• Title/Summary/Keyword: nasolacrimal duct

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Surgical anatomy for Asian rhinoplasty: Part II

  • Kim, Taek Kyun;Jeong, Jae Yong
    • Archives of Craniofacial Surgery
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    • v.21 no.3
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    • pp.143-155
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    • 2020
  • Surgical anatomy for Asian rhinoplasty Part I reviewed layered anatomy with neurovascular system of the nose. Part II discusses upper two-thirds of nose which consists of nasal bony and cartilaginous structures. Nasal physiology is mentioned briefly since there are several key structures that are important in nasal function. Following Part III will cover lower one-third of nose including in-depth anatomic structures which are important for advanced Asian rhinoplasty.

Prophylactic Intraoperative Nasolacrimal Duct Intubation in Surgical Treatment of Facial Fractures-Is There a Role?

  • Teoh, Ryan Liang Wei;Fong, Pei Yuan;Cai, Elijah Zhengyang;Yap, Yan Lin;Hing, Eileen Chor Hoong;Lee, Han Jing;Nallathamby, Vigneswaran;Ong, Wei Chen;Lim, Jane;Sundar, Gangadhara;Lim, Thiam Chye
    • Archives of Plastic Surgery
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    • v.49 no.2
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    • pp.195-199
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    • 2022
  • Nasolacrimal duct (NLD) damage is associated in the majority of type II and III naso-orbito-ethmoid (NOE) fractures. Our study aims to investigate the efficacy and safety of prophylactic NLD intubation in the setting of facial fractures, by comparing incidence of postoperative epiphora and wound infection. A retrospective matched control study was conducted on all patients with surgically treated facial fractures from 2008 to 2013 (n=280) (IRB ref number: DSRB 2013/01198). Patients with the following fracture types were included: NOE (n=16), frontal sinus (n=2), Le Fort II/III (n=8), and > 1 type (n=48). All patients in this study were included with the intention to treat. The study group comprised patients who were intubated, while the control group patients were not intubated. Each group had 37 patients matched for age, gender, fracture type, and injury type. A single oculoplastic surgeon skilled in lacrimal surgery performed the procedure for all intubated patients. Patients with more severe and complex facial fractures were intubated with bicanalicular Crawford stents. Postoperative epiphora and infective complications (both facial wound and dacryocystitis) were assessed at 1, 3, 6, and 12 months. There was no significant difference in incidence of either postoperative epiphora (p=0.152) or wound infection (p=0.556) comparing both groups. Reduced incidence of postoperative epiphora in the study group is statistically not significant and does not support the need for prophylactic intubation. If radiographic evidence of NLD disruption or regurgitation seen on syringing on the NLD intraoperatively is present, intubation is safe and efficacious only if performed by an expert.

Surgical treatment of esotropia and unilateral ptosis in a patient with Cornelia de Lange syndrome

  • Kim, Won Jae
    • Journal of Yeungnam Medical Science
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    • v.36 no.2
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    • pp.152-154
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    • 2019
  • Cornelia de Lange syndrome (CdLS) is a rare multisystemic disorder that is characterized by mental retardation, prenatal and postnatal growth retardation, limb anomalies, and distinctive facial features, which include arched eyebrows that often meet in the middle (synophrys), long eyelashes, low-set ears, small and widely spaced teeth, and a small and upturned nose. Ophthalmic manifestations include long eyelashes, nasolacrimal duct obstruction, myopia, ptosis, and strabismus. There has been no report of surgical treatment for esotropia and unilateral ptosis in patients with CdLS in Korea. I report a patient with CdLS who underwent surgical treatment for esotropia and unilateral ptosis with a good surgical outcome.

Role of Dacryoscintigraphy in the Diagnosis and Treatment of Pediatric Patients with Epiphora (유루를 호소하는 소아 환자의 진단 및 치료에서 누비공신티그라피의 역할)

  • Jeong, Hwan-Jeong;Bom, Hee-Seung;Song, Ho-Cheon;Min, Jung-Jun;Kim, Ji-Yeul;Jeong, Sang-Ki;Park, Yeoung-Geol
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.4
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    • pp.362-367
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    • 1999
  • Purpose: We conducted this study to evaluate the role of dacryoscintigraphy in the diagnosis and treatment of pediatric patients with epiphora. Materials and Methods: In 58 patients aged from 2 months to 15 years (mean age $2.8{\pm}2.3$ years), dacryoscintigraphy was performed using a gamma camera with 4 mm pinhole collimator. We correlated symptoms with dacryosicntigraphic findings in all patients. In 37 patients who underwent ophthalmologic procedures, we analyzed the agreements of dacryoscintigraphic findings with the operation. Results: High rates of agreements between epiphora and obstruction on dacryoscintigraphy (69/72, 95.8%), and between scintigraphic obstructive findings and operation sites (44/47, 93.6%) were noted. Nine of foully-four (20.5%) asymptomatic eyes showed obstructive findings on dacroscintigraphy. Conclusion: In pediatric patients with epiphora, dacryoscintigraphy is a useful tool not only in diagnosing nasolacrimal duct obstruction but also in making a decision for therapeutic procedures.

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Studies on Drug Absorption Characteristics for Development of Ocular Dosage Forms: Ocular and Systemic Absorption of Topically Applied ${\beta}-Blockers$ in the Pigmented Rabbit

  • Lee, Yong-Hee
    • Journal of Pharmaceutical Investigation
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    • v.24 no.3
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    • pp.59-66
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    • 1994
  • The objective of this study was to determine the influence of drug lipophilicity on the extent of ocular and systemic absorption following topical solution instillation in the pigmented rabbit. ${\beta}-Blockers$ of various lipophilicity were chosen as model drugs, $25\;{\mu}l$ of a 15 mM drug solution in isotonic pH 7.4 buffer was instilled, and ocular tissue and plasma drug concentrations were monitored. Ocular absorption was apparently increased in all eye tissues, but non-corneal absorption ratio was decreased by increasing of drug lipophilicity. Systemic bioavailability was ranged from 61% for atenolol to 100% for timolol, and at least 50% of the systemically absorbed drug reached the blood stream from the nasal mucosa. Occluding the nasolacrimal duct for 5 min reduced the extent of systemic absorption of timolol and levobunolol, but did not do so for atenolol and betaxolol. Taken together, the ocular absorption of topically applied ophthalmic drugs would be modest for lipophilic drugs. By contrast, the systemic bioavailability would be modest for drugs at the extremes of lipophilicity, and the nasal contribution to systemically absorbed drug diminished with increasing of drug lipophilicity.

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Mitomycin-C in Endoscopic Dacryocystorhinostomy (비내누낭비강문합술에서 Mitomycin-C의 효과)

  • 김명원;이종환;김은석;이상철;장백암;변영자
    • Korean Journal of Bronchoesophagology
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    • v.4 no.2
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    • pp.188-192
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    • 1998
  • Background and Objectives: The most common cause of the failure of endoscopic dacryocystorhinostomy is closure of the osteotomy site due to granulation or adhesion. We used mitomycin-C, an antineoplastic antibiotic agent, soaking over the osteotomy site to suppress fibrous proliferation and scar formation during the endoscopic dacryocystorhinostomy. Materials and Methods : A total of 20 Patients diagnosed with nasolacrimal duct obstruction were assigned randomly to either a mitomycin-C group or a control group. Endoscopic dacryocystochinostnmy has been used in both groups. In the mitomycin-C group, a piece of merocel soaked with 0.2 mg/ml mitomycin-C was applied to the osteotomy site and then after 30 minutes was removed. Results : All patients in the mitomycin-C group remained symptom free after removal of their silicone tube (100% success), and there were two patients in the control group who had recurrent epiphora (67% success). In the mitomycin-C group, the average surface area of the osteotomy at the end of the sixth postoperative month was 4.1 $\textrm{mm}^2$, whereas that of the control group was 2.5 $\textrm{mm}^2$. Neither serious systemic nor local toxicity were noted in the mitomycin-C group. Conclusion : Intraoperative mitomycin-C may possibly improve success rates over the endoscopic dacryocystorhinostomy procedure.

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Case Report of Patients Diagnosed with Epiphora Improved by Traditional Korean Medical Treatment and Auricular Acupuncture (이침치료를 동반한 한방치료로 호전된 유루증 환자 치험 1례)

  • Kim, Ji-Won;Noh, Hyeon-Min;Youn, Deok-Won;Kim, Young-Hyun
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.30 no.3
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    • pp.211-219
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    • 2017
  • Objectives : The purpose of this study is to report the effect of traditional Korean medical treatment and auricular acupuncture on the patient suffered from epiphora. Methods : One patient suffering from epiphora was treated with traditional Korean medical treatment including auricular acupuncture. HRQL(Health-related quality of life) and VAS(Visual Analogue Scale) were measured and compared to evaluate its treatment effectiveness. Results : We attained results which show recovery from watery eye, pain, eye strain in symptoms and improvement on quality of life. Conclusions : In this study, traditional Korean medical treatment can be effective in obtunding symtoms and improving quaility of life for patients suffering from epiphora.

Clinical Experience with Nasolabial Cysts Using the Sublabial Approach (구강내 접근법을 이용한 비순낭종의 치료 경험)

  • Kwon, Joon-Sung;Choi, Hwan-Jun;Choi, Chang-Yong;Park, Jae-Hong;Park, Nae-Kyeong;Kim, Sook
    • Archives of Plastic Surgery
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    • v.38 no.3
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    • pp.251-256
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    • 2011
  • Purpose: A nasolabial cyst is a rare non-odontogenic, soft-tissue, developmental cyst arising anywhere on the face inferior to the nasoalar region. It is thought to arise from either epithelial remnants trapped along the lines of fusion during the development of face or the remnants of the developing nasolacrimal duct. This study examines various features of nasolabial cysts with bony involvement to provide a basis for correct diagnosis and treatment. Methods: Eight cases of nasolabial cyst treated in Soonchunhyang Hospital between March 2002 and July 2010 were examined in terms of their clinical features and radiological and histological findings. Seven patients underwent surgical excision of the cyst via an intraoral, sublabial approach. One underwent incision and drainage. Results: Our eight patients were seven women and one man. The most frequent symptoms and signs were facial deformity and swelling of the nasolabial fold. Computed tomography (CT) showed a well-circumscribed cystic mass lateral to the pyriform aperture. Seven cases had erosive lesions on CT, and the intraoperative findings were consistent with a nasolabial cyst with a bony defect. Typical histopathological findings showed that these cysts were most frequently lined with respiratory epithelium with ciliated columnar cells and cuboid cells. No patient developed complications or recurrences. Conclusion: A nasolabial cyst is often unrecognized or confused with other intranasal masses, including fissural and odontogenic cysts, midface infections, or swelling in the nasolabial area. Therefore, a careful clinical and radiological evaluation should be preformed when considering the differential diagnosis. We present eight patients with nasolabial cysts treated via a gingivobuccal approach with excellent functional and cosmetic results.

Polysaccharide-based superhydrophilic coatings with antibacterial and anti-inflammatory agent-delivering capabilities for ophthalmic applications

  • Park, Sohyeon;Park, Joohee;Heo, Jiwoong;Lee, Sang-Eun;Shin, Jong-Wook;Chang, Minwook;Hong, Jinkee
    • Journal of Industrial and Engineering Chemistry
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    • v.68
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    • pp.229-237
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    • 2018
  • Medical silicone tubes are generally used as implants for the treatment of nasolacrimal duct stenosis. However, side effects such as allergic reactions and bacterial infections have been reported following the silicone tube insertion, which cause surgical failure. These drawbacks can be overcome by modifying the silicone tube surface using a functional coating. Here, we report a biocompatible and superhydrophilic surface coating based on a polysaccharide multilayer nanofilm, which can load and release antibacterial and anti-inflammatory agents. The nanofilm is composed of carboxymethylcellulose (CMC) and chitosan (CHI), and fabricated by layer-by-layer (LbL) assembly. The LbL-assembled CMC/CHI multilayer films exhibited superhydrophilic properties, owing to the rough and porous structure obtained by a crosslinking process. The surface coated with the superhydrophilic CMC/CHI multilayer film initially exhibited antibacterial activity by preventing the adhesion of bacteria, followed by further enhanced antibacterial effects upon releasing the loaded antibacterial agent. In addition, inflammatory cytokine assays demonstrated the ability of the coating to deliver anti-inflammatory agents. The versatile nanocoating endows the surface with anti-adhesion and drug-delivery capabilities, with potential applications in the biomedical field. Therefore, we attempted to coat the nanofilm on the surface of an ophthalmic silicone tube to produce a multifunctional tube suitable for patient-specific treatment.

Combination Surgery of Silicone Tube Intubation and Conjunctival Resection in Patients with Epiphora

  • Kim, Seon Tae;Jin, Long Yu;Ahn, Hee Bae
    • Korean Journal of Ophthalmology
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    • v.32 no.6
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    • pp.438-444
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    • 2018
  • Purpose: To compare the success rates of performing only silicone tube intubation versus carrying out both conjunctival resection and silicone tube intubation. Methods: The subjects of this study involved 62 patients (96 eyes) between October 2015 and May 2017 who were diagnosed as having punctal stricture or nasolacrimal duct stenosis. Out of 96 eyes, 47 underwent only silicone tube intubation, and 49 underwent both silicone tube intubation and conjunctival resection. Three parameters were measured at 1, 3, and 6 months after the surgery: the area of the tear meniscus using RTVue-100 anterior segment optical coherence tomography, the height of the tear meniscus using a slit lamp microscope, and the subjective satisfaction of patients as a result of improved sympotms like epiphora. The surgery was considered successful when the patients' experienced the resolution of symptoms and reduction of the area and height of the tear meniscus. Results: The area of the tear meniscus, height of the tear meniscus, and subjective satisfaction of patients was superior in the group that underwent both silicone tube intubation and conjunctival resection compared silicone tube intubation only. Based on these results, the success rate of the surgery was 68.9% in the group that underwent only silicone tube intubation and 78.7% in the group that underwent both silicone tube intubation and conjunctival resection. Conclusions: The resection of relaxed plica semilunares seems to increase the success rate of silicone tube intubation through the reduction of the area and height of the tear meniscus. Therefore, after determining the degree of conjunctivochalasis, if it was found to be severe, a combination with conjunctival resection was expected to increase the success rate of the surgery.