Background: This study evaluated the efficacy of the endoscopic medial orbital wall repair by comparing it with the conventional transcaruncular method. This surgical approach differs from the established endoscopic technique in that we push the mesh inside the orbit rather than placing it over the defect. Methods: We retrospectively reviewed 40 patients with isolated medial orbital blowout fractures who underwent medial orbital wall reconstruction. Twenty-six patients underwent endoscopic repair, and 14 patients underwent external repair. All patients had preoperative computed tomography scans taken to determine the defect size. Pre- and postoperative exophthalmometry, operation time, the existence of diplopia, and pain were evaluated and compared between the two methods. We present a case showing our procedure. Results: The operation time was significantly shorter in the endoscopic group (44.7 minutes vs. 73.9 minutes, p= 0.035). The preoperative defect size, enophthalmos correction rate, and pain did not significantly differ between the two groups. All patients with preoperative diplopia, eyeball movement limitation, or enophthalmos had their symptoms resolved, except for one patient who had preexisting strabismus. Conclusion: This study demonstrates that endoscopic medial orbital wall repair is not inferior to the transcaruncular method. The endoscopic approach seems to reduce the operation time, probably because the dissection process is shorter, and no wound repair is needed. Compared to the previous endoscopic method, our method is not complicated, and is more physiological. Larger scale studies should be performed for validation.
Algahtani, Hussein;Shirah, Bader;Alsaggaf, Khalid;Al-Qahtani, Mohammad H.;Abdulkareem, Angham Abdulrahman;Naseer, Muhammad Imran;Abuzinadah, Ahmad R.
Journal of Genetic Medicine
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v.18
no.2
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pp.121-126
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2021
Chronic progressive external ophthalmoplegia (CPEO) is a complex slowly progressive mitochondrial disorder characterized by extraocular muscle weakness with or without multisystem involvement. The mainstay of therapy in a patient with CPEO is supportive. However, in moderate cases, surgery might be indicated including surgeries for ptosis and strabismus. In this article, we report a Saudi patient with CPEO due to compound heterozygous variants in the DNA polymerase gamma (POLG) gene c.2246T>C p.(Phe749Ser) and c.1735C>T p.(Arg579Trp), which are classified as pathogenic. Proper diagnosis with genetic testing confirmation is important to guide the management and counsel the patient about the prognosis and the management options. The patient was successfully managed with bilateral frontalis sling and illustrates the importance of surgical intervention to improve vision and cosmetic appearance in patients with CPEO. We emphasize the importance of multidisciplinary care in the management of cases of mitochondriopathy, especially CPEO.
Ripplinger, Angel;de Melo, Stella Maris Pereira;Ferrarin, Denis Antonio;Schwab, Marcelo Luis;Wrzesinski, Mathias Reginatto;Rauber, Julia da Silva;Flores, Mariana Martins;Kommers, Glaucia Denise;Mazzanti, Alexandre
Journal of Veterinary Science
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v.23
no.2
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pp.30.1-30.6
/
2022
This report aims to describe the first case of muscular and collagenous choristoma in a dog. A 10-yr-old female mixed-breed dog presented with lateral recumbence, vocalization, positional vertical nystagmus, divergent strabismus, anisocoria, and status epilepticus. The clinical condition evolved to stupor and ultimately, death. Necropsy revealed a white mass causing an irregular increase in the volume of the cerebellar vermis. In histological analysis, a well circumscribed, unencapsulated mass was observed in the cerebellum, consisting of fibers of striated skeletal muscle and collagen fibers, mostly mineralized. Based on the histopathological and histochemical findings, a diagnosis of muscular and collagenous cerebellar choristoma was made.
For this study, we analysed the difference of values between noncycloplegic and cycloplegic autorefraction in primary school children. We classified the elementary school one, two, three grade (8~10age) 79children(158eyes) who did not have strabismus or amblyopia. They were examined by using the Autorefractor in domestic market before and after cycloplegic. Discrepancies beyond 0.50D in spherical and cylindrical power and 20 degree in cylindrical axis were regarded as significant. The percentages of discrepancy were greater in spherical power between noncydoplegic and cycloplegic autorefraction(p<0.05). The percentages of discrepancy were not greater in cylindrical power between noncycloplegic and cycloplegic autorefraction. The percentages of discrepancy were greater in cylindrical axis between noncydoplegic and cycloplegic autorefraction(p<0.05). In conclusion, for the primary school children who did not wear glasses, the prediction table of this study will be helpful to reduce the test error in visual acuity and refractive error tests.
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.23
no.2
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pp.111-118
/
2012
Botulinum toxin is a potent neurotoxin that is produced by the bacterium Clostridium botulinum. The agent causes muscle paralysis by preventing the release of acetylcholine at the neuromuscular junction of striated muscle. Botulinum toxin A (Botox, AllerganInc., Irvine, California) is the most potent of seven distinct toxin subtypes that are produced by the bacterium. The toxin was initially used clinically in the treatment of strabismus caused by hypertonicity of the extraocular muscles and was sub-sequently described in the treatment of multiple disorders of muscular spasticity and dystonia. In treating patients with Botox for blepharospasm, Carruthers and Carruthers [5] noticed an improvement in glabellar rhytids. This ultimately led to the introduction and development of Botox as a mainstay in the treatment of hyperfunctional facial lines in the upper face. Since its approval by the U.S. Food and Drug Administration for the treatment of facial rhytids (2002), botulinum toxin A has expanded into wide-spread clinical use. Forehead, glabellar, and periocular rhytids are the most frequently treated facial regions. Indications for alternative uses for Botox in facial plastic and reconstructive surgery are expanding. These include a variety of well-established procedures that use Botox as an adjunctive agent to enhance results. In addition, Botox injection is finding increased usefulness as an independent modality for facial rejuvenation and rehabilitation. The agent is used beyond its role in facial rhytids as an effective agent in the management of dynamic disorders of the face and neck. Botox injection allows the physician to precisely manipulate the balance between complex and conflicting muscular interactions, thus resetting their equilibrium state and exerting a clinical effect. This article will address some of the new and unique indications on Botox injection in the face (the lower face and neck, combination with fillers). Important points in terms of its clinical relevance will be stressed, such as an understanding of functional facial anatomy, the importance of precise injections, and correct dosing all are critical to obtaining natural outcomes.
Kim, Ahlee;Moon, Jin Soo;Yang, Hye Ran;Chang, Ju Young;Ko, Jae Sung;Seo, Jeong Kee
Clinical and Experimental Pediatrics
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v.58
no.1
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pp.28-32
/
2015
Purpose: Diencephalic syndrome is an uncommon cause of failure to thrive in early childhood that is associated with central nervous system neoplasms in the hypothalamic-optic chiasmatic region. It is characterized by complex signs and symptoms related to hypothalamic dysfunction; such nonspecific clinical features may delay diagnosis of the brain tumor. In this study, we analyzed a series of cases in order to define characteristic features of diencephalic syndrome. Methods: We performed a retrospective study of 8 patients with diencephalic syndrome (age, 5-38 months). All cases had presented to Seoul National University Children's Hospital between 1995 and 2013, with the chief complaint of poor weight gain. Results: Diencephalic syndrome with central nervous system (CNS) neoplasm was identified in 8 patients. The mean age at which symptoms were noted was $18{\pm}10.5$ months, and diagnosis after symptom onset was made at the mean age of $11{\pm}9.7$ months. The mean z score was $-3.15{\pm}1.14$ for weight, $-0.12{\pm}1.05$ for height, $1.01{\pm}1.58$ for head circumference, and $-1.76{\pm}1.97$ for weight-for-height. Clinical features included failure to thrive (n=8), hydrocephalus (n=5), recurrent vomiting (n=5), strabismus (n=2), developmental delay (n=2), hyperactivity (n=1), nystagmus (n=1), and diarrhea (n=1). On follow-up evaluation, 3 patients showed improvement and remained in stable remission, 2 patients were still receiving chemotherapy, and 3 patients were discharged for palliative care. Conclusion: Diencephalic syndrome is a rare cause of failure to thrive, and diagnosis is frequently delayed. Thus, it is important to consider the possibility of a CNS neoplasm as a cause of failure to thrive and to ensure early diagnosis.
Purpose: The purpose of this study was to investigate the correlation between non-strabismic binocular dysfunctions and academic achievement for primary school children. Methods: A total of 1,123 parents and their children aged 8-13 years responded to the College of Optometrists in Vision Development Quality of Life (COVD-QOL) questionnaire. Among the all participants, 123 children who have ${\geq}20$ of visual symptom scores, no amblyopia, no strabismus, no any ocular and systemic pathology, and no contact lenses wearing were chosen for this study finally. Binocular functions were evaluated for final subjects. Results: Of 123 primary school children who have criteria-eligible symptoms 93 had non-strabismic binocular dysfunctions. Accommodative dysfunction was significantly correlated to subjects of science and English, and vergence dysfunction was also significantly correlated to Korean, mathematics, social science, science and English in the final subjects. Conclusions: Correlations between academic achievement and accommodative/vergence dysfunctions were statistically significant. Therefore, accommodative/vergence dysfunctions may be factors to affect academic achievement.
Cockayne syndrome is a rare autosomal recessive disorder characterized by cachectic dwafism, mental retardation, loss of facial subcutaneous adipose tissue, microcephaly and photosensitive dermatitis. It is associated with renal abnormalities characterized by hyalinization of glomeruli, atrophy of tubules and interstitial fibrosis. To our knowledge, this is the first report of a case of Cockayne syndrome with FSGS in Korea. A 7-year old boy was admitted for evaluation of hypertension and proteinuria, which were detected 2 month ago. He was followed for short stature(<3 percentile), mental retardation(IQ 55), strabismus and dental caries since 3 years ago. He also showed microcephaly, a bird-like face and relatively large hands and feet. Laboratory findings showed decreased creatinine clearance($C_{Cr}$ 76.1 mL/min/$1.73m^2$) and proteinuria(1,548 mg/day). Renal biopsy demonstrated focal segmental glomerulosclerosis of the hilar type with large hyaline deposits, moderate tubular atrophy and interstitial fibrosis. His cardinal features, mental retardation, and renal biopsy findings were consistent with Cockayne syndrome. We report here a very rare case of Cockayne syndrome with FSGS presenting with proteinuria and hypertension.
This research was performed to screen eye health status for pre-school children (4~5 age) and establish as eye health checking system m community health center. This data was collected from 1st February, 1995 to 31st October, 1995. To screen the state of their vision, the Developed Visuual Test (D.V.T) was used for pre-school children. This is used at home by their parents and then it is also used among the kindergarten health team at Jung-gu health center in Seoul. This was done with the and of Randot and Han Choun Souk tests. The total number of children who were tested was 1441. Among the children, children aged 5 were 707, and those aged 4 were 734. The results of this study were as follows; * Description of the health status for the pre-school children. 1. The rate of children average vision in both eyes, whose was below 05 by Han Choun Souk are 7.6% (age 4) and 4.8% (age 5). 2. Only 20 4% (age 5) and 30 8% (age 4) of the pre-school children had been tested through the ophthalmic department. 3. The children with a level below 05 (Han Choun Souk test) had been tested only 43% (age 4), and 12% (age 5) 4. There was no particular difficulty in understanding the D.Y.T: 13.9% (age 4), 11.6% (age 5) of the tested children had eye problems. 5. 231 cases were trichiasis, entropin, strabismus, and amblyopia. * The different visual tests. The results of the visual tests between the two groups (parents and health teams) are similar and it shows that parents can easily test at home. * Delivery system of the D.V.T questionnaire The way children's parents received the D.V.T questionnaire were carried out by two ways By mall from the community health center. Send through the institution, for example the kindergarten school The receipt rate of this D.V.T questionnaire sent through the institution was higher than sent by mall.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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v.13
no.1
/
pp.280-290
/
2000
We analyzed statistics study in 1695 patients, who had visited to the Dept. of surgery, ophthalmology & otolaryngology Hospital of Downtown Orirental Medicine Kyung Hee University from March, 1996 to July, 1998. The results were as follows. 1. Distribution of ophthalmology, otolaryngology and dermatology classification was $43.48\%\;in\;ophthalmology,\;16.70\%\;in\;rhinology,\;5.72\%\;in\;laryngology,\;17.94\%\;in\;dermatology\;and\;16.17\%$ in otiatrics. 2. Ophthalmology group were $31.93\%$ males and $47.90\%$ females in 10 years old within. In treatment term, opthalmology patients who had treated for 1 month within was $59.70\%$. Strabismus and visual disorder was the most common ophthalmo-disease. 3. Rhinology group were $30.00\%$ males in 10 years old within and $21.56\%$ females in 21-30years old. In treatmentm, rhinology patients who had treated for 1 month within was $53.71\%$. Rhinitis and sinusitis was the most common rhinio-disease. 4. Otiatrics group were $30.54\%$ males in 41-50 years old and $31.78\%$ females in 51-60 years old. In treatment term, otiatries patients who had treated for 1 month within was $53.28\%$. Tinnitus, hearing loss and otitis media was the most common otiatrics-disease. 5. Laryngology group were $29.27\%$ males in 31-40 years old and $28.57\%$ females in 51-60 years old. In treatment term. Laryngology patients who had treated for 1 month within was $91.75\%$ Epipharyngitis and abnormal sensation pharyngolarylgeal region was the most common laryngo-disease. 6. Dermatology group were $39.82\%$ males and $39.79\%$ females in 21-30 years old. In treatment term, dematology patients who had treated for 1 month within was $83.55\%$. Acne and Pruritus was the most common ophthalmo-disease.
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