• Archives of Plastic Surgery
• /
• 제33권2호
• /
• pp.149-154
• /
• 2006

The levator and $M{\ddot{u}}ller^{\prime}s$ muscle balanced tucking was performed to correction myogenic or aponeurotic blepharoptosis. Through the blepharoplasty incision, the upper half of tarsal plate was exposed and the orbital was opened to show the levator aponeurosis. the $M{\ddot{u}}ller^{\prime}s$ muscle dissected from the upper border of the tarsal plate and from the posteriorly located conjunctiva with sharp scissors. $M{\ddot{u}}ller^{\prime}s$ muscle was advanced about 3 mm to 8 mm on anterior surface of the tarsal plate and fixed approximately upper one third of the tarsal plate with three horizontal 6-0 Nylon mattress sutures. The amount of tucking of $M{\ddot{u}}ller^{\prime}s$ muscle was controlled by the location of the upper eyelid margin 2 mm below the upper limbus in primary gaze after first temporary fixations suture in the maximum superior point of the limbus. The amount of advancement of levator aponeurosis was controlled by the location of the upper eyelid margin 1 mm below the upper limbus in primary gaze after first temporary fixations suture in the maximum superior point of the limbus. And then levator aponeurosis was fixed with three horizontal 6-0 Nylon mattress on beside the point that was tucked $M{\ddot{u}}ller^{\prime}s$ muscle. We have been thirty cases with levator and $M{\ddot{u}}ller^{\prime}s$ muscle balanced tucking from January 2004 to Jun 2005. 3 cases were traumatic blepharoptosis with 3-5 mm ptosis and poor levator function. 27 cases were myogenic or aponeurotic blepharoptosis with 2-5 mm ptosis with and more than 4 mm of levator function. the age of the patients ranged from 6 to 78 years. The levator aponeurosis and $M{\ddot{u}}ller^{\prime}s$ muscle tucking procedure can reduce the amount of the levator and $M{\ddot{u}}ller^{\prime}s$ muscle resection, and improve discomfort when the patients open eyes.

• Archives of Plastic Surgery
• /
• 제42권2호
• /
• pp.257-259
• /
• 2015

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제22권3호
• /
• pp.356-359
• /
• 2000

Superior orbital fissure syndrome is characterized by ophthalmoplegia, ptosis of the eye, reflex dilation of the pupil, and anesthesia of the upper eyelid and forehead. This syndrome may be the result of craniofacial fractures as well as neoplasms of the retrobulbar space, hematomas in the orbital muscle cone and retrobulbar space, and hematoma and infection of the cavernous sinus. A case of superior orbital fissure syndrome is described.

• Archives of Plastic Surgery
• /
• 제32권3호
• /
• pp.299-303
• /
• 2005

The epicanthal fold is common natural finding in Asian eyes. It is very common that patients, who look for oriental blephaloplasty for double eye lid, request correction epicanthal fold. It is very often difficult to achieve satisfactory results if the correction of the epicanthal fold is not corrected concomitantly. Many authors described surgical procedures for correction of epicanthal folds. But most of them leave additional scars which tend to be hypertrophic and noriceable. We achieved satisfactory result in epicanthoplasty with invisible scar, using combination of procedures, such as upward incision, double eyelid operation, anchoring suture of the medial upper lid skin to the medial canthal tendon, trans-nasal root subcutaneous mattress suture of the epicanthal fold itself and combined rhinoplasty. For past six years (1998 to 2003) 17 patients have been operated with one of these mentioned procedures. The mean follow up was 4months (2weeks to 6months). All patients were satisfied and no major complication was noted. This method can be one of the effective procedures for correcting the Asian epicanthal fold for avoiding potential visible scar and ancillary procedure in double eye lid blephaloplasty.

• 대한두개안면성형외과학회지
• /
• 제19권4호
• /
• pp.300-303
• /
• 2018

Intraorbital wooden foreign bodies may present difficulties in diagnosis due to their radiolucent nature. Delayed recognition and management can cause significant complications. We present a case report that demonstrates these problems and the sequela that can follow. A 56-year-old man presented with a 3-cm laceration in the right upper eyelid, sustained by a slipping accident. After computed tomography (CT) scanning and ophthalmology consultation, which revealed no fractures and suggested only pneumophthalmos, the wound was repaired by a plastic surgery resident. Ten days later, the patient's eyelid displayed signs of infection including pus discharge. Antibiotics and revisional repair failed to solve the infection. Nearly 2 months after the initial repair, a CT scan revealed a large wooden fragment in the superomedial orbit. Surgical exploration successfully removed the foreign body and inflamed pocket, and the patient healed uneventfully. However, the prolonged intraorbital infection had caused irreversible damage to the superior rectus muscle, with upgaze diplopia persisting 1 year after surgery and only minimal muscle function remaining. We report this case to warn clinicians of the difficulties in early diagnosis of intraorbital wooden foreign bodies and the grave prognosis of delayed management.

• 동의생리병리학회지
• /
• 제26권2호
• /
• pp.253-258
• /
• 2012

Facial expression was an important communication methods. In oriental medicine, according to the emotion the face has changed shape and difference occurs in physiology and pathology. To verify such a theory, we studied the correlation between emotional facial expressions and meridian and collateral flow. The facial region divided by meridian, outer brow was Gallbladder meridian, inner brow was Bladder meridian, medial canthus was Bladder meridian, lateral canthus was Gallbladder meridian, upper eyelid was Bladder meridian, lower eyelid was Stomach meridian, central cheeks was Stomach meridian, lateral cheeks was Small intestine meridian, upper and lower lips, lip corner, chin were Small and Large intestine meridian. Meridian and collateral associated with happiness was six. This proves happiness is a high importance on facial expression. Meridian and collateral associated with anger was five. Meridian and Collateral associated with fear and sadness was four. This shows fear and sadness are a low importance on facial expression than different emotion. Based on yang meridian which originally descending flow in the body, the ratio of anterograde and retrograde were happiness 3:4, angry 2:5, sadness 5:3, fear 4:1. Based on face of the meridian flow, the ratio of anterograde and retrograde were happiness 5:2, angry 3:4, sadness 3:5, fear 4:1. We found out that practical meridian and collateral flow change by emotion does not correspond to the expected meridian and collateral flow change by emotion.

• 대한두경부종양학회지
• /
• 제11권1호
• /
• pp.36-40
• /
• 1995

Sebaceous carcinomas of the eyelids are uncommon but lethal tumors. Lesions are usually seen in the elderly, predominantly women. The meibomian glands of the tarsus are the most frequent site of origin. Less commonly, the tumor arises in other sebaceous glands, e.g., the gland of Zeis, eyebrow or caruncle. Regardless of the location, sebaceous malignancies must be considered aggressive neoplasms with a potential for regional and distant metastasis. Diagnosis may be difficult, given the low incidence and inconsistencies in histopathologic classification. Treatment requires wide surgical excision with removal of involved regional lymph nodes and exenteration is reserved for those patients with orbital involvement or diffuse intraepithelial neoplasia. Opinions are divided regarding the use of postoperative irradiation or chemotherapy. Recently we experienced 46-year-old male patient with a 12-month history of painless, firm nodule and conjunctivitis due to sebaceous carcinoma of the left upper eyelid. After surgery, serial sections of the entire conjunctiva and eyelids showed a positive cut margin in medial and lateral border. We report herein this patient that supports irradiation as the postoperative treatment of these tumors in selected patients with a review of literatures.

• 한방안이비인후피부과학회지
• /
• 제22권2호
• /
• pp.238-250
• /
• 2009

Recurrence of peripheral nerve palsy is unusual, specially in eye. So there's seldom report about recurrent peripheral nerve palsy in eye. We treated a patient who had consecutive oculomotor nerve palsy after recovery of abducent nerve palsy at right eye. The patient visited our clinic for abducent nerve palsy. When he was hospitalized, ophthalmalgia was VAS 4 but it disappeared when he discharged on 21th of June. Although there was, in the case of abduction of eye, no noticeable change during the hospitalization, it was healed after he received outpatient service twice a week until Nov. 3rd. Oculomotor nerve palsy appeared on 24th of November, 2008 and the patient was hospitalized on Nov. 26th. At that time ophthalmalgia was VAS 4, but disappeared when he discharged. When he entered hospital, the length between upper & lower eyelid and MRD 1 were all 0mm. However, when he discharged, the length between upper & lower eyelid was 11mm, and MRD 1, 4mm which were the same lengths as those of the normal left eye. In the case of eye movement, the motion of supraduction, infraduction, and adduction was entirely inhibited when the patient was hospitalized. By the time of discharge, the inhibition of infraduction was recovered after that of adduction, but the inhibition of supraduction was not recovered. This is a very rare case of peripheral nerve palsy, nevertheless he recovered complete twice by acupuncture and herb medicine therapy.

• Archives of Plastic Surgery
• /
• 제33권4호
• /
• pp.521-524
• /
• 2006

Purpose: The history of biometry dates back to ancient Greek. The ideal body ratio from biometry is used as a guideline in many works of art. Biometry is also used as a medical standard to determine normal or abnormal. Since the biometry of face is so complicated, many surgeons tend to regard preoperative evaluation as a bother and substitute medical records with some photographs. We introduce a new method to measure $MRD_1$ and levator function using digital photographs, which becomes widely used lately. Methods: $MRD_1$ can be measured with the primary-gaze-view photo which is magnified by PhotoshopR 7.0.1. The distance from coneal reflex of ring flash to upper eyelid margin is converted to mm-unit using the piece of ruler attached on the patient's face. Levator function can be measured with up-gaze-view photo and down-gaze-view photo which are superimposed on another. The excursion distance of upper eyelid margin (a) and the excursion distance of eyebrow (b) are measured respectively. The levator function can be assessed through subtraction of two values (a-b). This method is simple and precise and can be applied directly to patient without photos. Results: Using magnified digital photos and computer, this method can reduce personal error and instrumental error. Taking some digital photos doesn't take long time, so it can reduce the effort of preoperative evaluation and discomfort of patients. Conclusion: Digital photo-biometry is useful for retrospective study. Especially reducing personal error, it is useful when the number of specimens is huge. New levator function test is much more useful for Asian-specific eyes than Berke's method allowing frontalis muscle compensation.

• Archives of Plastic Surgery
• /
• 제37권5호
• /
• pp.659-666
• /
• 2010

Purpose: Blepharoplasty plays a vital role in facial rejuvenation. Aging eyelids are the result of relaxation of lid structures as the skin, the orbicularis muscle, and mainly the septum, with subsequent protrusion or pseudoherniation of intraorbital fat contents. Traditional blepharoplasty has often involved the excision of excessive lax skin and muscle and removal of fat, leaving the eyelid unnatural and even causing the brow ptosis. The authors propose the septal approach through which the amount of skin excision can be decreased and solid fixation can be achieved in the upper blepharoplasty. Methods: From November 2007 to February 2010, total of 15 patients underwent upper blepharoplasty with septal approach. In 9 patients, orbital septum anchored into the orbital periosteum only. But in 6 patients, the attenuated septum was strengthened through shortening and fixing into orbital periosteum with non-absorbable suture. Results: Pleasing results were obtained from most of the patients. But one patient who had septum anchoring procedure complained of slight undercorrection, therefore secondary operation with septum shortening procedure was followed. Conclusion: We found that the method using orbital septum fixation into orbital periosteum has several advantages: less amount of skin excision, less recurrence rate, and more natural appearance. And the results were reliable and satisfactory.