phenylephrine-hydrochloride and Eyelid-Diseases

Nasal surgeries (such as Functional Endoscopic Sinus Surgery, Rhinoplasty, and Septorhinoplasty) are popular procedures. But perioperative bleeding, eyelid edema, and periorbital ecchymosis remain problems. Tranexamic acid (TXA) is an antifibrinolytic, and it was used to reduce the perioperative bleeding. However, there is no enough evidence judging its safety and efficiency. Therefore, a meta-analysis is conducted by us to evaluate the role of TXA in patients undergoing nasal surgeries.. A search of the literature was performed until June 2018; the PubMed, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar databases were searched for related articles using search strategy. Two authors independently assessed the methodological quality of the included studies and extracted data. Surgical information and postoperative outcomes were analyzed. Only randomized controlled trial (RCT) articles were included, and subgroup analysis was established to deal with heterogeneity. RevMan 5.3 software was selected to conduct the meta-analysis.. Eleven RCTs were included in our meta-analysis. There were significant differences in blood loss (P < .001), surgical field quality (P < .001), edema rating of upper (P < .001) and lower (P < .001) eyelid, ecchymosis rating of upper (P < .001) and lower eyelid (P < .001) when comparing the TXA group to the placebo group. However, the difference in operation time (P = .57) was not significant between the two groups.. Perioperative TXA could reduce the blood loss and improve the quality of surgery field during nasal surgery, and it was helpful for reducing the edema and ecchymosis after nasal surgeries, but it has little influence in reducing the operation time.

Topics: Antifibrinolytic Agents; Blood Loss, Surgical; Ecchymosis; Edema; Eyelid Diseases; Humans; Nasal Surgical Procedures; Nose; Operative Time; Randomized Controlled Trials as Topic; Tranexamic Acid

Facial trauma commonly includes injury to the nose and perinasal area. In this review, we will focus on the sequelae of severe nasal trauma and provide examples of correction of the severely deviated nose, the severely collapsed nose, and revision of a traumatic deformity after prior rhinoplasty. We will then discuss coexistent deformities of perinasal regions in addition to functional and posttraumatic nasal correction, including posttraumatic periorbital deformities.

Topics: Adult; Athletic Injuries; Cartilage; Cicatrix; Ethmoid Bone; Eyelid Diseases; Eyelids; Female; Follow-Up Studies; Fractures, Cartilage; Humans; Iatrogenic Disease; Male; Nasal Bone; Nasal Cartilages; Nasal Obstruction; Nasal Septum; Nose; Nose Deformities, Acquired; Orbit; Orbital Fractures; Osteotomy; Reoperation; Rhinoplasty; Skull Fractures; Young Adult

The Gorlin-Goltz syndrome is characterized by four primary symptoms: multiple nevoid basal cell epitheliomas that usually undergo malignant transformation; jaw keratocysts that show constant growth; skeletal anomalies; and intracranial calcifications. A myriad of additional findings may also be noted. Among the most frequent are: palmar and plantar pits, a characteristic flattened facies and broad nasal root, frontal and parietal bossing, mandibular prognathia, hypertelorism, strabismus, dystrophia of the canthi, and clefts of the lip, alveolus, and/or palate. In this study, we review the literature and our 25 cases of Gorlin-Goltz syndrome patients, questioning their incidence of cleft formations (8.5%) as compared to the general population (0.1%). It is our contention that all patients who present with an orofacial cleft warrant deeper investigation as to the presence of additional signs indicative of Gorlin-Goltz syndrome. The nevi turn malignant with time, and thus, early diagnosis, follow-up, and treatment are imperative.

Topics: Adult; Alveolar Process; Basal Cell Nevus Syndrome; Brain Diseases; Calcinosis; Cell Transformation, Neoplastic; Cleft Lip; Cleft Palate; Diagnosis, Differential; Eyelid Diseases; Face; Facies; Female; Follow-Up Studies; Foot Deformities; Frontal Bone; Hand Deformities; Humans; Hypertelorism; Incidence; Jaw Cysts; Male; Mouth Abnormalities; Nose; Parietal Bone; Prognathism; Strabismus

Many types of graft tissue have been used to reconstruct the posterior lamella of the eyelids in cases of full-thickness defect, lid retraction, and loss of lower lid stability. In this study, lower lateral cartilage of the nose was used for the reconstruction of posterior lamella of the eyelids, which mimics the tarsal plate in shape, thickness, and size.. This study included 10 patients who underwent lid reconstruction to support tarsal plate strength and repair full-thickness defects of the eyelids due to tumor excision and trauma. While anterior lamella was reconstructed with local or regional flaps, posterior lamella was repaired by using either chondromucosal or chondral graft of the lower lateral cartilage of the nose. Graft harvesting was performed on the inner surface of the alar rim by turning it inside out.. Cartilage grafts were sufficient to reconstruct the tarsal plate in all of the patients having eyelid defects of various sizes. In 3 patients, horizontal half of the eyelid was defective, in 3 patients 3/4, and in 2 patients 4/5 of the lids were missing. The inferior eyelid was totally reconstructed in 1 patient. Surgical outcomes provided good lid symmetry and esthetics, patient satisfaction, and proper lid function without any nasal deformity, incision scar, or discomfort.. Ala graft provides a thin, pliable, and curved cartilage for the eyelid reconstruction. It has a high similarity with the anatomy of the tarsal plate, making it adaptable to the convex surface of the eyeball, and making 3 dimensional repair possible.

Topics: Cartilage; Esthetics; Eyelid Diseases; Eyelid Neoplasms; Eyelids; Humans; Nose; Plastic Surgery Procedures; Surgical Flaps

To investigate relationships between local tear osmolarity and tear film characteristics and dry eye disease (DED) symptoms.. Prospective, cross-sectional, observational study.. Nasal and temporal tear osmolarity were measured in subjects with DED. The difference between nasal and temporal tears (OSM difference) was then calculated. Ocular symptoms were evaluated and tear break-up time (TBUT), corneal fluorescein staining score (CFSS), eyelid hyperemia, and tear production were measured. Correlations between DED symptoms and nasal tear osmolarity, temporal tear osmolarity, OSM difference, and tear film characteristics were evaluated using Pearson correlation analyses. Subjects were divided into 3 groups based on OSM difference: the temporal group had a temporal osmolarity > nasal osmolarity, the nasal group had a temporal osmolarity < nasal osmolarity, and the equal group had an OSM difference < 10 mOsm/L.. Forty-eight eyes of 48 subjects were included. Eleven eyes were in the temporal group, 17 eyes were in the equal group, and 20 eyes were in the nasal group. Temporal osmolarity, nasal osmolarity, and OSM difference were not correlated with TBUT, CFSS, lid hyperemia, or tear production. Nasal tear osmolarity was correlated with cold sensitivity frequency (r = 0.298, P = .040), foreign body sensation severity (r = 0.293, P = .043), and light sensitivity severity (r = 0.293, P = .043). Additionally, OSM difference was correlated with daily symptom frequency (r = 0.339, P = .019).. Nasal tear osmolarity and OSM difference play an important role in DED symptoms. Lid hyperemia, TBUT, CFSS, and tear secretion volume are not significantly affected by tear osmolarity. It is important to measure both nasal and temporal tear osmolarity when evaluating patients with DED.

Topics: Adult; Aged; Cross-Sectional Studies; Dry Eye Syndromes; Eyelid Diseases; Female; Fluorescent Dyes; Fluorophotometry; Humans; Hyperemia; Male; Middle Aged; Nose; Osmolar Concentration; Prospective Studies; Tears

Rhinoplasty is one of the most commonly performed aesthetic procedures today. Although nasal airway obstruction is frequently treated concomitantly with the aesthetic procedure, chronic sinusitis has typically postponed until full resolution of inflammatory symptoms.. To investigate the feasibility of combining FESS with septorhinoplasty by measuring different outcomes including operative time, blood loss, post-operative edema of the upper and lower eyelids, periorbital ecchymosis, patient discomfort and complication rates.. The study included 20 patients with deformed nose associated with chronic rhinosinusitis (CRS) not responding to medical treatment for at least 3 continuous months, irrespective to sex, of ages 20-60, and without any systemic diseases (study group), and 20 patients with deformed nose without any sinus problems (control group).. There was no significant difference between the two groups in the different measured outcomes (P>0.05) except for the operative time which was significantly less in the control group (P<0.05).. Concurrent rhinoplasty and endoscopic sinus surgery may be performed safely and effectively with minimal risks. Proper patient selection and sound intraoperative judgment can avoid potential complications.

Topics: Adult; Case-Control Studies; Ecchymosis; Edema; Endoscopy; Eyelid Diseases; Feasibility Studies; Female; Follow-Up Studies; Humans; Male; Middle Aged; Nasal Cavity; Nose; Operative Time; Patient Satisfaction; Postoperative Complications; Prospective Studies; Rhinitis; Rhinoplasty; Sinusitis; Young Adult

Injuries to the nose and perinasal region are common. Although the nasal fractures are commonly recognized and properly addressed, injuries to adjacent structures such as the orbit, medial canthus, and midface skeleton can be missed or misdiagnosed, leading to improper primary treatment and subsequent secondary deformities. In this discussion, three common injuries will be discussed, including nasomaxillary fractures, limited naso-orbital-ethmoid fractures, and severe central facial injuries with naso-orbital-ethmoid fractures. For instructional purposes, a case example of inadequate primary diagnosis and subsequent delayed or secondary management will be followed by a case example of proper initial diagnosis and proper primary management.

Topics: Adult; Bone Substitutes; Bone Transplantation; Cicatrix; Durapatite; Enophthalmos; Ethmoid Bone; Eyelid Diseases; Female; Follow-Up Studies; Fracture Fixation, Internal; Humans; Imaging, Three-Dimensional; Male; Maxillary Fractures; Maxillofacial Injuries; Middle Aged; Nasal Bone; Nasal Cavity; Nasal Obstruction; Nose; Nose Deformities, Acquired; Orbital Fractures; Postoperative Complications; Rhinoplasty; Skull Fractures; Surgical Flaps; Tomography, X-Ray Computed; Zygomatic Fractures

Topics: Abnormalities, Multiple; Adult; Cysts; Diagnosis, Differential; Ethmoid Sinus; Eyebrows; Eyelid Diseases; Eyelids; Humans; Magnetic Resonance Imaging; Male; Microphthalmos; Mucocele; Nose; Orbital Diseases; Paranasal Sinus Diseases; Tomography, X-Ray Computed

Topics: Aged; Continuous Positive Airway Pressure; Eyelid Diseases; Humans; Male; Nose; Sleep Apnea, Obstructive; Subcutaneous Emphysema

Blepharophimosis-ptosis-epicanthus syndrome (BPES) is a rare genetic condition occurring sporadically and transmitted by autosomal dominant inheritance. Type I BPES is associated with a high incidence of menstrual irregularities and infertility. Its clinical presentation is attributed to either an ovarian resistance to gonadotropins or to a true premature menopause. Two pathophysiological underlying mechanisms have been proposed: one suggests that one or more mechanisms lead to inhibition of early follicular development or follicule atresia. The other raises the possibility that BPES results from microdeletion of genetic material containing at least 2 independent genes. We report a familial case of BPES identified at birth and who required several surgical procedures. Several members of the patient's family are also affected. Early recognition of this condition may allow appropriate counselling and/or treatments including egg donation in case of hypergonadotropic hypogonadism.

Topics: Adult; Blepharophimosis; Eyelid Diseases; Female; Humans; Infertility, Female; Nose; Pedigree; Syndrome

The conotruncal anomaly face syndrome (CTAF) comprises congenital heart disease and dysmorphic face, and is frequently associated with cleft palate or hypernasality. There have been many discussions about the overlap with velocardiofacial syndrome (VCF). The aim of this study was to clarify the craniofacial characteristics of CTAF patients by clinical examination, and photogrammetric and cephalometric analyses, and to clarify the differences compared to published data on VCF.. The facial features of CTAF included hypertelorism, small palpebral fissures, upward slanting of palpebral fissures, bloated eye lids, low nasal bridge, small mouth, open mouth at rest, and malformed auricles. Cephalometric features included bialveolar protrusion, small gonial angle, backward rotation of the mandibular ramus, and labial inclination of the maxillary incisors. An acute cranial base angle was also noted. These results differed from those of VCF. There were, however, no obvious pathognomonic findings for the differential diagnosis between CTAF and VCF.. Considering these findings, use of CATCH 22, the inclusive classification of cardiac anomalies, cleft palate, and dysmorphic face may be of value for the clinical understanding in these patients.

Topics: Alveolar Process; Cephalometry; Child; Child, Preschool; Cleft Palate; Craniofacial Abnormalities; Diagnosis, Differential; Ear, External; Eyelid Diseases; Eyelids; Female; Heart Defects, Congenital; Humans; Hypertelorism; Incisor; Male; Malocclusion; Mandible; Maxilla; Mouth Abnormalities; Nose; Photogrammetry; Rotation; Skull Base; Speech Disorders; Syndrome

A clinical study of the craniofacial features in Apert syndrome is based on our experience with 136 cases. Characteristics included hyperacrobrachycephaly, steep wide forehead, flat occiput, common craniofacial asymmetry, ocular hypertelorism and proptosis, downslanting palpebral fissures, divergent upgaze and esotropic downgaze, a tendency towards large ears, and marked depression of the nasal bridge. The nose is short and wide with a bulbous tip, and the anterior facial height is reduced. Common features during infancy included horizontal grooves above the supraorbital ridges that disappear with age, a break in the continuity of the eyebrows, and a trapezoidal-shaped mouth at rest. Radiographic aspects of Apert syndrome were also assessed. Tables are provided which compare the craniofacial features of Apert and Crouzon syndromes.

Topics: Acrocephalosyndactylia; Craniofacial Dysostosis; Ear, External; Esotropia; Exophthalmos; Eyelid Diseases; Face; Facial Asymmetry; Facial Bones; Forehead; Humans; Hypertelorism; Infant; Mouth Abnormalities; Nasal Bone; Nose; Occipital Bone; Orbit; Radiography; Skull; Strabismus

Facial nerve palsy disrupts both the static and dynamic equilibrium of the half-face involved. The imbalance worsens with age and senility further aggravates the situation. Palliative surgery can be used in complete intractable facial palsy or rarement for partial palsies or as a temporary treatment. The operation is proposed mostly for elderly patients and does not create other malformations or dysfunctions. Simple and effective reduction, cervicofacial lifting and plicature of the skin muscles is used with ocular protection (passive eyelid circle, lateral de-epidermalized skin flap, blepharorraphia) with or without use of locoregional tissues (orbito-naso-genial and labiogenial flaps) are usually sufficient.

Topics: Aged; Chin; Dermatologic Surgical Procedures; Ectropion; Eyelid Diseases; Eyelids; Facial Muscles; Facial Paralysis; Humans; Nose; Orbit; Palliative Care; Surgical Flaps; Xerophthalmia

Recognition of the allergic individual is facilitated by an awareness of certain characteristic actions and various facial lesions which may be clues to other allergic problems. A gaping expression, clearing of the throat and rubbing or mashing of the eyes and nose may indicate significant rhinitis. Dark circles and bags under the eyes, long, silky eyelashes and injected conjunctivas are other signs. Bruxism and malocclusion may also be related to an allergic diathesis.

Topics: Adolescent; Adult; Behavior; Bruxism; Child; Conjunctivitis; Eczema; Eye Manifestations; Eyelid Diseases; Female; Glossitis, Benign Migratory; Habits; Humans; Hypersensitivity; Male; Mouth Breathing; Nose; Oral Manifestations; Rhinitis, Allergic, Seasonal

Topics: Blepharitis; Cartilage; Entropion; Eyelid Diseases; Humans; Mucous Membrane; Nose; Tissue Adhesions; Transplantation, Autologous