Background:Upper eyelid retraction is a challenging complication of cosmetic upper eyelid blepharoplasty.To avoid extra trauma,we developed a new technique for correcting iatrogenic upper eyelid retraction by postmigr...Background:Upper eyelid retraction is a challenging complication of cosmetic upper eyelid blepharoplasty.To avoid extra trauma,we developed a new technique for correcting iatrogenic upper eyelid retraction by postmigrating a compound flap of the orbicularis muscle and fascia(OFC)on the anterior surface of the tarsal plate.This method extends the aponeurosis of the levator palpebrae superioris muscle(LPS),which can achieve a good correction for post-blepharoplasty retraction.Methods:We collected data from 15 patients with mild to moderate iatrogenic upper eyelid retraction who were treated at our hospital between February 2017 and December 2019.The OFC was used to replace the missing part of the LPS,and post-migration of the LPS and fixation of the OFC to the tarsal margin were conducted.Postoperative outcome measurements included postoperative binocular symmetry,double eyelid smoothness,eyelid fullness,margin reflex distance(MRD1),degree of eyelid closure,and exposure keratitis.The patients were followed-up at seven days,one month,and six months postoperatively.Results:One patient with moderate eyelid retraction showed undercorrection 6 months postoperatively,with the upper eyelid margin located at the upper edge of the pupil.The remaining patients had the upper eyelid margin stabilized at 1.0–2.0 mm below the upper corneal margin.Other observational indicators were satisfactory,including binocular symmetry,double eyelid fluency,and eyelid fullness.During the follow-up,no exposure keratitis was identified.The MRD1 indexes after the operation were significantly different(P<0.001)from those before the procedure.Conclusions:Extension and post-migration of the LPS using the orbicularis muscle and OFC structure can effectively correct mild iatrogenic eyelid retraction after ptosis with less damage and good postoperative eyelid morphology and closure function.展开更多
BACKGROUND The prevalence of pelvic organ prolapse(POP)increases with age and parity.Specifically,the prevalence of POP among women aged 20 to 39 is 9.7%,while it rises to 49%among women over 80 years old.Additionally...BACKGROUND The prevalence of pelvic organ prolapse(POP)increases with age and parity.Specifically,the prevalence of POP among women aged 20 to 39 is 9.7%,while it rises to 49%among women over 80 years old.Additionally,as the number of deliveries increases,the prevalence of POP also rises accordingly,with a rate of 12.8%for women with one delivery history,18.7%for those with two deliveries,and 24.6%for women with three or more deliveries.It causes immense suffering for pregnant women.AIM To evaluate the relationship between the levator ani muscle’s hiatus(LH)area and POP in patients with gestational diabetes mellitus(GDM)using perineal ultrasound.METHODS The study cohort comprised 104 patients aged 29.8±3.7 years who sought medical care at our institution between January 2021 and June 2023.All were singleton pregnancies consisting of 75 primiparas and 29 multiparas,with an average parity of 1.7±0.5.According to the POP diagnostic criteria,the 104 subjects were divided into two groups with 52 members each:POP group(patients with GDM combined with POP)and non-POP group(patients with GDM without POP).Perineal ultrasound was used to measure differences in the anteroposterior diameter,transverse diameter,and LH area.Receiver operating characteristic curves were drawn to determine the optimal cutoff values for the LH anteroposterior diameter,transverse diameter,and area for diagnosing POP.RESULTS Statistically significant increase in the LH area,anteroposterior diameter,and lateral diameter were observed in the POP group compared with the non-POP group(P<0.05).Both groups exhibited markedly elevated incidence rates of macrosomia and stress urinary incontinence.For the POP group,the area under the curve(AUC)for the LH area was 0.906 with a 95%confidence interval(CI):0.824-0.988.The optimal cutoff was 13.54cm²,demonstrating a sensitivity of 83.2%and a specificity of 64.4%.The AUC for the anteroposterior diameter reached 0.836 with a 95%CI:0.729-0.943.The optimal cutoff was 5.53 cm with a sensitivity of 64.2%and a spe展开更多
文摘Background:Upper eyelid retraction is a challenging complication of cosmetic upper eyelid blepharoplasty.To avoid extra trauma,we developed a new technique for correcting iatrogenic upper eyelid retraction by postmigrating a compound flap of the orbicularis muscle and fascia(OFC)on the anterior surface of the tarsal plate.This method extends the aponeurosis of the levator palpebrae superioris muscle(LPS),which can achieve a good correction for post-blepharoplasty retraction.Methods:We collected data from 15 patients with mild to moderate iatrogenic upper eyelid retraction who were treated at our hospital between February 2017 and December 2019.The OFC was used to replace the missing part of the LPS,and post-migration of the LPS and fixation of the OFC to the tarsal margin were conducted.Postoperative outcome measurements included postoperative binocular symmetry,double eyelid smoothness,eyelid fullness,margin reflex distance(MRD1),degree of eyelid closure,and exposure keratitis.The patients were followed-up at seven days,one month,and six months postoperatively.Results:One patient with moderate eyelid retraction showed undercorrection 6 months postoperatively,with the upper eyelid margin located at the upper edge of the pupil.The remaining patients had the upper eyelid margin stabilized at 1.0–2.0 mm below the upper corneal margin.Other observational indicators were satisfactory,including binocular symmetry,double eyelid fluency,and eyelid fullness.During the follow-up,no exposure keratitis was identified.The MRD1 indexes after the operation were significantly different(P<0.001)from those before the procedure.Conclusions:Extension and post-migration of the LPS using the orbicularis muscle and OFC structure can effectively correct mild iatrogenic eyelid retraction after ptosis with less damage and good postoperative eyelid morphology and closure function.
文摘BACKGROUND The prevalence of pelvic organ prolapse(POP)increases with age and parity.Specifically,the prevalence of POP among women aged 20 to 39 is 9.7%,while it rises to 49%among women over 80 years old.Additionally,as the number of deliveries increases,the prevalence of POP also rises accordingly,with a rate of 12.8%for women with one delivery history,18.7%for those with two deliveries,and 24.6%for women with three or more deliveries.It causes immense suffering for pregnant women.AIM To evaluate the relationship between the levator ani muscle’s hiatus(LH)area and POP in patients with gestational diabetes mellitus(GDM)using perineal ultrasound.METHODS The study cohort comprised 104 patients aged 29.8±3.7 years who sought medical care at our institution between January 2021 and June 2023.All were singleton pregnancies consisting of 75 primiparas and 29 multiparas,with an average parity of 1.7±0.5.According to the POP diagnostic criteria,the 104 subjects were divided into two groups with 52 members each:POP group(patients with GDM combined with POP)and non-POP group(patients with GDM without POP).Perineal ultrasound was used to measure differences in the anteroposterior diameter,transverse diameter,and LH area.Receiver operating characteristic curves were drawn to determine the optimal cutoff values for the LH anteroposterior diameter,transverse diameter,and area for diagnosing POP.RESULTS Statistically significant increase in the LH area,anteroposterior diameter,and lateral diameter were observed in the POP group compared with the non-POP group(P<0.05).Both groups exhibited markedly elevated incidence rates of macrosomia and stress urinary incontinence.For the POP group,the area under the curve(AUC)for the LH area was 0.906 with a 95%confidence interval(CI):0.824-0.988.The optimal cutoff was 13.54cm²,demonstrating a sensitivity of 83.2%and a specificity of 64.4%.The AUC for the anteroposterior diameter reached 0.836 with a 95%CI:0.729-0.943.The optimal cutoff was 5.53 cm with a sensitivity of 64.2%and a spe
