as squamous cell carcinoma, melanoma, and sarcoma. These malignant tumors have potential of metastasis by regional lymph node drainage. The lymph node around parotid gland has been known as a common site of regional lymph node metastasis. The rarity of malignant tumors in the periorbital area makes it difficult to determine the optimal extent of treatment. We report a case of parotid metastasis after eyelid cancer operation in a 60-year-old man.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup1
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• pp.124-127
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• 2001

Langerhans' cell histiocytosis is a rare disease showing proliferation of histiocytes in multiple organ system. Bone lesions are the most common radiolologic manifestation of Langerhans' cell hysticytosis. Extraskeletal sites of Langerhans' cell hystiocytosis involvement include the skin, lymph nodes, thymus, lungs, central nervous system, liver, pancrease, spleen, and bowel. The authors have experienced a case of Langerhans' cell histiocytosis which involved the skull. A 3-year-old female presented with soft tissue mass on right periorbital area. Plain skull X-ray showed punched out bone lesion. Computed tomography showed non-enhancing osteolytic lesion on right frontal skull. Histologic findings of an excised mass revealed pathologic features of Langerhans' cell histiocytosis.

• Archives of Craniofacial Surgery
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• v.20 no.4
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• pp.274-278
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• 2019

Orbital tuberculosis is a rare form of extrapulmonary tuberculosis, even in endemic areas. It may involve the soft tissue, lacrimal gland, periosteum, or bones of the orbital wall. We present a case of orbital tuberculosis on the lower eyelid. An 18-year-old woman with no underlying disease visited our clinic for evaluation of an oval nodule ($1.5{\times}1.2cm$) on the right lower eyelid. Incision and drainage without biopsy was performed 2 months ago in ophthalmology department, but the periorbital mass had deteriorated, as the patient had erythematous swelling, tenderness, and cervical lymphadenopathy. Visual acuity was normal; there were no signs of proptosis, diplopia, or ophthalmoplegia. Computed tomography revealed a small abscess cavity without bony involvement. We performed an excision and biopsy through a percutaneous incision under local anesthesia. Histological examination revealed a granuloma and was diagnosed as orbital tuberculosis. The patient was additionally treated with anti-tuberculosis therapy for 6 months and recovered without complication or recurrence by 7 months. Orbital tuberculosis occurs in patients with or without associated pulmonary tuberculosis, and should be considered as a differential diagnosis in patients with inflammatory orbital disease and an orbital mass. If recurrence occurs despite adequate initial treatment, we recommend an additional examination and excisional biopsy.

• Archives of Craniofacial Surgery
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• v.20 no.3
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• pp.164-169
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• 2019

Background: The conventional surgical method for reconstructing orbital floor fractures involves restoration of orbital continuity by covering an onlay with a thin material under the periorbital region. However, in large orbital floor fractures, the implant after inserting is often dislocated, leading to malposition. This study aimed to propose a novel implanting method and compare it with existing methods. Methods: Among patients who underwent surgery for large orbital floor fractures, 24 who underwent the conventional onlay implanting method were compared with 21 who underwent the novel ${\gamma}$ implanting method that two implant sheets were stacked and bent to resemble the shape of the Greek alphabet ${\gamma}$. When inserting a ${\gamma}$-shaped implant, the posterior ledge of the orbital floor was placed between the two sheets and the bottom sheet was impacted onto the posterior wall of the maxilla to play a fixative role while the top sheet was placed above the residual orbital floor to support orbital contents. Wilcoxon signed-rank test and Mann-Whitney U test were used for data analyses. Results: Compared to the conventional onlay method, the gamma method resulted in better restoration of orbital contents, better improvement of enophthalmos, and fewer revision surgeries. Conclusion: Achieving good surgical outcomes for extended orbital floor fractures is known to be difficult. However, better surgical outcomes could be obtained by using the novel implantation method of impacting a ${\gamma}$-shaped porous polyethylene posteriorly.

• Archives of Craniofacial Surgery
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• v.22 no.2
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• pp.115-118
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• 2021

Intramuscular hemangioma is a rare vascular benign proliferation that can occur within any muscle, particularly in the trunk and extremities. In the head and neck region, the masseter muscle is most commonly involved, followed by the periorbital and sternocleidomastoid muscles. Diagnosing intramuscular hemangioma is challenging because there are no characteristic symptoms; instead, magnetic resonance imaging is the best imaging modality to diagnose these lesions. Complete surgical resection is the treatment of choice, although the local recurrence rate is high. Herein, we report a rare case of intramuscular hemangioma located in the zygomaticus minor muscle, which is related to smiling and usually runs along the orbicularis oculi muscle. Distinguishing or separating these two muscles is challenging. However, based on the muscle vector of the midface and radiological findings, the two muscles were successfully separated. The zygomaticus minor was cut very slightly to approach to the lesion and the muscle fibers were split to excise it. A follow-up examination revealed no nerve damage or muscle dysfunction at 4 weeks postoperatively. This rare case may serve as a reference for managing intramuscular hemangioma in the head and neck region.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.4
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• pp.286-290
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• 2021

Objectives: The use of fat grafts in maxillofacial sculpturing is currently a common technique. Unlike fillers, autologous fats unite with facial tissues, but long-term results may still be unsatisfactory. Sharing long-term follow-ups can be helpful in making outcomes more predictable. Materials and Methods: The data from patients who were admitted from 2014 to 2016 for fat augmentation were collected. In all cases, fat grafts were injected by blunt cannula using a tunneling technique in different planes. A fan shape order for the malar, periorbital, nasolabial fold, mandibular angle and body, and perioral area was established. Results: Autologous fat was used for different sites of the maxillofacial regions. Of 15 patients, two patients were not satisfied due to fat graft resorption. For this, further injections were performed six months after the first injection using preserved fat grafts. One patient continued to be dissatisfied. There were no other complications related to fat transplants. Conclusion: Fat transplantation is a safe, reliable, and non-invasive method for facial contour and facial soft tissue defect restoration. Additional methods such as mesenchymal stem cells along with fat injection increase the survival rate of transferred fat.