1/49. Orbicularis oculi myocutaneous flap in reconstruction of postburn lower eyelid ectropion.The management of postburn lower eyelid ectropion is difficult, since the contraction of the skin graft may give rise to secondary deformities especially around the lateral 1/3 of the lower eyelid. In this paper, the results of reconstruction in lower eyelid ectropion with a laterally based orbicularis oculi myocutaneous flap from the upper eyelid in 7 young patients are presented. Satisfactory function and cosmesis were obtained in the evaluation of the patients up to 40 months follow-up. The method proved versatile as the donor scar was well-hidden in the supratarsal fold and the temporally based myocutaneous flap provided additional support to the lower eyelid by exerting an upward pull against the gravity. It is concluded that usage of this flap in postburn ectropion cases is worthwhile to avoid any recurrences. reserved.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
2/49. Malar fat pad elevation: An aid to closure.BACKGROUND: In closure of defects inferior to the eye, it is important to avoid inducing lower lid ectropion. OBJECTIVE: To describe a new technique for closure of defects inferior and lateral to the eye. methods: A case of malar fat pad elevation to close a post-Mohs surgical defect is described and the procedure is detailed. RESULTS: This technique enabled good wound closure with minimal tension and avoided the complication of ectropion. A transient asymmetry was manifest postoperatively. CONCLUSION: Malar fat pad elevation is an effective and elegant means of closing defects inferior and lateral to the eye. This technique minimizes extensive tissue undermining and movement with its consequences of postoperative tissue swelling, bruising, and hematoma formation. The side effect of ectropion is prevented.- - - - - - - - - - ranking = 0.125keywords = lower (Clic here for more details about this article) |
3/49. The tarsal sandwich: a new technique in lateral canthoplasty.PURPOSE: Trauma and infection sometimes produce lower lid malpositions that are difficult to repair cosmetically with standard canthoplasty techniques. A new variation is described. methods: Surgical techniques of the tarsal strip canthoplasty and of lateral tarsorrhaphy are combined into the tarsal sandwich. RESULTS: Representative cases with preoperative and postoperative photos are presented. CONCLUSION: The sandwich technique allows the surgeon more flexibility in achieving the necessary vertical lift of the lateral canthus in difficult cases of entropion, ectropion, and lagophthalmos.- - - - - - - - - - ranking = 0.125keywords = lower (Clic here for more details about this article) |
4/49. poland-Moebius syndrome: a case report.BACKGROUND: The primary site of pathology in Moebius syndrome is still unknown, although several studies have variably localized the lesion in the extraocular muscles, cranial nerves, or central nervous system. CASE: A 24-year-old man with poland-Moebius syndrome and acquired progressive bilateral paralytic lower eyelid ectropion is described. OBSERVATIONS: In this patient, magnetic resonance imaging studies revealed a barely detectable pontine hypoplasia and normal recti muscles. Nerve conduction studies of the facial nerves showed a severe demyelinating or dysmyelinating type of neuropathy. Bilateral lower eyelid ectropium of the patient was successfully corrected by canthal tightening procedures. CONCLUSION: Contrary to many reported cases, this patient serves as a rare example of a progressive type of poland-Moebius syndrome presumably resulting from a combination of a brainstem abnormality and a peripheral neural degenerative process.- - - - - - - - - - ranking = 0.25keywords = lower (Clic here for more details about this article) |
5/49. ectropion caused by periocular dermatitis.A 78-year-old woman had ectropion of both lower eyelids 4 weeks after the appearance of dermatitis around the eyes. Treatment with topical corticosteroids resulted in disappearance of both dermatitis and ectropion within 10 days. No relevant contact allergies were found. Her advanced age and a familial tendency toward edema around the eyes, indicating preexisting loss of elasticity, probably facilitated this apparently rare reaction.- - - - - - - - - - ranking = 0.125keywords = lower (Clic here for more details about this article) |
6/49. anthrax as the cause of preseptal cellulitis and cicatricial ectropion.A 54-year-old female farmer with anthrax infection of the eyelids is presented. She was initially managed with high dose intravenous penicillin g treatment. Following complete healing of the eyelid lesions, significant cicatricial ectropion resulted. Her right lower eyelid ectropion was corrected by surgical reconstruction using full thickness skin graft after a period of 6 months during which the cicatrization process stabilized. Satisfactory cosmetic and functional improvement was achieved. anthrax of the eyelid must be considered in the differential diagnosis of preseptal or orbital cellulitis and any reconstructive procedure should be attempted only after the cessation of the healing process.- - - - - - - - - - ranking = 0.125keywords = lower (Clic here for more details about this article) |
7/49. Transcaruncular medial orbitotomy for stabilization of the posterior limb of the medial canthal tendon.PURPOSE: A method to stabilize the posterior limb of the medial canthal tendon (MCT), using a transcaruncular medial orbitotomy (TMO) approach, is described in a stepwise fashion.The technique described is a modified version of procedures published by Ritleng, Crawford and Collin, and Fante and Elner methods: A prospective clinical evaluation of MCT stabilization via the TMO approach was undertaken in I I consecutive patients who presented with MCT laxity as one of the features of their ectropion. These cases are initially described in detail in two representative case reports, and summarized in 11 cases. The stepwise surgical approach is outlined. RESULTS: All patients had improved symptomatology in terms of epiphora and comfort. Furthermore, in all cases the lid position was improved or normalized. In four of the I cases (36%) the lower punctum did not ultimately reside in the lacrimal ake, but the punctal position was nevertheless improved and the MCT was stabilized. CONCLUSION: The TMO procedure provides both excellent MCT stabilization and adequate placement of the lower lacrimal punctum onto the globe. It does not require canalicular resection, and avoids continued anterior displacement of the medial lower lid which may occur when only the anterior limb of the MCT is addressed surgically.- - - - - - - - - - ranking = 0.375keywords = lower (Clic here for more details about this article) |
8/49. Management of eyelid anomalies associated with Blepharo-cheilo-dontic syndrome.PURPOSE: To describe the previously unreported management of the eyelid anomalies associated with blepharocheilo-dontic syndrome. Blepharo-cheilo-dontic syndrome is a syndrome of congenital cleft lip/palate, oligodontia, euryblepharon, eyelid ectropion, and lagophthalmos. methods: Case report. A 3-month-old male presented with bilateral upper and lower eyelid ectropion with eyelid retraction, marked euryblepharon, severe lagophthalmos, and a right side cleft lip/palate. Lateral tarsal strips, lower eyelid retractor disinsertion, myocutaneous advancement of the cheek and eyelids, and lateral tarsorrhaphy were performed. RESULTS: Correction of the ectropion, eyelid retraction, euryblepharon, and marked improvement in his lagophthalmos were achieved postoperatively. No recurrence of the ectropion or euryblepharon has been noted after 6 months of follow-up. CONCLUSION: Appropriate reconstructive surgery of the eyelids reduces the morbidity associated with the eyelid anomalies and provides an excellent cosmetic result for patients with blepharo-cheilo-dontic syndrome.- - - - - - - - - - ranking = 0.25keywords = lower (Clic here for more details about this article) |
9/49. Treatment of bilateral severe eyelid burns with skin grafts: an odyssey.Eyelid burns occur in about 10% of thermal injuries and pose a considerable challenge for the reconstructive surgeon. A consensus on a treatment regime has not been reached and plastic surgeons are divided on the subject. A case of severe bilateral eyelid burns was treated with full- and split-thickness skin grafts. The patient was first operated at 2 years post-injury, and a total of 5 operations in 5 years were necessary to address recurrent ectropion of both upper and lower eyelids.- - - - - - - - - - ranking = 0.125keywords = lower (Clic here for more details about this article) |
10/49. Composite Z plasty for cicatricial ectropion of Tessier III cleft.Tessier III clefts represent one of the most difficult and challenging malformations of the face to repair. ectropion caused by a Tessier III cleft may be secondary to a vertical loss of both the anterior and posterior lamellae of the lower eyelids.A composite Z plasty to treat recurrence of cicatricial ectropion of the lower eyelids in Tessier III cleft is described. This is not only a technically easy and effective surgical method but also has a short operation time. To the best of the authors' knowledge, this is the first report of the application of a composite Z plasty in the successful treatment of ectropion.- - - - - - - - - - ranking = 0.25keywords = lower (Clic here for more details about this article) |
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