Sample records for blepharoptosis

  1. Acquired blepharoptosis

    NARCIS (Netherlands)

    Oosterhuis, HJGH


    A review is given of the aetiology and possible treatment of acquired (non-congenital) blepharoptosis, which is a common but not specific sign of neurological disease: The diagnostic categories of upper eyelid drooping are scheduled as (a) pseudo-ptosis due to a local process or overactivity of eye

  2. Surgical treatment for medically refractory myasthenic blepharoptosis

    Directory of Open Access Journals (Sweden)

    Shimizu Y


    Full Text Available Yusuke Shimizu,1 Shigeaki Suzuki,2 Tomohisa Nagasao,1 Hisao Ogata,1 Masaki Yazawa,1 Norihiro Suzuki,2 Kazuo Kishi1 1Department of Plastic and Reconstructive Surgery, 2Department of Neurology, Keio University School of Medicine, Tokyo, JapanPurpose: Currently, only a few reports have recommended surgery as a suitable treatment for blepharoptosis associated with myasthenia gravis. The present study aims to introduce our surgical criteria, surgical options, outcomes, and precautions for medically refractory myasthenic blepharoptosis. Patients and methods: Eight patients who failed to respond to at least 2 years of medical treatment and who underwent blepharoptosis surgery, from January 2008 to December 2011, were enrolled in this study. Medical records, photographs, and questionnaire results regarding postoperative status were evaluated. Of the eleven procedures performed, four involved frontal suspension, four involved external levator advancement, one involved nonincisional transconjunctival levator advancement, and two involved subbrow blepharoplasty with orbicularis oculi muscle tucking. The margin reflex distance improved postoperatively in seven patients. Results: Seven patients had very minimal scarring, and one had minimal scarring. Five patients showed no eyelid asymmetry, one had subtle asymmetry, and two had obvious asymmetry. Seven patients were very satisfied, and one patient was satisfied with the overall result. Postoperative complications included mild lid lag with incomplete eyelid closure, prolonged scar redness, and worsened heterophoria. No patient experienced postoperative exposure keratitis or recurrent blepharoptosis during the study period. Conclusion: Our results indicate that blepharoptosis surgery is effective for patients with myasthenia gravis, especially those with residual blepharoptosis despite multiple sessions of medical treatments. We recommend that neurologists and surgeons collaborate more systematically and

  3. Blepharoptosis and hypertrophic osteoarthropathy: A case report

    Directory of Open Access Journals (Sweden)

    Aysun Sanal Dogan


    Full Text Available A 52-year-old male patient presented to our hospital with a history of secondary hypertrophic osteoarthropathy (HOA associated with an abdominal neoplasia and blepharoptosis. He had finger clubbing, hyperhidrosis, and hypertrichosis. He also had a recent history of extensive abdominal surgery with a pathology report of myelolipoma. Routine blood work was unremarkable. Upper eyelid reconstruction with blepharoplasty, upper eyelid wedge resection, and brow suspension was performed to address his eyelid concerns. By this case report, we would like to attract notice that the eyelid involvement may be a part of HOA and to emphasize the importance of systemic and pathologic evaluation in failed blepharoptosis surgery.

  4. Blepharoptosis and hypertrophic osteoarthropathy: A case report. (United States)

    Dogan, Aysun Sanal; Acaroglu, Gölge; Dikmetas, Ozlem


    A 52-year-old male patient presented to our hospital with a history of secondary hypertrophic osteoarthropathy (HOA) associated with an abdominal neoplasia and blepharoptosis. He had finger clubbing, hyperhidrosis, and hypertrichosis. He also had a recent history of extensive abdominal surgery with a pathology report of myelolipoma. Routine blood work was unremarkable. Upper eyelid reconstruction with blepharoplasty, upper eyelid wedge resection, and brow suspension was performed to address his eyelid concerns. By this case report, we would like to attract notice that the eyelid involvement may be a part of HOA and to emphasize the importance of systemic and pathologic evaluation in failed blepharoptosis surgery. PMID:27221686

  5. Upper eyelid motility in blepharoptosis and in the aging eyelid

    NARCIS (Netherlands)

    R.J. Wouters; W.A. van den Bosch (Willem); H.G. Lemij (Hans); P.G.H. Mulder (Paul)


    textabstractPURPOSE. To study the metrics of lid saccades in blepharoptosis and to distinguish any differences in the dynamics of eyelid movements that are related to the cause of blepharoptosis and to aging. METHODS. The lid and vertical eye saccades of 7 patients with

  6. Elevator Muscle Anterior Resection: A New Technique for Blepharoptosis. (United States)

    Zigiotti, Gian Luigi; Delia, Gabriele; Grenga, Pierluigi; Pichi, Francesco; Rechichi, Miguel; Jaroudi, Mahmoud O; d'Alcontres, Francesco Stagno; Lupo, Flavia; Meduri, Alessandro


    Blepharoptosis is a condition of inadequate upper eyelid position, with a downward displacement of the upper eyelid margin resulting in obstruction of the superior visual field. Levator resection is an effective technique that is routinely used to correct aponeurotic ptosis. The anterior levator resection is the procedure of choice in moderate blepharoptosis when there is moderate to good levator muscle function, furthermore, with an anterior approach, a greater resection can be achieved than by a conjunctival approach. The authors describe a modification in the Putterman technique with a resection done over a plicated elevator, plication that was suggested by Mustardè. The technique has been named as elevator muscle anterior resection. The elevator muscle anterior resection inspires from the Fasanella-Servat operation by the use of a clamp, making the operation simple and predictable. PMID:26703054

  7. Frontalis muscle flap suspension for the correction of congenital blepharoptosis in early age children.

    Directory of Open Access Journals (Sweden)

    Dianju Hou

    Full Text Available BACKGROUND: We aimed to report our successful use of frontalis muscle flap suspension for the correction of congenital blepharoptosis in early age children. METHODS: This retrospective study included 61 early age children (41 boys, 20 girls with an average age of 6 years (range, 3-10 years with congenital blepharoptosis who received surgery during the period from March 2007 to January 2011. There were 39 cases of unilateral blepharoptosis and 22 cases of bilateral blepharoptosis, thus a total of 83 eyes were affected. If patient had bilateral blepharoptosis, both eyes were operated on in the same surgery. Patients were followed for 3 months to 5 years. The procedure was performed without complications in all cases. RESULTS: The postoperative healing grade was good in 81 eyes (97.6%; the correction of blepharoptosis was satisfactory, the double eyelid folds were natural and aesthetic, the eyelid position and the curvature were ideal, and the eyes were bilaterally symmetrical. The postoperative healing grade was fair in 2 eyes (2.4%; blepharoptosis was improved compared with that before surgery. At discharge, lagophthalmos was noted in 10 eyes of which 4 cases resolved by the last follow-up. The remaining 6 cases were mild. Eleven eyes received reoperation for residual ptosis after the first surgery. The curvature of the palpebral margin was not natural in 4 eyes. These unnatural curvature possibly was caused by an excessively low lateral fixation point or postoperative avulsion. CONCLUSION: Frontalis muscle flap suspension under general anesthesia for the correction of congenital blepharoptosis in early age children can achieve good surgical results.

  8. [Suspending of blepharoptosis on temporalis fascia slings: our own experience]. (United States)

    Kokot, W; Półjanowski, P


    There are many procedures providing treatment of ptosis. In cases with palpebrae levator palsy, procedures involving mechanical suspension of palpebrae are used. Artificial and natural materials are used to suspend the lid. We describe surgical treatment of blepharoptosis using autogenous temporalis fascia sling. The sling is attached to the tarsus and spreads to the frontalis muscle. We have used this procedure in 12 cases. Full effect of functional elevation of palpebrae was achieved in 14 to 30 days after procedure. We did not encounter any significant complications due to this material. These operative modifications make this procedure more closely parallel to the normal eyelid dynamics and provide consistently good results for this difficult problem.

  9. Obesity as a Potential Risk Factor for Blepharoptosis: The Korea National Health and Nutrition Examination Survey 2008-2010.

    Directory of Open Access Journals (Sweden)

    Ji-Sun Paik

    Full Text Available To examine obesity parameters as potential risk factors associated with blepharoptosis in a representative Korean population.We analyzed the Korea National Health and Nutrition Examination Survey (KNHANES, conducted between 2008 and 2010. 10,285 Korean adults (4,441 men and 5,844 women aged 40 years or older was enrolled. We compared body mass index (BMI, waist circumference (WC and percentage body fat (BF, according to the severity of blepharoptosis. Multiple logistic regression analysis was conducted to examine the associations of each obesity parameter with blepharoptosis.The overall prevalence of age-related blepharoptosis was 14.8 % in South Korea. There were significant and graded associations between increasing blepharoptosis severity and the mean value of obesity parameters (P for trend < 0.05. As marginal reflex distance 1 (MRD1 decreased, the prevalence of general obesity and overweight status increased (P for trend=0.121 in men and < 0.001 in women; the prevalence of abdominal obesity increased (P for trend < 0.001 for both genders; the prevalence of highest quartile of percentage BF increased (P for trend ≤0.001 for both genders. Blepharoptosis was significantly associated with general obesity in women (adjusted odds ratio (aOR, 2.14; 95% confidence intervals (CI, 1.32-3.47; and with the highest quartile of percentage BF in men (aOR, 2.01; 95% CI, 1.34-2.97 and in women (aOR, 1.52; 95% CI, 1.06-2.3317, after adjusting for age, smoking exercise, drinking alcohol, total energy intake, fat intake, total cholesterol, and high density lipoprotein cholesterol, diabetes, hypertension, and family history of eye disease.The etiology of age-related blepharoptosis may be multifactorial and is unclear. Our results suggest that obesity parameters such as BMI, WC and percentage BF might be potential risk factors for age-related blepharoptosis in a representative Korean population.



    Ruchi; Parth


    AIM & OBJECTIVE: The aim of the study is to evaluate the functional and cosmetic outcome and compare the complications of various ptosis surgeries done for simple congenital ptosis at a tertiary care hospital. METHODS: 46 patients with 52 eyelids having undergone ptosis surger y for congenital simple blepharoptosis were included in our study. Patients of all age groups and either sex which post - operatively completed a follow – up period at 1, 3, 6 m...

  11. Blefaroptose em usuários de lentes de contato Blepharoptosis in contact lens wearers

    Directory of Open Access Journals (Sweden)

    Tiana Gabriela Burmann


    Full Text Available OBJETIVO: Investigar a freqüência de blefaroptose adquirida em usuários de lentes de contato. MÉTODOS: Avaliação prospectiva de 50 pacientes, usuários de lentes de contato, do Setor de Lentes de Contato do Serviço de Oftalmologia do Complexo Hospitalar Santa Casa de Porto Alegre, durante o período de abril a novembro de 2004. A distância reflexo-margem (MRD foi avaliada em 99 pálpebras de usuários de lentes de contato e para as 52 pálpebras de controle. Pacientes cuja medida da distância reflexo-margem se apresentou inferior a 2 mm ou com assimetria de distância reflexo-margem maior ou igual a 2 mm foram considerados portadores de blefaroptose. Foram avaliados o tipo de lente de contato utilizada e o tempo de uso das mesmas. RESULTADOS: Cinco pacientes apresentaram ptose, todos eles eram usuários de lentes de contato rígidas, um com ptose bilateral e quatro, unilateral. A distância reflexo-margem dos pacientes usuários de lentes de contato foi, em média, 0,88 mm inferior aos não usuários. Os valores de distância reflexo-margem foram progressivamente decrescentes nos grupos estudados: controles, usuários de lentes gelatinosas e de lentes rígidas. CONCLUSÃO: O estudo sugere que os usuários de lentes de contato possuem alteração dos valores de distância reflexo-margem, principalmente os que usam lentes rígidas.PURPOSE: To investigate the occurrence of acquired blepharoptosis in contact lens wearers. METHODS: Prospective analysis of 50 contact lens wearers being followed at the Contact Lenses Section of the Ophthalmology Service at the "Complexo Hospitalar Santa Casa de Porto Alegre" between April and November 2004. The margin reflex distance (MRD was evaluated for the 99 eyelids of contact lens wearers and for the 52 eyelids of controls. A patient whose measurement was less than 2 mm or with an assymetry of margin reflex distance greater or equal to 2 mm were considered with blepharoptosis. The contact lens type and

  12. Suspensory Materials for Surgery of Blepharoptosis: A Systematic Review of Observational Studies (United States)

    Pacella, Elena; Mipatrini, Daniele; Pacella, Fernanda; Amorelli, Giulia; Bottone, Andrea; Smaldone, Gianpaolo; Turchetti, Paolo; La Torre, Giuseppe


    Background Frontalis suspension surgery is considered the procedure of choice in cases of blepharoptosis. Among all the materials used in this type of surgery, ophthalmic and plastic surgeons prefer to use autologous Fascia Lata. However, during years, other autogenous and exogenous materials have been introduced. Objectives The aim of this study was therefore that of systematically reviewing the functional results and the rate of complications of different synthetic materials, as compared to autogenous Fascia Lata. The primary objective was to determine the rates of Successful Surgeries (SSs) of these materials. The secondary objective was to assess the onset of complications. The following materials were investigated: Fascia Lata, Mersilene, polytetrafluoroethylene (PTFE) and Silicon. Data Source and Methods Following the Prisma procedure, on January 30th, 2016 we used the following electronic databases to select the studies: MEDLINE and Scopus. Results The search strategy retrieved 48 publications that met the eligibility criteria of the systematic review. All studies were non-comparative. PTFE (n = 5) showed the best rate of SSs among the materials compared (statistically significant). Surgeries performed with autogenous Fascia Lata (n = 19) had a 87% rate of success those performed with Mersilene (n = 12)had 92% and those performed with Silicon (n = 17)88%. PTFE had the best outcome, with 99% success rate. As for complications, surgeries performed with PTFE had a higher rate of suture infections (1.9%) as compared to Fascia Lata, but lower incidence for all other complications. Conclusions Although most studies were good quality cohort studies, the overall quality of this evidence should be regarded as low due to their non-comparative design. Our data suggest that PTFE seems to be the most valid alternative material for frontalis suspension surgery, with low recurrence rates and good cosmetic and functional results. PMID:27631781

  13. Surgical anatomy and histology of the levator palpebrae superioris muscle for blepharoptosis correction

    Directory of Open Access Journals (Sweden)

    Đorđević Boban


    s crease was formed by the conjoined fascia including the fascia of the orbicularis muscle, the superficial layer of the orbital septum, and the aponeurosis of the LPS muscle, as well as the pretarsal fascia. Conclusion. The conducted study provided a valuable morphological basis for biomechanical and clinical considerations regarding blepharoptosis surgery. [Projekat Ministarstva nauke Republike Srbije, br. 175030

  14. Intra-eyebrow frontalis suspension using inverted Y-shaped short autogenous fascia lata for blepharoptosis with poor levator function. (United States)

    Shimizu, Yusuke; Nagasao, Tomohisa; Shido, Hirokazu; Fujii, Takako; Kato, Tatsuya; Aoki, Marie; Takada, Keiko; Kishi, Kazuo


    Frontalis suspension using autogenous fascia lata is a common procedure for blepharoptosis with poor levator function. However, donor-site morbidity associated with fascia lata harvest cannot be ignored. In conventional procedures, the required length of the fascia lata is usually >5-12 cm with a lateral thigh skin incision of approximately 5 cm or more. The present study introduces a new frontalis suspension procedure in which the required size (length and width) of the fascia lata and length of lateral thigh incision is much smaller. The harvested fascia lata is tailored to an inverted Y shape and the separated caudal legs are fixed to the tarsus while the cephalic end is grafted inside the eyebrow through a suborbital septum tunnel. In the present study, 11 patients who underwent the new procedure with a minimum of 6 months of follow-up were evaluated. The average length and width of the harvested fascia lata in unilateral ptosis cases were 2.85 and 0.89 cm, respectively. The average length of the lateral thigh incision was 1.25 cm. The margin reflex distance improved in all cases at 6 months postoperatively. The cosmetic result was graded as good to excellent in most of the patients. Trichiasis, widened donor scar, and eyebrow notch were noted as complications. The present method is a good alternative for the treatment of blepharoptosis with poor levator function. It potentially reduces donor-site morbidity as compared with conventional frontalis muscle suspension procedures using autogenous fascia lata.

  15. Palpebral position interdependence in blepharoptosis: comparison of the effect of instillation of 10% phenylephrine drop and digital lifting

    Directory of Open Access Journals (Sweden)

    Ivana Cardoso Pereira


    Full Text Available Purpose: To quantify and compare the effects of instillation with 10% phenylephrine and digital lifting on the contralateral upper eyelid of patients with involutional bilateral blepharoptosis. Methods: The present prospective clinical study involved patients with involutional bilateral blepharoptosis who underwent two tests: 1 digital lifting of the more ptotic eyelid and observation of the effect on the contralateral eyelid and 2 instillation of two drops of 10% phenylephrine in the more ptotic eye and observation of the effect on the contralateral eyelid. Patients were filmed before and 5, 10, and 15 min after instillation, and the resulting images were analyzed to obtain eyelid measurements. The results were tested using a linear mixed-effects model. Results: A total of 27 patients, ranging from 52 to 82 years of age (mean age 68.51 ± 8.21 years, 24 (88.88% of whom were women, were included in the present study. In eyes that received instillation, the marginal distance reflex-1 (MDR1 values increased from baseline (1.21 ± 0.60 mm until 10 min after instillation, then remained statistically unchanged until 15 min after instillation (2.42 ± 0.90 mm. Significant differences were observed in the contralateral eye of the group that underwent digital lifting (1.51 ± 0.53 mm - 1.63 ± 0.56 mm and in the contralateral eye of the group that underwent 10% phenylephrine instillation (1.38 ± 0.54 mm - 1.63 ± 0.56 mm; p=0.02 and p<0.01, respectively. Conclusion: In all eyes, 10% phenylephrine elevated the upper eyelid, with improved eyelid height at 10 min after instillation. Significant differences were observed in the height of the contralateral eyelid when compared before and after each intervention in each group; however, this difference was very small and nearly undetectable by conventional clinical evaluation in the digital lifting group. However, the 10% phenylephrine eye-drop test resulted in substantial changes in MDR1 values in the

  16. The surgical treatment of 379 cases of congenital blepharoptosis%先天性上睑下垂379例治疗体会

    Institute of Scientific and Technical Information of China (English)

    翟文娟; 潘叶; 唐东润; 孙丰源


    目的 应用不同术式治疗先天性上睑下垂,并对手术效果及其并发症进行评价.方法 自2002年6月至2007年10月间,共收治先大性上睑下垂患者379例(460只眼).其中重度上睑下垂300例(381只眼),中度上睑下垂47例(47只眼),轻度上睑下垂32例(32只眼).行阔筋膜悬吊术196例(246只眼),额肌瓣悬吊术104例(135只眼),提上睑肌缩短术47例(47只眼),提上睑肌腱膜折叠术32例(32只眼).结果 术后满意率为94.6%,好转率为5.0%,总有效率为99.6%.其中阔筋膜悬吊术手术满意率为91.9%,额肌瓣悬吊术满意率为95.5%,提上睑肌缩短术满意率为95.7%,提上睑肌腱膜折叠术满意率为96.9%.手术后有50只眼(10.9%)出现各种并发症,主要有额部血肿、暴露性角膜炎、矫正不全和上穹隆结膜脱垂,经相应处理后均好转.结论 对于提上睑肌无力的重度上睑下垂患者,采取阔筋膜悬吊术或额肌瓣悬吊术治疗,术后重睑自然,远期外观效果较好.提上睑肌力较好的轻度上睑下垂患者宜采取提上睑肌手术,术后重睑弧度自然,并发症少,是较理想的治疗方法.%Objective To investigate the various surgical techniques and their effects for correcting different types of blepharoptosis.Methods From June 2002 to October 2007,460 eyes of 379 eases patients with congenital blepharoptosis were received the surgical treatment.The patients with severe blepharoptosis were 300 cases(381 eyes),the patients with moderate blepharoptosis were 47 cases(47 eyes)and the patients with mild blepharoptosis were 32 cases(32 eyes).The surgical techniques included fascia lata sling with 196 cases(246 eyes),frontalis muscle flap suspension with 104 cases(135 eyes),superior levator muscle shortening with 47 cases(47 eyes)and superior levator aponeurosis folding with 32 cases(32 eyes).Results The satisfactory rate of the operations was 94.6%,5.0% patients were obtained better results,and the total effective rate was 99

  17. Treatment of blepharoptosis by modified frontalis muscle-fascial flap suspension%改进的额肌筋膜瓣悬吊矫正上睑下垂

    Institute of Scientific and Technical Information of China (English)

    张莉; 赵天兰; 李光早; 蚌埠医学院附属医院整形烧伤科; 徐静; 葛树星


    Objective:To evaluate the effect of modified frontalismuscle-fascial flap suspension in the treatment of blepharoptosis.Methods:We have improved on the conventional frontalis muscle-fascial flap suspention in the treatment of blepharoptosis.The skin and hypodermis were incised along the supratarsal fold line,then the tunnel between the orbicularis ocularis muscle and orbital septum was made.The frontal muscle-fascia was incised transversely 1 cm in its inserting level.Then the deep parts and the superficial parts of the frontal muscle-fascial flap were dissected in succession.Results:Fifty-four patients with blepharoptosis were treated using this modified frontal muscle-fascial flap and the outcome was satisfactory.Conclusions:This approach minimizes the range of dissection,thus reducing the trauma,bleeding and operating time;futhermore,the superficial parts of the frontal muscle-fascial flap being dissected firstly diminishes the injury to the flap so the operative outcome can be improved.%目的:评价改进的额肌筋膜瓣悬吊术治疗上睑下垂的疗效。方法:在原额肌筋膜瓣悬吊术治疗上睑下垂的基础上进行改进,按重睑术切口切开皮肤、皮下,于眼轮匝肌和眶隔之间向上分离至眶上缘,横断额肌筋膜止点约1cm,先将之与眉皮下浅层分离,再自骨膜上掀起眉部额肌及筋膜,达眉上1~1.2cm。结果:用该法治疗54例中、重度上睑下垂患者,疗效满意。结论:本法减少额肌筋膜瓣的分离范围,仅用重睑切口即可完成上睑下垂矫正术,省去重睑切口上缘眼轮匝肌与浅层皮下的分离,操作简单,损伤小,出血少,缩短手术时间,改善手术效果。

  18. Check ligament suspension for correction of congenital severe blepharoptosis%翼状韧带悬吊矫正先天性重度上睑下垂

    Institute of Scientific and Technical Information of China (English)

    潘贰; 张毓; 李琳; 沈绍勇; 王向阳; 王洪勇; 郝永生


    Objective To evaluate the clinical result of check ligament suspension for correction of congenital severe blepharoptosis. Methods Since Jan. 2010 to Nov. 2010, 15 eyes in 15 cases with congenital severe blepharoptosis were treated with the check ligament suspension. Palpebralis aponeurosis was exposured by opening fascia palpebralis during blepharoplasty. Palpebralis aponeurosis was cut off about 5 mm above the tarsus. The check ligament was seen in the intermuscular space between the segment of levator and the anterior one third of superior rectus attached to the conjunctival fornix. Congenital blepharoptosis could be corrected by suturing the check ligament and levator palpebrae superior to the upper margin of tarsal plate with 3-0 silk thread. Double eyelid plasty was carried out in the end. Results The follow-up period was 3-11 months with good cosmetic result. All the cases could close their eyes in 15 to 30 days with no complication. Conclusions In conclusion, this technique is quite successful in raising the level of the upper eyelid in severe congenital blepharoptosis. The check ligament moves in a similar direction as the natural movement of levator muscle, so both the postoperative static and dynamic appearance of the upper lid is more natural.%目的 探讨翼状韧带悬吊矫正重度先天性上睑下垂的临床效果.方法 2010年1~11月,应用翼状韧带悬吊法治疗先天性重度上睑下垂患者15例15只眼,按照切开重睑术术式,打开眶隔,在距睑板上缘5 mm处剪断上睑提肌腱膜进入到上睑提肌下层,向结膜上穹窿分离,在上直肌前1/3和上睑提肌之间找到翼状韧带,用3-0丝线同上睑提肌缝合于睑板上缘,悬吊矫正上睑下垂,缝合形成重睑.结果 经过3~11个月随访,15只眼矫正良好,眼裂均在15~30 d基本闭合,无其他并发症发生,重睑弧度形态自然,外观满意.结论 翼状韧带悬吊治疗重度先天性上睑下垂疗效可靠,用翼状韧带代替

  19. Suspensão ao músculo frontal com politetrafluoretileno para o tratamento da blefaroptose Frontalis suspension with polytetrafluorethylene for the treatment of blepharoptosis

    Directory of Open Access Journals (Sweden)

    Juliana Silvério


    Full Text Available OBJETIVO: Relatar a experiência com o uso do fio de politetrafluoretileno nas cirurgias de suspensão ao músculo frontal para correção de blefaroptose. MÉTODOS: Foram estudados todos os casos de blefaroptose grave submetidos à cirurgia pela técnica de suspensão ao músculo frontal como fio de politetrafluoretileno, no período de fevereiro de 2003 a abril de 2007. Foram realizadas 36 cirurgias em 23 pacientes, a média de seguimento foi de 15,8 meses (variando de 3 a 36 meses. A técnica cirúrgica utilizada foi a descrita por Fox. RESULTADOS: Entre as causas de blefaroptose foram encontradas: congênita em 20 (86,95% pacientes, blefarofimose em 2 (8,69% pacientes e traumática em 1 (4,35% paciente. Na primeira semana de pós-operatório, 6 (26,08% pacientes referiram assimetria palpebral, 4 (17,39% notaram edema local, 3 (13,04% pacientes apresentaram granuloma no local do fio e 1 (4,35% paciente apresentou celulite facial na região frontal unilateral. Após 3 meses de seguimento, 3 (13,04% pacientes referiram assimetria palpebral, e em 1 (4,35% paciente persistia o granuloma. CONCLUSÃO: O politetrafluoretileno - Modelo CV3, 6.0 (Gore-Tex®; W.L. Gore & Associates Inc, Flagstaff, AZ, EUA é um material adequado com bons resultados funcionais (86,9%, baixos índices de complicação (4,35% e insatisfação (13,4%, podendo ser uma alternativa em relação à fáscia lata, na cirurgia de suspensão ao frontal para tratamento de ptose palpebral grave.PURPOSE: To evaluate the functional results and complications of the use of expanded polytetrafluoroethylene in frontalis suspension surgery for the treatment of blepharoptosis. METHODS: Frontalis suspension procedure with polytetrafluoroethylene was performed between 2003 and 2007 on 23 patients (36 eyes with blepharoptosis. An average follow-up time was 15.8 months (range, 3 to 36. Surgical technique used was described by Fox. RESULTS: The causes of blepharoptosis found were: congenital in

  20. Improvement of frontal muscle-fascia suspension for blepharoptosis treatment%以额肌为动力治疗上睑下垂方法的改进

    Institute of Scientific and Technical Information of China (English)

    赵天兰; 余道江; 谢晓明; 张云涛; 徐妍; 陈琦; 吴浩荣


    目的 探索一种简便、实用的以额肌为动力治疗上睑下垂的方法的改进.方法 对22例不同程度的上睑下垂患者仍利用额肌作为动力,将分离的额肌筋膜直接固定于睑板上缘进行治疗.术中经重睑成形术切口将额肌筋膜与皮下组织充分游离,在眶上缘下横行切开额肌筋膜长约1.5 cm,在骨膜表面向上分离额肌筋膜,至眶上1.5 cm左右,不制作额肌筋膜瓣,然后将分离的额肌筋膜直接向下牵拉与睑板上缘睑上提肌腱膜缝合固定3~4针,并调整固定至张力适度为止,术中无需分离眼轮匝肌后隧道.结果 22例伤口均Ⅰ期愈合,睁眼时无抬眉、皱额表现,重睑外形佳,双眼对称,手术效果良好,患者满意.经3~6个月随访,无1例复发.结论 借用额肌作为动力,将额肌筋膜直接与睑板上缘缝合悬吊治疗上睑下垂,方法简便,疗效稳定,损伤小,并发症少.此方法可应用于额肌功能正常的各型上睑下垂患者.%Objective To introduce a new and practical method of treating blepharoptosis with direct suspension of the frontal muscle-fascia improvement. Methods 22 cases of blepharoptosis were corrected by direct suspension of the frontal muscle-fascia in which the dynamia still came from frontal muscle.Through double-fold eyelid incision, the frontal muscle-fascia was dissected from the subcutaneous tissue and a 1.5 cm length incision of the frontal muscle-fascia was cut under the supraorbital margin. And through the incision, the frontal muscle-fascia on the superficies of periosteum was dissected 1.5 cm to the upper margin of orbital, and then the frontal muscle-fascia was pulled down and fixed to the levator muscle aponeurosis directly by mattress sutures, with the tension being adjusted to a moderate degree. Results 22 cases of blepharoptosis were cured by primary healing with this method. The patients were followed up for 3 to 6 months with satisfactory results and no recurrence

  1. Surgical desensitisation of the mechanoreceptors in Müller's muscle relieves chronic tension-type headache caused by tonic reflexive contraction of the occipitofrontalis muscle in patients with aponeurotic blepharoptosis. (United States)

    Matsuo, Kiyoshi; Ban, Ryokuya


    Proprioceptively innervated intramuscular connective tissues in Müller's muscle function as exterior mechanoreceptors to induce reflex contraction of the levator and occipitofrontalis muscles. In aponeurotic blepharoptosis, since the levator aponeurosis is disinserted from the tarsus, stretching of the mechanoreceptors in Müller's muscle is increased even on primary gaze to induce phasic and tonic reflexive contraction of the occipitofrontalis muscle. It was hypothesised that in certain patients with aponeurotic blepharoptosis, the presence of tonic reflexive contraction of the occipitofrontalis muscle due to the sensitised mechanoreceptors in Müller's muscle, can cause chronic tension-type headache (CTTH) associated with occipitofrontalis tenderness. To verify this hypothesis, this study evaluated (1) what differentiates patients with CTTH from patients without CTTH, (2) how pharmacological contraction of Müller's smooth muscle fibres as a method for desensitising the mechanoreceptors in Müller's muscle affects electromyographic activity of the frontalis muscle, and (3) how surgical aponeurotic reinsertion to desensitise the mechanoreceptors in Müller's muscle electromyographically or subjectively affects activities of the occipitofrontalis muscle or CTTH. It was found that patients had sustained CTTH when light eyelid closure did not markedly reduce eyebrow elevation. However, pharmacological contraction of Müller's smooth muscle fibres or surgery to desensitise the mechanoreceptor electromyographically reduced the tonic contraction of the occipitofrontalis muscle on primary gaze and subjectively relieved aponeurotic blepharoptosis-associated CTTH. Over-stretching of the mechanoreceptors in Müller's muscle on primary gaze may induce CTTH due to tonic reflexive contraction of the occipitofrontalis muscle. Therefore, surgical desensitisation of the mechanoreceptors in Müller's muscle appears to relieve CTTH.

  2. 单切口额肌上睑SMAS瓣经眶隔后悬吊治疗上睑下垂%Single-incision frontalis muscle and SMAS flap suspension through the orbital septum for blepharoptosis

    Institute of Scientific and Technical Information of China (English)

    王卫峻; 张路; 王炜


    Objective To study the indications and practices of single-incision frontalis muscle and SMAS flap ( SIFSF) suspension through orbital septum for blephroptosis ( modified Song' s multi-incision technique). Methods From July 1993 to November 2009, 148 cases with 215 eyelids blepharoptosis were treated. Among them , the SIFSF was applied in 81 cases with 121 eye, including serious and recurded blepharoptosis,Horner's Syndrome, Marcus Gunn jaw-winking syndrome, Congenital Blepharophimosis syndrome and Treacher-Collins Syndrom with blepharoptosis. Results The SIFSF suspension for blepharoptosis which was avoided an incision under the eyebrow. It is not only to treat upper eyelid ptosis but also can rebuild the aesthetic double eyelid. Totally 49 cases with 69 blepharoptosis were followed up for four weeks to ten years post operatively, excellent results were received in 30 cases with 45 eyelids, good in 17 cases and 22 eyelids, poor in 2 cases and 2 eyelids. The successful rate was 97% . The postoperative complications such as cornea ulcer happened in 1 case , conjunctival prolapse in 2 cases, eyelid inversion in 1 case and hematoma in 2 cases. All cases of complication were treated by conservative treatment except 1 case with upper eyelid inversion which was treated by a surgery. Also the second stage operation were taken for two cases with poor results. Conclusion The SIFSF suspension through orbital septum for blepharoptosis can effectively treated serious and recurded upper eyelid ptosis , and several syndromes with blepharoptosis. It could avoid an incision under the eyebrow and reconstruct a similar levator dynamic function , with a good functional and aesthetic results for blepharoptosis.%目的 总结单切口额肌上睑SMAS瓣经眶隔后悬吊治疗上睑下垂的适应证及手术方法.方法 取上睑重睑皱襞切口,SIFSF悬吊治疗上睑下垂,重建上睑提升动力通道近似上睑提肌滑行路径.自1993年7月至2009年11

  3. Clinical observation different operative method in treatment of children with congenital blepharoptosis%不同手术方法治疗儿童先天性重度上睑下垂的临床观察

    Institute of Scientific and Technical Information of China (English)



    目的 观察不同的手术方式矫治儿童重度先天性上睑下垂的治疗效果.方法 36例47眼,应用额肌筋膜瓣悬吊术组18例24眼,自体阔筋膜悬吊术组18例23眼,比较两组术后疗效.结果 随访6个月,满意率比较两组无明显差异性(P>0.05).结论 两种方法各有优缺点,对治疗儿童重度上睑下垂均有效.%Objective To observe the clinical effect of different surgical treatment in children severe congenital blepharoptosis. Methods Totally 36 cases of 47 eyes,used forehead myofascial disc sling operation group 18 cases of 24eye,rich autologous fascia of sling operation 18 cases 23 eye,Compared postoperative curative effect of two groups. Results Follow - up 6 months,satisfaction rate was compared between the two groups has no obvious difference. Conclusions Two kinds of method have its advantages and disadvantages,to treating children severe blepharoptosis are valid.

  4. 额肌筋膜瓣经眶隔膜转移矫正重度先天性上睑下垂%Frontalis muscle fascial flap passing through pulley of orbital septum for correction of severe congenital blepharoptosis

    Institute of Scientific and Technical Information of China (English)

    谢锋; 张正文; 李磊; 李昊; 翟弘峰; 康深松


    目的 探讨额肌筋膜瓣经眶隔膜转移矫正重度先天性上睑下垂的临床效果.方法 2007年1月至2010年10月收治重度先天性上睑下垂42例,49只眼,常规经眼轮匝肌下分离松解制成额肌筋膜瓣,横向切开眶隔,去除部分脂肪后,将额肌筋膜瓣从眶隔内穿过,缝合于睑板上缘.结果 经过6个月随访,49只眼形态自然,无其它并发症发生.结论 本术式的额肌筋膜瓣运动方向接近上睑提肌运动方向且不易与周围组织粘连,术后眼睑外形逼真,值得临床应用.%Objective To evaluate the clinical result of the frontalis muscle fascial flap passing through the pulley of orbital septum for correction of severe congenital blepharoptosis. Methods Totally 49 eyes in 42 cases with severe congenital blepharoptosis were treated from 2007 to 2010. After the frontalis muscle fascial flap was prepared beneath the orbicularis oculi muscle, the pulley was created by two parallel horizontal incision on the orbital septum at the upper orbital rim and under the upper rim. The frontalis muscle fascial flap was then pulled down behind the pulley and out to be attached to the upper margin of tarsal plate. Results The following - up period was 6 months. Satisfactory cosmetic result was achieved in 49 eyes. No other complication was ovserved. Conclusions The pulley created by the orbital septum makes the tracton lines of the frontalis muscle fascial flap in a similar direction as the natural movement of levator muscle. The technique is very practicable in correction of severe congenital blepharoptosis.

  5. Comparison of Two Methods for Upper Lid Fascia Lata Sling in Congenital Blepharoptosis: a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Abbas Bagheri


    Full Text Available

    PURPOSE: To compare the results of two different methods of upper lid sling with autogenous fascia lata in the treatment of congenital ptosis. METHODS: In a randomized clinical trial, patients with congenital upper lid ptosis and poor levator function (< 4mm were randomly assigned to two different methods of upper lid sling: group A, bitriangular fascia sling (modified Crawford method and group B, monotriangular fascia sling (modified Fox method. RESULTS:  This study included 30 upper eyelids (15 eyelids in each surgical group of 19 patients (8 unilateral and 11 bilateral cases with congenital ptosis. Mean increase in eyelid fissure height was 2.7±2.3 mm in group A and 3.4±2.2 mm in group B, respectively. Change in eyelid fissure in both groups was significant (P < 0.001, paired t-test but intergroup difference was not (P=0.4, independent sample t-test. Early complications such as corneal epithelial defects and entropion, and late complications such as undercorrection were comparable in the two groups. No patient experienced recurrent ptosis requiring reoperation in either group. CONCLUSION:  The monotriangular method of upper lid fascia sling can be used instead of the more popular bitriangular method. Advantages include less need for fascial tissue, less periocular scar formation and a shorter period of anesthesia.

  6. 改进额肌筋膜瓣悬吊治疗中重度上睑下垂%Treatment of moderate and severe blepharoptosis with modified frontalis muscle-fascial flap suspension

    Institute of Scientific and Technical Information of China (English)

    赵天兰; 熊世文; 李光早; 张莉; 徐静



  7. 提上睑肌-额筋膜瓣吻合治疗重度上睑下垂%To treat the serious blepharoptosis with anastomosis of levator muscle of upper eyelid and forehead fascial flap

    Institute of Scientific and Technical Information of China (English)




  8. 提上睑肌短缩术矫治重度上睑下垂临床分析%Analysis of application of levator muscle resection on severe blepharoptosis patients

    Institute of Scientific and Technical Information of China (English)

    朴荣利; 赵自然; 张可佳


    目的 证明提上睑肌短缩术治疗重度上睑下垂的可行性及疗效,并与其他手术方法进行比较,为临床选择合理手术方法提供理论及临床依据。方法 将32例已施行上睑下垂手术的病人按照不同的手术方式分为:提上睑肌短缩术组24例、额肌瓣悬吊术组8例。通过上睑下垂矫正术后上睑缘位置、眼睑闭合程度、上睑迟滞现象及暴露性角膜炎的发生情况,对病人进行至少6个月的随访观察,比较各组的手术疗效。结果 提上睑肌短缩术组治愈率与额肌筋膜瓣悬吊术组差异无统计学意义(P>().05),其上睑迟滞及其他并发症发生率均低于额肌筋膜瓣悬吊术组(P<0.05)。结论 对于肌弹性15 mm以上的重度上睑下垂患者,提上睑肌短缩术效果优于额肌筋膜瓣悬吊术的手术方法,能达到既符合眼睑生理功能,又改善美观的效果。%Objective To prove the feasibility and curative effect of levator muscle resection, and to compare it with other operative methods, to offer both theoretical and clinical evidence to clinical works. Methods According to operation methods, the patients were divided into 2 groups, 24 (29eyes) had gone through levator muscle resection, while the other 8 (9 eyes) had frontal muscle ventrofixation. The patients were observed for 6 months at least, and compared the effect of operation according to palpebra superior location after operation, palpebral fissure hysteresis, palpebra superior dysraphism and exposure keratitis. Results In group that was done shortening operation, after 6 months, the incidence of insufficient rectification and hysteresis of upper eyelid was lower than that of ventrofixation. Meanwhile, success rate of operation after 6 months in former group was similar to that of latter one. Conclusions If elasticity of levator muscle is more than 15mm, levator muscle resection is suitable to severe congenital ptosis; shortening operation shows superiority over the operative method of frontal muscle fascial flap, by recovering physiological function of eyelid and improving the outlook.

  9. Frontalis muscle fascial flap passing through the pulley of orbital septum for correction of severe blepharoptosis%额肌筋膜瓣经眶隔膜滑车下转移矫治重度上睑下垂

    Institute of Scientific and Technical Information of China (English)

    叶信海; 杨青华; 陈熙; 周胜杰; 王开元


    目的 探讨额肌筋膜瓣经眶隔膜滑车下转移矫治重度上睑下垂的临床效果.方法 2004年以来我们收治了先天性重度上睑下垂52例,57只眼,常规经眼轮匝肌下分离松解制成额肌筋膜瓣,于眶上缘及眶上缘下约1 cm处分别横向切开眶隔,上下切口线平行,制成眶隔膜滑车带,额肌筋膜瓣经过前者后方缝合于睑板上缘,常规缝合创口.结果 经过3~6个月随访,52只眼外形满意,3只眼复发,2只眼眼睑弧度形态不自然,经第二次修整术后均感满意,无其他并发症发生.结论 本术式的肌肉运动方向更加接近上睑提肌的自然运动方向,术后眼睑外形动态与静态更加逼真,值得临床推广.

  10. 单切口改良额肌筋膜瓣悬吊术治疗重度上睑下垂%Clinical application and effect of simple cut and modified forehead muscle flap suspension operation in treating severe blepharoptosis

    Institute of Scientific and Technical Information of China (English)



    目的 探讨改进传统的额肌瓣悬吊术治疗重度上睑下垂的方法及效果.方法 采用单一重睑线切口制作倒梯形额肌筋膜瓣,并经眶囊隧道悬吊睑板.结果 本组病例共7例10只眼,(单侧4例、双侧3例),术后随访3~18个月,效果满意,无复发.结论 改良单一切口额肌筋膜瓣矫正重度上睑下垂疗效确切,创伤小,值得推广应用.

  11. Spontaneously reduced isolated orbital roof fracture. (United States)

    Itinteang, Tinte; Lambe, Gerald Francis; MacKinnon, Craig; Agir, Hakan


    We report a case of a spontaneously reduced isolated orbital roof blow-in fracture with resolution of associated diplopia and blepharoptosis highlighting the need for a low threshold for reimaging this cohort of facial fracture patients. PMID:22801127

  12. 应用眶隔筋膜瓣联合额肌瓣悬吊矫正重度上睑下垂的临床分析%Clinical analysis of correction of severe blepharoptosis with the orbital musculo-fascial flap and frontalis muscle flap suspension

    Institute of Scientific and Technical Information of China (English)

    孙玉峰; 张芳; 王俊河; 石英光


    目的 探讨眶隔筋膜瓣联合额肌瓣悬吊术在治疗重度上睑下垂中的临床疗效及优势.方法 将2010年9月至2014年9月收治的22例(42只眼)重度上睑下垂患者随机分为两组(每组11例),分别采用改良单切口额肌筋膜瓣悬吊术和眶隔筋膜瓣联合额肌瓣悬吊术治疗,并比较其临床疗效.结果 术后随访1周,1、3、6个月,22例患者(42只眼)4周内上睑均能完全闭合,重睑外形良好,未发生暴露性角膜炎.改良单切口额肌筋膜瓣组中,1例患者术后欠矫,1例出现上睑内翻,5例上睑迟滞;眶隔筋膜瓣联合额肌瓣悬吊组中,1例术后复发.两组患者中,改良单切口额肌筋膜瓣悬吊术矫正程度略高(P<0.05);术后6个月,观察两组疗效差异无统计学意义(P>0.05);术后1个月,眶隔筋膜瓣联合额肌瓣悬吊组较单切口额肌筋膜瓣悬吊组术后上睑回缩量明显减少;术后6个月,两组上睑回缩量差异有显著的统计学意义(P<0.01).结论 两种手术方法均是治疗重度上睑下垂的有效方法,手术安全性高,满意度高.但相对来说,眶隔筋膜瓣联合额肌瓣悬吊术具有并发症少,远期效果较稳定,手术创伤小的优点,值得临床推广应用.

  13. Predictive images of postoperative levator resection outcome using image processing software

    Directory of Open Access Journals (Sweden)

    Mawatari Y


    Full Text Available Yuki Mawatari,1 Mikiko Fukushima2 1Igo Ophthalmic Clinic, Kagoshima, 2Department of Ophthalmology, Faculty of Life Science, Kumamoto University, Chuo-ku, Kumamoto, Japan Purpose: This study aims to evaluate the efficacy of processed images to predict postoperative appearance following levator resection.Methods: Analysis involved 109 eyes from 65 patients with blepharoptosis who underwent advancement of levator aponeurosis and Müller’s muscle complex (levator resection. Predictive images were prepared from preoperative photographs using the image processing software (Adobe Photoshop®. Images of selected eyes were digitally enlarged in an appropriate manner and shown to patients prior to surgery.Results: Approximately 1 month postoperatively, we surveyed our patients using questionnaires. Fifty-six patients (89.2% were satisfied with their postoperative appearances, and 55 patients (84.8% positively responded to the usefulness of processed images to predict postoperative appearance.Conclusion: Showing processed images that predict postoperative appearance to patients prior to blepharoptosis surgery can be useful for those patients concerned with their postoperative appearance. This approach may serve as a useful tool to simulate blepharoptosis surgery. Keywords: levator resection, blepharoptosis, image processing, Adobe Photoshop® 

  14. Ptosis - infants and children (United States)

    Blepharoptosis-children; Congenital ptosis; Eyelid drooping-children; Eyelid drooping-amblyopia; Eyelid drooping-astigmatism ... Ptosis in infants and children is often due to a problem with the muscle that raises the eyelid. A nerve problem in the eyelid can ...

  15. Congenital Fibrosis of the Extraocular Muscles

    Directory of Open Access Journals (Sweden)

    Leyla Niyaz


    Full Text Available Congenital fibrosis of the extraocular muscles (CFEOM is a rare disorder characterized by hereditary non-progressive restrictive strabismus and blepharoptosis. Although most of the cases are bilateral and isolated, some patients may have systemic findings. CFEOM is divided into three groups as CFEOM 1, 2, and 3 according to the phenotype. Primary responsible genes are KIF21A for CFEOM type 1 and 3 and PHOX2A/ARIX gene for CFEOM type 2. Studies suggest that abnormal innervation of the extraocular muscles is the cause of muscle fibrosis. Early treatment is important because of the risk of amblyopia. Surgery is the primary treatment option for strabismus and blepharoptosis. (Turk J Ophthalmol 2014; 44: 312-5

  16. Trigeminal Proprioception Evoked by Strong Stretching of the Mechanoreceptors in Müller's Muscle Induces Reflex Contraction of the Orbital Orbicularis Oculi Slow-Twitch Muscle Fibers


    Matsuo, Kiyoshi; Ban, Ryokuya; Ban, Midori; Yuzuriha, Shunsuke


    Objective: The mixed orbicularis oculi muscle lacks an intramuscular proprioceptive system such as muscle spindles, to induce reflex contraction of its slow-twitch fibers. We evaluated whether the mechanoreceptors in Müller's muscle function as extrinsic mechanoreceptors to induce reflex contraction of the slow-twitch fibers of the orbicularis oculi in addition to those of the levator and frontalis muscles. Methods: We evaluated in patients with aponeurosis-disinserted blepharoptosis whether ...

  17. Kirurško zdravljenje ptoze z mersilensko mrežico: Surgical treatment of ptosis with mersilene mesh:


    Beltram, Matej; Drnovšek-Olup, Brigita


    Background. Frontalis suspension is the best surgical procedure for severe ptosis with poor or absent levator muscle function. The transmission of frontalis muscle activity to the upper lid is achieved by the insertion of thebiologically acceptable stretchable connection between the two. The authorsdescribe the results of thirteen years of use of the Mersilene mesh sling for the correction of severe blepharoptosis. Methods. From January 1990 to October 2003 brow suspension was performed on 55...

  18. Michels syndrome: The first case report from India and review of literature

    Directory of Open Access Journals (Sweden)

    Adedayo A Adio


    Full Text Available A 2-year 7-month-old girl born out of a consanguineous marriage, presented at our facility with clinical features characterized by the eyelid triad of blepharophimosis, blepharoptosis and epicanthus inversus in association with hypertelorism, cleft palate and craniosynostosis. This constellation of features is suggestive of Michels syndrome. At the time of writing this report, there were only ten reported cases worldwide and to the best of our knowledge, there have been no published reports from India.

  19. Surgical strategy for congenital blepharophimosis syndrome

    Institute of Scientific and Technical Information of China (English)

    HUANG Wei-qing; QIAO Qun; ZHAO Ru; WANG Xiao-jun; FANG Xue-quan


    Background So far, most of the surgical techniques for congenital blepharophimosis syndrome are two-stage procedures. In this study, we investigated a modified one-stage procedure to reduce the suffering of patients.Methods From 2003 to 2005, we adopted an one-stage technique combining blepharoptosis correction with medial canthoplasty in 16 patients with congenital blepharophimosis syndrome (10 male, 6 female; aged from 6 to 21). All the patients had bilateral severe blepharoptosis, epicanthus inversus, and flat dorsum nasi. The movement of the upper lid was 0 to 3 mm, vertical length of the eye fissure 2 to 4 mm, horizontal length 13 to 22 mm, and the distance between the eyes was 35 to 39 mm. The patients were followed up for one half to 2 years after the operation.Results In all the patients, after the operation, the horizontal length of the eyelid >25 mm, the vertical length > 6 mm.and the distance between the eyes < 35mm. The appearance of their double eyelids was satisfying.Conclusion The modified one-stage technique combining blepharoptosis correction with medial canthoplasty can achieve favorable outcomes for patients with congenital blepharophimosis syndrome.

  20. Electrical stimulation to the trigeminal proprioceptive fibres that innervate the mechanoreceptors in Müller's muscle induces involuntary reflex contraction of the frontalis muscles. (United States)

    Matsuo, Kiyoshi; Osada, Yoshiro; Ban, Ryokuya


    The levator and frontalis muscles lack interior muscle spindles, despite consisting of slow-twitch fibres that involuntarily sustain eyelid-opening and eyebrow-raising against gravity. To compensate for this anatomical defect, this study hypothetically proposes that initial voluntary contraction of the levator fast-twitch muscle fibres stretches the mechanoreceptors in Müller's muscle and evokes proprioception, which continuously induces reflex contraction of slow-twitch fibres of the levator and frontalis muscles. This study sought to determine whether unilateral transcutaneous electrical stimulation to the trigeminal proprioceptive fibres that innervate the mechanoreceptors in Müller's muscle could induce electromyographic responses in the frontalis muscles, with monitoring responses in the orbicularis oculi muscles. The study population included 27 normal subjects and 23 subjects with aponeurotic blepharoptosis, who displayed persistently raised eyebrows on primary gaze and light eyelid closure. The stimulation induced a short-latency response in the ipsilateral frontalis muscle of all subjects and long-latency responses in the bilateral frontalis muscles of normal subjects. However, it did not induce long-latency responses in the bilateral frontalis muscles of subjects with aponeurotic blepharoptosis. The orbicularis oculi muscles showed R1 and/or R2 responses. The stimulation might reach not only the proprioceptive fibres, but also other sensory fibres related to the blink or corneal reflex. The experimental system can provoke a monosynaptic short-latency response in the ipsilateral frontalis muscle, probably through the mesencephalic trigeminal proprioceptive neuron and the frontalis motor neuron, and polysynaptic long-latency responses in the bilateral frontalis muscles through an unknown pathway. The latter neural circuit appeared to be engaged by the circumstances of aponeurotic blepharoptosis.

  1. Horner's Syndrome Incidental to Medullary Thyroid Carcinoma Excision: Case Report and Brief Literature Review. (United States)

    Mastronikolis, Nicholas S; Spiliopoulou, Sofia P; Zolota, Vassiliki; Papadas, Theodoros A


    Horner's syndrome is characterized by a combination of ipsilateral miosis, blepharoptosis, enophthalmos, facial anhidrosis, and iris heterochromia in existence of congenital lesions. The syndrome results from a disruption of the ipsilateral sympathetic innervation of the eye and ocular adnexa at different levels. Though rare, thyroid and neck surgery could be considered as possible causes of this clinical entity. We present a case of Horner's syndrome in a patient after total thyroidectomy and neck dissection for medullary thyroid cancer with neck nodal disease and attempt a brief review of the relevant literature. PMID:27200201

  2. Regeneração aberrante do nervo oculomotor secundária a aneurisma intracraniano: relato de caso Aberrant regeneration of the oculomotor nerve followed by intracranial aneurysm: case report

    Directory of Open Access Journals (Sweden)

    Renato Wendell Ferreira Damasceno


    Full Text Available Relatar um caso de regeneração aberrante secundária à paralisia aguda do nervo oculomotor causada por aneurisma intracraniano. Paciente atendida em fevereiro de 2006 queixando-se de dor de cabeça acompanhada de visão dupla e queda da pálpebra no olho direito. Na avaliação da motilidade ocular extrínseca, verificou-se incapacidade da adução, da supradução e da infradução associada à blefaroptose no olho direito. Com relação à motilidade intrínseca, midríase paralítica no olho direito. Formulou-se diagnóstico de paralisia aguda de nervo oculomotor no olho direito e solicitou-se avaliação neurológica. No Departamento de Neurocirurgia, após ser diagnosticada presença de aneurisma de artéria comunicante posterior, a paciente foi submetida a tratamento cirúrgico. Em dezembro de 2006, observou-se melhora relativa da adução, mantendo a incapacidade da supradução e da infradução com blefaroptose melhorada à adução do olho direito. Com relação à motilidade intrínseca, miose no olho afetado. O diagnóstico de regeneração aberrante do nervo oculomotor pós-paralisia aguda foi formulado baseando-se na anamnese e nos exames oftalmológicos seqüenciais.To report a case of aberrant regeneration followed by acute palsy of the oculomotor nerve caused by intracranial aneurysm. A 59-year-old patient was attended in February 2006 complaining of headache with diplopia and blepharoptosis in the right eye. At the external ocular motility exam. Aduction, supraduction and infraduction defects with blepharoptosis in the right eye were observed. Regarding the internal ocular motility, mydriasis in the right eye. Acute palsy of the oculomotor nerve in the right eye was diagnosed and neurological examination was requested. At the Department of Neurosurgery, after having diagnosed aneurysm of the posterior communicating artery, the patient was submitted to an operation. In December 2006, it improvement of the aduction was

  3. Horner's syndrome and contralateral abducens nerve palsy associated with zoster meningitis. (United States)

    Cho, Bum-Joo; Kim, Ji-Soo; Hwang, Jeong-Min


    A 55-year-old woman presented with diplopia following painful skin eruptions on the right upper extremity. On presentation, she was found to have 35 prism diopters of esotropia and an abduction limitation in the left eye. Two weeks later, she developed blepharoptosis and anisocoria with a smaller pupil in the right eye, which increased in the darkness. Cerebrospinal fluid analysis showed pleocytosis and a positive result for immunoglobulin G antibody to varicella zoster virus. She was diagnosed to have zoster meningitis with Horner's syndrome and contralateral abducens nerve palsy. After intravenous antiviral and steroid treatments, the vesicular eruptions and abducens nerve palsy improved. Horner's syndrome and diplopia resolved after six months. Here we present the first report of Horner's syndrome and contralateral abducens nerve palsy associated with zoster meningitis.

  4. Lenz microphthalmia syndrome: three additional cases with rare associated anomalies. (United States)

    Temtamy, S A; Ismail, S I; Meguid, N A


    Lenz microphthalmia syndrome is an extremely rare inherited disorder, characterized by unilateral or bilateral microphthalmia. In rare cases affected patients exhibit complete absence of eye or blepharoptosis resulting in visual impairment. Additional physical abnormalities are often associated with this disorder, orofacial, digital, skeletal and urogenital abnormalities. Here we present three cases of Lenz microphthalmia with additional manifestations: two brothers of first cousin mating, the elder one has bilateral congenital cataract which is a rare ophthalmological finding in this syndrome and a third case who presented to us because of ambiguous genitalia. She was 12 years old, and reared as a female. Chromosomal analysis showed 46,XY karyotype, and hormonal studies indicated 5-alpha reductase deficiency. This is the first report of the association of 5-alpha reductase deficiency with Lenz microphthalmia syndrome.

  5. Familial blepharophimosis syndrome: study of two colombian families and two sporadic cases Síndrome de la blefarotimosis familiar: estudio de dos familias colombianas y dos casos esporádicos

    Directory of Open Access Journals (Sweden)

    José Luis Ramírez Castro


    Full Text Available

    The blepharophimosis syndrome includes several associated anomalies, namely: blepharophimosis, blepharoptosis, epicanthus inversus and telecanthus. It is inherited as an autosomal dominant defect with essentially 100% penetrance. To the nearly 180 previously reported cases our report adds another 25 occurring in two colombian families through 3 and 4 generations (23 cases and in 2 sporadic cases. Some related clinical, embryological and genetic aspects of this syndrome are discussed.

    El síndrome denominado blefarofimosis familiar comprende varias anomalías asociadas entre las cuales se destacan: blefarofimosis, blefaroptosis, epicanto Inverso y telecanto. Se hereda en forma autosómica dominante con una penetrancia completa. Se han Informado en la literatura aproximadamente 180 casos, a los cuales se adicionan 23 detectados en las 2 familias colombianas que estamos reponando a través de 3 y 4 generaciones (familias A y B respectivamente y dos esporádicos. Se discuten aspectos clínicos, embriológicos y gen éticos relacionados con el síndrome.

  6. Further evidence for the role of the caudate nucleus in programming motor and nonmotor behavior in Java monkeys. (United States)

    Vrijmoed-de Vries, M C; Cools, A R


    This study describes the short-term effects of intracaudate microinjections of carbachol in temporarily isolated and restrained Java monkeys. The monkeys were found to display a series of motor disturbances including blepharoptosis, facial twitches, tongue protrusions, ear flattening, torticollis, and compulsive alternations of rapid flexions and extensions of the extremities. In general, carbachol was found to produce consistent effects as far as it concerns its ability to elicit motor disturbances. Three of the five tested monkeys had previously received another series of carbachol injections when they were freely moving and living in a stabilized social group. Accordingly, the present study enabled us to compare the effectiveness of threshold doses of carbachol in the same monkey in two distinct situations. We concluded first, that motor disturbances and disturbances in social communication were closely coupled in relation to the involvement of a particular cholinoceptive substrate within the caudate nucleus of Java monkeys. Second, the motor disturbances under study appeared to require a larger degree of dysfunctioning of this substrate than did subtle disturbances in the social communication of these monkeys. And, finally, stress inherent to restraint increased the susceptibility of the cholinoceptive substrate within the caudate nucleus. The clinical impact of our findings is discussed in view of differences between the premorbid and manifest phases of Parkinson's disease.

  7. Antidepressant effect of bioactive compounds from Paecilomyces tenuipes in mice and rats

    Institute of Scientific and Technical Information of China (English)

    Hongwei Kan; Liang Ming; Chunru Li; Hongxing Kan; Bei Sun; Yan Liang


    A bioactive compound from Paecilomyces tenuipes(BCPT)has an inhibitory effect on monoamine oxidase A(MAO-A)in vitro.Researchers have thought that BCPT may be a potential antidepressant.The MAO-A suppressor moclobemide served as a control,and this study investigated the mechanisms of BCPT as an antidepressant.Results demonstrated that BCPT induced significantly increased sucrose intake in chronic unpredictable stressed rats,shortened immobility time in forced swimming mice,improved the scores of blepharoptosis and akinesia in reserpine-treated mice,increased the number of 5-hydroxy tryptophan-induced head-twitches,remarkably enhanced the expression of hippocampus mineralcorticoid receptor and glucocorticoid receptor mRNA,decreased the ratio of mineralcorticoid receptor to glucocorticoid receptor and raised the levels of dopamine,norepinephrine and 5-hydroxytryptamine,while decreasing hydroxyindole acetic acid levels or dihydroxy-phenyl acetic acid in chronic unpredictable stressed rats.Behavioral test results suggested that BCPT potentially had antidepressant-like activity.Meanwhile,BCPT increased the levels of neurotransmitters,and mineralcorticoid receptor and glucocorticoid receptor mRNA in the hippocampus,which may be an important mechanism of its antidepressant effect.

  8. Secondary Bilateral Orbital Involvement from Primary Non-Hodgkin Lymphoma of the Cheek. (United States)

    Furudoi, Shungo; Yoshii, Takashi; Komori, Takahide


    We describe a patient with oculomotor nerve palsy due to secondary orbital infiltration from the primary malignant lymphoma of the cheek. The patient was a 78-year-old female who had non-Hodgkin lymphoma (diffuse large B cell lymphoma [DLBCL]) of the cheek. The patient received chemotherapy and local radiation therapy. The combined treatment brought about complete remission. About 6 months after the last treatment the patient began to have left blepharoptosis and impaired vision. Findings from ophthalmological and neurosurgical examinations suggested no intraorbital or intracranial lesions. Repeated MRI and CT scans also showed no such lesions. One month later, the patient suddenly had a left oculomotor disturbance, diplopia and exophthalmus, followed by right oculomotor nerve palsy. An MRI revealed bilateral intraorbital tumors. Recurrence at the orbital tissue of malignant lymphoma originated from the left cheek appeared to cause the ophthalmological symptoms. Salvage chemotherapy was performed and her ocular symptoms were recovered. However, the patient died approximately 10 months after recurrent orbital tumor onset. PMID:27604535

  9. 开郁胶囊对抑郁动物模型的影响%Effects of Kaiyu Capsule on Depression-like Animal Models

    Institute of Scientific and Technical Information of China (English)

    李雅莉; 赵玲; 魏海峰; 李林


    head-twitching number induced by 5-HTP( P < 0. 01 ), and shortened the latency period ( P < 0. 05 ). After sc reserpine, the mice appeared physical signs such as blepharoptosis, akinesia and hypothermia. The middle and high doses of Kaiyu capsule significantly ameliorated the blepharoptosis and akinesia( P < 0. 01 ), and decreased the range of hypothermia in reserpine-induced model mice( P <0. 01 ). Conclusion: Kaiyu capsule has the significant antidepressant effect, and the mechanisms may be related to the enhancement of serotonergie and noradrenergic functions.

  10. Stereoscopic Three-Dimensional Images of an Anatomical Dissection of the Eyeball and Orbit for Educational Purposes

    Directory of Open Access Journals (Sweden)



    Full Text Available The purpose of this study was to develop a series of stereoscopic anatomical images of the eye and orbit for use in the curricula of medical schools and residency programs in ophthalmology and other specialties. Layer-by-layer dissection of the eyelid, eyeball, and orbit of a cadaver was performed by an ophthalmologist. A stereoscopic camera system was used to capture a series of anatomical views that were scanned in a panoramic three-dimensional manner around the center of the lid fissure. The images could be rotated 360 degrees in the frontal plane and the angle of views could be tilted up to 90 degrees along the anteroposterior axis perpendicular to the frontal plane around the 360 degrees. The skin, orbicularis oculi muscle, and upper and lower tarsus were sequentially observed. The upper and lower eyelids were removed to expose the bulbar conjunctiva and to insert three 25-gauge trocars for vitrectomy at the location of the pars plana. The cornea was cut at the limbus, and the lens with mature cataract was dislocated. The sclera was cut to observe the trocars from inside the eyeball. The sclera was further cut to visualize the superior oblique muscle with the trochlea and the inferior oblique muscle. The eyeball was dissected completely to observe the optic nerve and the ophthalmic artery. The thin bones of the medial and inferior orbital wall were cracked with a forceps to expose the ethmoid and maxillary sinus, respectively. In conclusion, the serial dissection images visualized aspects of the local anatomy specific to various procedures, including the levator muscle and tarsus for blepharoptosis surgery, 25-gauge trocars as viewed from inside the eye globe for vitrectomy, the oblique muscles for strabismus surgery, and the thin medial and inferior orbital bony walls for orbital bone fractures.

  11. Refined distribution of myelinated trigeminal proprioceptive nerve fibres in Mueller's muscle as the mechanoreceptors to induce involuntary reflexive contraction of the levator and frontalis muscles. (United States)

    Yuzuriha, Shunsuke; Matsuo, Kiyoshi; Hirasawa, Chihiro; Moriizumi, Tetsuji


    Stretching of mechanoreceptors in Mueller's muscle induces reflexive contraction of not only the levator muscle but also the frontalis muscle as two different eyelid-opening muscles. Previously, we reported that fine neural myelinated structures, acting as mechanoreceptors, were found in the proximal Mueller's muscle. Since there is a risk of misunderstanding that the middle and distal Mueller's muscle does not contain mechanoreceptors and can be invalidated or resected, the accurate distribution of myelinated trigeminal proprioceptive nerve fibres as mechanoreceptors in Mueller's muscle was refined horizontally in this study. We explored 10 whole Mueller's muscles between the levator muscle and the tarsus of the upper eyelids obtained from five Japanese cadavers. The specimens were serially sliced along the horizontal plane and stained with HE, S-100 protein to determine the presence of Schwann cells, and smooth muscle actin antibody to determine the presence of Mueller's smooth muscle fibres. Although all myelinated nerve fibres in the intermuscular connective tissues among the sympathetically innervated Mueller's multi-unit smooth muscle fibres may not correspond to the proprioceptive nerve fibres, the nerve bundles consisting of multiple myelinated nerve fibres were well distributed in the proximal Mueller's muscle, and single myelinated nerve fibres were well distributed in the middle and distal Mueller's muscle. We believe that the mechanoreceptors in Mueller's muscle consist of myelinated proprioceptive nerve fibres with nerve endings possibly attached to collagen fibres in the intermuscular connective tissues present among Mueller's smooth muscle fibres. As the myelinated nerve fibres innervate the middle and distal Mueller's muscle to a greater extent than those in the proximal Mueller's muscle, the former may be more important as mechanoreceptors than the latter and should not be invalidated or excised during surgery for treatment of blepharoptosis to

  12. Uso da fáscia temporal na suspensão frontal: descrição da técnica cirúrgica - Relato de caso Use of temporal fascia in frontalis suspension: description of the surgical technique - Case report

    Directory of Open Access Journals (Sweden)

    Tânia Pereira Nunes


    Full Text Available OBJETIVOS: Familiarizar o oftalmologista com a anatomia da região temporal, descrever a técnica cirúrgica da retirada da fáscia temporal e da suspensão frontal e analisar as vantagens e desvantagens da fáscia temporal na suspensão frontal. MÉTODOS: Revisão do prontuário de uma paciente com blefaroptose grave que foi submetida à suspensão frontal com fáscia temporal. Revisão da anatomia da fossa temporal e das técnicas cirúrgicas. RESULTADOS: Bom resultado estético e funcional foi conseguido no caso descrito. CONCLUSÃO: A fáscia temporal é boa opção na suspensão frontal com algumas vantagens: é um tecido autógeno, de fácil obtenção e mínima morbidade no pós-operatório.PURPOSE: To familiarize the ophthalmologist with the anatomy of the temporal region, to describe the surgical technique of temporal fascia harvest and frontalis suspension and to demonstrate advantages and disadvantages of temporal fascia in frontalis suspension. METHODS: Review of the clinical and surgical data of one case with severe blepharoptosis who underwent frontalis suspension using temporal fascia. Review of the anatomy of the temporal fossa and the surgical techniques. RESULTS: Good esthetic and functional results were obtained in this case. CONCLUSION: Temporal fascia is a good choice for frontalis suspension with some advantages: it is autogenous, it is easily harvested and it yields minimal post-operative morbidity.

  13. 保留"眼台"的睑袋修复术%Repair of baggy deformity with lower eyelid step reservation

    Institute of Scientific and Technical Information of China (English)

    乔锋丽; 陈兵; 张维娜; 白南; 柳大烈; 王飏; 安阳; 袁继龙


    目的 探讨保留"眼台"的睑袋修复方法 及效果.方法 通过睑缘切口,采用皮瓣与肌皮瓣联合的方法 适当保留睑板前眼轮匝肌,并对眶隔前眼轮匝肌和眼轮匝肌眶部、眶隔及眶隔脂肪行适当处理,去除适量的皮肤,在保留"眼台"的同时修复睑袋.结果 本组58例受术者,术后随访6~24个月,下睑形态良好,外观自然,富有立体感,效果满意.结论 保留"眼台"的睑袋修复方法,在解决下睑袋状突出问题的同时,能使下睑外观更自然,更符合美学要求,使眼部更年轻.%Objective To explore the operation method and effect of repairing baggy deformity with lower eyelid step reservation. Methods The method of skin flap and musculo cutaneous flap with pretarsal orbicularis oculi reservation was adopted through palpebral margin incision, then the preseptal orbicularis oculi and orbital part , orbital septum and orbital septum fat of orbitalis muscle were treated suitably to remove appropriate amount of skin. The lower eyelid step was reserved and repair of blepharoptosis was performed simultaneously.Results Fifty-eight patients were followed up for 6 ~ 24 months, and all were satisfied with good shaped eyelid , natural and spatial construe, which more met aesthetic requirements and looked younger. Conclusion The method of repairing baggy deformity with lower eyelid step reservation could not only solve problem of eye bags , which produces a more desirable appearance, but also meet aesthetic requirements and rejuvenative appearance.

  14. Corrección de ptosis palpebral por la incisión de blefaroplastia Upper eyelid ptosis treatment using blepharoplasty incision

    Directory of Open Access Journals (Sweden)

    A. Novo Torres


    y por tanto la recuperación es mas rápida; posibilita también la cirugía de rescate en caso de correcciones insuficientes y evita el problema de sobrecorrección con exceso de resección de tejido conjuntival. En resumen se trata de una modificación quirúrgica que facilita la técnica, disminuye las complicaciones postoperatorias, mejora la recuperación y evita la sensación de cuerpo extraño intraocular de una resección conjuntivalBlepharoptosis is the abnormally low of the top eyelid during the direct look. Best results are obtained by resection or advance of the elevator muscle or aponeurosis, whenever the elevator has a suitable function. We present a modification to the Blaskovics´s technique for correction of moderate blepharoptosis, with good function of the elevator muscle. We present a serie of 10 cases where we used a variant of Blaskovics’s technique of resection of the elevator for surgical correction of ptosis. Seven were bilateral cases and 3 unilateral ones. In all the cases the elevator function was between 4 and 8 mm and ptosis was major than 4mm with visual field decrease in the direct look. Surgical technique included a cutaneous horizontal incision of Blepharoplasty, wide exhibition of elevator muscle and aponeurosis, respecting orbicular fatty bags and separating it from the palpebral conjunctive. In all the cases correction of the ptosis were obtained. The grade of asymmetry was lower than 0,3 cm. One case presented in the inmediate postoperatory opening of the suture in his medial side and had to be re-taken after 10 days. The palpebral postoperative edema was solved between 2 – 8th day allowing evaluation in that moment. Patient’s satisfaction was good or very good and the visual field was complete in all patients Classic surgical techniques and its modifications for correction of ptosis keep on being valid. With this modification that respects conjuctive we avoid to add morbidity to the surgical process. We think that

  15. Clinical analysis on 8 cases with Turner syndrome%8例Tumer综合征临床分析

    Institute of Scientific and Technical Information of China (English)

    刘德云; 杨俐琦; 蒋惠珍; 张志红; 周美玲; 李桢


    目的:提高临床医生对Turner综合征的认识.方法:分析Turner综合征临床和辅助检查特点.结果:所有患者都有矮小,乳房发育不良或不发育,同时伴有黑痣增多5例,发际低5例,眼裂不等大l例,眼睑下垂4例,鼻梁低平2例,颈蹼4例,乳头问距明显增宽5例,明显肘外翻4例.性腺BUS:2例子宫、卵巢发育不良,3例子宫卵巢显示不清,3例子宫、卵巢未显示.染色体核型分析:45,XO 4例;45XO/46 XX 2例;46,X,i(Xq)1例;46,X,del(Xq)1例.骨龄:8例均提示骨龄落后,平均1~3年.其中2例有第4掌骨短小.生长激素激发试验:1例激发试验生长激素水平正常,5例生长激素部分缺乏,2例生长激素完全缺乏.结论:Turner综合征具有典型的临床特点,临床发病率高,提高对本病认识,及时进行染色体核型分析可以确诊.早期诊断、及时治疗对增加患者终身高,提高Turner综合征患者的生活质量有重要意义.%Objective: To improve the cognition of clinical doctors to Turner syndrome. Methods: The clinical and examination characteristics of Turner syndrome were analysed. Results: All the cases were short, mammary dysplasia or agenesis, and 5 eases of more moles, 5 cases of low hairline, 1 case of different oculi rimae, 4 cases of blepharoptosis, 2 cases of low and fiat bridge of the nose, 4 ca-ses of webbed neck, 5 eases of wide distance of two nipples, 4 cases of valgus cubitus were found. Sex glands BUS found 2 cases of hypo-genesis of uterus and ovary, 3 cases of indiseemible uterus and ovary, 3 cases of invisible uterus and ovary. Karyotype analysis found 4 ca-see of 45, XO; 2 cases of 45XO/46 XX; 1 case of 46, X, i (Xq) and 1 ease of 46, X, del (Xq). Skeletal age detection indicated that all the 8 cases had laggard skeletal age, the mean time was 1 ~ 3 years, and 2 cases were found with a shorter fourth metacarpal.Growth hormone provocative test showed that 1 case was nrmal, 5 eases were deficiency partially, 2 eases were

  16. Cerebral circulation characteristics of patients with persistent trigeminal artery combined with cerebrovascular diseases and their clinical relevance%永存三叉动脉合并脑血管病的脑循环及临床研究

    Institute of Scientific and Technical Information of China (English)

    王佳楠; 张雄伟; 王磊; 尹世敏; 杜彬; 李险峰


    Objective To explore the cerebral circulation characteristics of patients with persistent trigeminal artery (PTA) combined with cerebrovascular diseases and their clinical relevance.Methods Eight patients with PTA,admitted our hospital from March 2010 to March 2013 and conformed by DSA,MR radiography (MRA) or CT angiography (CTA),were chosen in our study; their cerebral circulation features and clinical manifestations were retrospectively analyzed.Results In these eight patients,two were combined with cerebral infarction,one with cerebral artery stenosis,two with cerebral infarction and cerebral artery stenosis,one with transient ischemic attack,and the left two with cerebral aneurysm.Four patients complained for paroxysmal dizziness (one of them with one-side weakness),two patients complained for numbness of a limb,One patient had headache and blepharoptosis and one patient had diplopia.Saltzman type Ⅰ was noted in six patients,type H in one and special type in one.The pathogenesis of cerebral infarction was related to PTA.Conclusion The clinical features of the patients with PTA often determine by merger cerebrovascular diseases; PTA can change the normal cerebral circulation; PTA detection can be helpful in the diagnosis of the pathogenesis of multiple cerebral infarction.%目的 探讨永存三叉动脉(PTA)合并脑血管病的脑循环及临床特征. 方法 选择自2010年3月至2013年3月第二炮兵总医院神经内科和神经介入科收治的经数字减影血管造影(DSA)、磁共振血管造影(MRA)或CT血管成像(CTA)证实存在PTA的脑血管病患者8例为研究对象,回顾性分析其脑循环特征及临床表现. 结果 8例PTA合并脑血管病患者中,2例合并脑梗死,1例合并脑动脉狭窄,2例合并脑梗死和脑动脉狭窄,1例合并短暂性脑缺血发作,2例合并动脉瘤;发作性头晕4例(其中1例伴一侧肢体力弱),一侧肢体麻木2例,头痛、眼睑下垂1例,复视1例;PTA分型Saltzman Ⅰ型6

  17. CC2D2A基因变异所致Joubert综合征一家系的临床及分子遗传学分析%Clinical and genetic analysis for a Joubert syndrome family with CC2D2A gene mutations

    Institute of Scientific and Technical Information of China (English)

    苏艳华; 谢建生; 尉姗姗; 罗红玉; 吴维青; 徐志勇


    Objective To confirm the genetic diagnosis for providing services for genetic counseling and prenatal diagnosis,we analyzed the clinical and genetic data of a pedigree which is clinically diagnosed as Joubert syndrome.Method A Joubert syndrome pedigree was enrolled as subject of this study from our hospital's outpatients in 2013.Following the medical history collection of the proband and the suffering fetus,target sequence capture and the next-generation sequencing technology were used for the proband and the suffering fetus to find the causative genes and sanger sequencing for the members of the pedigree to check and verify if the inherited mutations are in accordance with the Mendelian inheritance.Combining the clinical symptoms and signs with the total testing results,we analyzed the Joubert syndrome pedigree clinically and genetically.Result The proband showed abnormal respiratory patterns (neonatal tachypnea)and hypertonia without abnormal eye movements,and reflected the molar tooth sign on the magnetic resonance imaging.And afterwards the patient developed hypotonia,ataxia,growth and intellectual disability accompanied by congenital blepharoptosis.There were no any symptoms and signs of liver,kidney and eyesight abnormalities so far.The affected fetus showed hydrocephalus by the auxiliary examination during the second trimesters of pregnancy without any appearance deformities.Both the proband and the affected fetus carried a missense mutation of CC2D2A gene c.2999A > T (p.Glu1000Val) from their father and carried the deletion of exon 20-21 on the same gene.Both variations were confirmed to be the Mendelian genetic compound heterozygous pattern.Whereas,the missense mutations c.2999A > T(p.Glul000Val) on the CC2D2A gene have been proved to be inherited from the proband's father and the proband as well as the affected fetus.However,the proband's mother was normal at this locus of CC2D2A gene.The missense mutations c.2999A > T (p.Glu1000Val) have been

  18. 结膜上穹窿联合筋膜鞘悬吊术治疗先天性重度上睑下垂%Conjunctival fornix combined fascial sheath suspension surgery for severe congenital ptosis

    Institute of Scientific and Technical Information of China (English)



    Objective to describe a new surgical method for the treatment of severe congenital severe eyelid prolapse, and to obtain a good cosmetic result.Methods the tarsal plate suture suspension in the conjunctiva fornix of superior rectus muscle and upper eyelid muscle joint provided between the fascial sheath, can effectively improve the height of the upper eyelid, and through adjusting the suture in the joint fascial sheath of different position, will be adjusted to the height of the upper eyelid proper position, adjust the right upper eyelid curvature at the same time.Results from December 2014 to December 2008, 324 patients were treated with this technique. 106 patients were treated with 170 cases, 64 eyes were followed up for 20 years to 6 years. 42 patients were followed up for 1 years to 5 years. 146 patients were satisfied with 85.8% eyes, 11.8% were invalid, 2.4% were invalid. To 4 ineffective eyes and 20 only to improve the eye to do a two adjustment, the adjustment time is the shortest for 3 weeks, the longest for 6 months after the operation, the adjustment in addition to 2 eyes appeared mild recession, 3 eyes were improved, and the rest are to meet the standard.Conclution fornix combined fascial sheath suspension technique for treatment of severe congenital blepharoptosis by the conclusionis a kind of dynamic ptosis suspension technology, can effectively improve the height of the upper eyelid, and can obtain very good cosmetic effect, but also has little injury, quick recovery, eyes closed low incidence, low recurrence rate, repeated operation and other characteristics, this method is worth applying widely.%目的:描述一种新的既能更有效地纠正先天性重度眼睑下垂,又能获得良好美容效果的手术方法。方法将睑板缝合悬吊到位于结膜上穹窿的上直肌与提上睑肌之间的联合筋膜鞘上,可以有效地提高上眼睑的高度,并可通过调整缝合在联合筋膜鞘上位置的不同,将上睑调整

  19. 儿童急性全植物神经功能不全临床特征及诊断%Clinical characteristics and diagnosis of acute pandysautonomia in childhood

    Institute of Scientific and Technical Information of China (English)

    丁昌红; 王晓慧; 邹丽萍; 吕俊兰; 吴沪生; 伍妘; 王红梅


    ,electroencephalography(EEG),spinal cord MRI and somatosensory evoked potential(SEP)were also performed in some patients.Results Of the 6 patients,1 was male,and 5 were female.The age of onset was from 2.3 to 14.5 years(average 8.2 years).The initial symptoms were gastrointestinal dysfunction in 3 patients and somatic motor dysfunction as their initial had irritability in 1 case,pain in 1 and dysphagia in 1, respectively. Autonomic nerve signs and symptoms:① Skin and mucosa are rough and dry, there was no or little perspiration, alacrimia or little tear in all patients.② Vision problem appeared in 1 patient,blepharoptosis in 3 patients,pupillary abnormality existed in all patients. ③ Gastrointestinal symptoms were present in all patients. Vomiting and constipation were present in 4 patients,diarrhea and constipation were alternatively present in 1 patient,abdominal distention and abdominal pain wer present in 2patients.④ Cardiovascular system manifestations included postural dizziness or syncope in 3 patients, tightness and palpitation in 2 patients.⑤ Urinary dysfunction was present in 4 patients.In addition,mild to moderate somatic motor dysfunction was present in 5 patients,sensory dysfunction in 3 patients.Autonomic nerve function tests were abnormal in all patients.Laboratory findings included serum IgM antibody to herpes simplex virus and antistreptolysin "O" (ASO)test were positive respectively in 1 patient.The immunological markers in CSF were abnormal in 3 patients and the protein level in CSF was slightly elevated in 3 patients.Cranial MRI was slightly abnormal in 4 patients.ECG was slightly abnormal in all patients.EMG was abnormal in 5 patients.SEP was abnormal in 3 patients.Five patients received IVIG therapy.Five patients were followed-up.One patient died,one lost to follow up and one had slight improvement.Significant improvement was seen in 2 patients.Conclusion Acute pandysautonomia in children usually had non-specific symptoms and could affect multiple organs