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Cai W, Wang H, Zhou Y, Zheng X, Li Z, Cai J, Zhou Y, Ma Y, Lin Y. Canalicular laceration repair using a novel bicanalicular silicone stent versus traditional bicanalicular stent with nasal fixation. J Plast Reconstr Aesthet Surg 2024; 90:192-199. [PMID: 38394833 DOI: 10.1016/j.bjps.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/17/2023] [Accepted: 02/01/2024] [Indexed: 02/25/2024]
Abstract
PURPOSE To compare the clinical effects of two types of lacrimal stents in the repair of canalicular lacerations. METHODS A retrospective analysis was conducted on patients with canalicular lacerations between January 2017 and December 2022. The canalicular reconstruction was performed using either the Runshi-RS bicanalicular silicone stent or the traditional bicanalicular silicone stent with nasal fixation, under a surgical microscope. The stent was placed for 3 months, and patients were followed up for more than 3 months after extubation. The anatomical and functional success rates were compared between the two groups. Anatomical success was assessed through diagnostic probing and irrigation of lacrimal passage, while functional success was determined by the patient's subjective symptoms of epiphora. RESULTS The study included 315 patients (315 eyes) undergoing canalicular laceration repair. The Runshi-RS stent was utilized in 147 patients (46.7%), while the traditional stent with nasal fixation was employed in 168 patients (53.3%). The anatomical success rates (99.3% vs 98.8%, P = 0.642) and functional success rates (87.2% vs 88.1%, P = 0.926) were similar between the RS group and the traditional stent group. Postoperative complications were fewer (4.1% vs 10.1%, P = 0.04) and the operation time was shorter (67.1 ± 35.3 min vs 86.1 ± 43.4 min, P < 0.001) in the RS group. CONCLUSION The Runshi-RS tube demonstrates favorable surgical outcomes for the repair of canalicular lacerations. Compared to the traditional stent with nasal fixation, the RS stent allows for shorter operation times and fewer postoperative complications in the repair of canalicular lacerations.
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Affiliation(s)
- Weihao Cai
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Dong Xia Road, Shantou, Guangdong Province, People's Republic of China
| | - Hongxi Wang
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Dong Xia Road, Shantou, Guangdong Province, People's Republic of China
| | - Yekai Zhou
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Dong Xia Road, Shantou, Guangdong Province, People's Republic of China
| | - Xin Zheng
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Dong Xia Road, Shantou, Guangdong Province, People's Republic of China
| | - Zeyi Li
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Dong Xia Road, Shantou, Guangdong Province, People's Republic of China
| | - Jianhao Cai
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Dong Xia Road, Shantou, Guangdong Province, People's Republic of China
| | - Yuansheng Zhou
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Dong Xia Road, Shantou, Guangdong Province, People's Republic of China
| | - Yueting Ma
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Dong Xia Road, Shantou, Guangdong Province, People's Republic of China
| | - Yongdong Lin
- Department of Ophthalmology, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Dong Xia Road, Shantou, Guangdong Province, People's Republic of China.
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Tana C, Wavreille O. [Lacrimal canalicular transposition for lower canaliculus repair: About four cases]. J Fr Ophtalmol 2023; 46:750-755. [PMID: 37156718 DOI: 10.1016/j.jfo.2022.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/26/2022] [Accepted: 12/06/2022] [Indexed: 05/10/2023]
Abstract
The main function of the eyelids is to support and protect the globe. The lower eyelid and medial canthus are often the location of malignant tumors that can be locally aggressive and require disfiguring surgeries. Chronic epiphora often appears in cases of inadequate reconstruction in this location and can require secondary procedures. We report four cases of medial canthus repair after tumor removal with loss of the inferior canaliculus. The ipsilateral superior canaliculus was removed before being transposed into the lower eyelid. This simple method allows for complete canalicular reconstruction. It obviates the need for artificial material and its potential associated complications. It has the advantage of a one-step eyelid and canalicular reconstruction and prevents epiphora after tumor resection.
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Affiliation(s)
- C Tana
- Faculté de médecine Henri Warembourg, Lille, France.
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Cai W, Li Z, Xie J, Lv W, Lin Y. Canalicular laceration repair with a novel bicanalicular silicone tube. J Plast Reconstr Aesthet Surg 2022; 75:4243-4248. [DOI: 10.1016/j.bjps.2022.08.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/01/2022] [Accepted: 08/17/2022] [Indexed: 10/31/2022]
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Chiu SJ, Currie ZI, Tan JH. Holding back the tears: is there a role for marsupialisation? BMJ Open Ophthalmol 2022; 7:bmjophth-2022-000985. [PMID: 36161857 PMCID: PMC9389104 DOI: 10.1136/bmjophth-2022-000985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/02/2022] [Indexed: 11/30/2022] Open
Abstract
Objective Medial eyelid tumours may result in the loss of the proximal lacrimal system during staged excision and delayed reconstruction, to achieve tumour margin clearance. The remnant canaliculus was marsupialised during reconstruction. The aim was to understand how many patients experienced symptomatic epiphora as a consequence of this. Methods and analysis A retrospective study including patients over a 15-year period with medial eyelid tumours, where the proximal lacrimal system was sacrificed to achieve tumour margin clearance. Included were all who had marsupialisation of the remnant distal stump as part of their delayed reconstruction. All who had pre-existing epiphora were excluded. The primary objective was the rate of epiphora following the procedure. A systematic literature review of postoperative epiphora occurring in patients with lid tumours requiring lacrimal system injury/sacrifice during tumour excision. Results There were 22 eyes (22 patients). All were basal cell carcinomas except for 1 (4.5%) tarsal conjunctival squamous cell carcinoma. All cases involved the lower lid. There were two (9.1%) patients who developed epiphora. One patient underwent a superior three-snip punctoplasty, botulinum toxin to the lacrimal gland and conjunctivodacryocystorhinostomy with Lester Jones tube insertion. The other patient was not overly troubled and did not require further treatment. The literature review showed the median postoperative rate of epiphora in these patients was 12.5% (range 0%–100%). Conclusion Marsupialisation of the remnant canaliculus during delayed reconstruction is a straightforward and effective surgical option, which may help prevent postreconstruction epiphora when the proximal lacrimal system is sacrificed for tumour margin clearance. Trial registration number 10391.
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Affiliation(s)
- Stephanie J Chiu
- Ophthalmology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Zanna I Currie
- Ophthalmology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Jennifer Hy Tan
- Ophthalmology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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Teoh RLW, Fong PY, Cai EZ, Yap YL, Hing ECH, Lee HJ, Nallathamby V, Ong WC, Lim J, Sundar G, Lim TC. Prophylactic Intraoperative Nasolacrimal Duct Intubation in Surgical Treatment of Facial Fractures—Is There a Role? Arch Plast Surg 2022; 49:195-199. [PMID: 35832673 PMCID: PMC9045536 DOI: 10.1055/s-0042-1744407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Nasolacrimal duct (NLD) damage is associated in the majority of type II and III naso-orbito-ethmoid (NOE) fractures.
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Our study aims to investigate the efficacy and safety of prophylactic NLD intubation in the setting of facial fractures, by comparing incidence of postoperative epiphora and wound infection. A retrospective matched control study was conducted on all patients with surgically treated facial fractures from 2008 to 2013 (
n
= 280) (IRB ref number: DSRB 2013/01198). Patients with the following fracture types were included: NOE (
n
= 16), frontal sinus (
n
= 2), Le Fort II/III (
n
= 8), and > 1 type (
n
= 48). All patients in this study were included with the intention to treat. The study group comprised patients who were intubated, while the control group patients were not intubated. Each group had 37 patients matched for age, gender, fracture type, and injury type. A single oculoplastic surgeon skilled in lacrimal surgery performed the procedure for all intubated patients. Patients with more severe and complex facial fractures were intubated with bicanalicular Crawford stents. Postoperative epiphora and infective complications (both facial wound and dacryocystitis) were assessed at 1, 3, 6, and 12 months. There was no significant difference in incidence of either postoperative epiphora (
p
= 0.152) or wound infection (
p
= 0.556) comparing both groups. Reduced incidence of postoperative epiphora in the study group is statistically not significant and does not support the need for prophylactic intubation. If radiographic evidence of NLD disruption or regurgitation seen on syringing on the NLD intraoperatively is present, intubation is safe and efficacious only if performed by an expert.
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Affiliation(s)
- Ryan Liang Wei Teoh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Pei Yuan Fong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Elijah Zhengyang Cai
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, National University Health System, Singapore, Singapore
| | - Yan Lin Yap
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, National University Health System, Singapore, Singapore
| | - Eileen Chor Hoong Hing
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, National University Health System, Singapore, Singapore
| | - Han Jing Lee
- Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, National University Health System, Singapore, Singapore
| | - Vigneswaran Nallathamby
- Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, National University Health System, Singapore, Singapore
| | - Wei Chen Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, National University Health System, Singapore, Singapore
| | - Jane Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, National University Health System, Singapore, Singapore
| | - Gangadhara Sundar
- Division of Oculoplastic Surgery, Department of Ophthalmology, National University Health System, Singapore, Singapore
| | - Thiam Chye Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, National University Health System, Singapore, Singapore
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Heichel J, Struck HG, Paulsen F, Javed Ali M, Viestenz A. [Deep periocular trauma with affection of the lacrimal ducts during Caesarean section]. HNO 2021; 70:60-64. [PMID: 33822270 PMCID: PMC8760212 DOI: 10.1007/s00106-021-01039-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2021] [Indexed: 11/30/2022]
Abstract
Periokuläre Verletzungen im Rahmen einer Kaiserschnittentbindung sind extrem selten. Anhand einer Kasuistik eines 5 h alten Neugeborenen soll das Trauma-Management in Hinblick auf Diagnostik, Therapie und Nachsorge einer tiefen periokulären Weichteilwunde dargestellt werden. Das Verletzungsmuster umfasste durchgreifende Wunden des medialen und lateralen Lidwinkels mit Eröffnung der Bindehautumschlagsfalte, der Tenonkapsel und Durchtrennung des oberen Tränenröhrchens. Der schichtweise Wundverschluss beinhaltete eine autostabile monokanalikulonasale Intubation der ableitenden Tränenwege.
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Affiliation(s)
- Jens Heichel
- Universitätsklinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle, Deutschland.
| | - Hans-Gert Struck
- Universitätsklinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle, Deutschland
| | - Friedrich Paulsen
- Institut für Anatomie, Lehrstuhl II, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstr. 19, 91054, Erlangen, Deutschland
| | - Mohammad Javed Ali
- Govindram Seksaria Institute of Dacryology, L. V. Prasad Eye Institute, 500034, Hyderabad, Indien
| | - Arne Viestenz
- Universitätsklinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle, Deutschland
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Guo T, Qin X, Wang H, Lu Y, Xu L, Ji J, Xiao C, Zhang Z. Eiology and prognosis of canalicular laceration repair using canalicular anastomosis combined with bicanalicular stent intubation. BMC Ophthalmol 2020; 20:246. [PMID: 32571261 PMCID: PMC7310031 DOI: 10.1186/s12886-020-01506-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 06/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the etiology of lacrimal canalicular laceration and explore the possible risk factors influencing prognosis. METHODS The data of 142 patients (142 eyes) with lacrimal canalicular lacerations who were surgically treated using canalicular anastomosis combined with bicanalicular stent intubation between March 2017 and March 2018 were reviewed. The analyzed data contained demographic information, types of trauma, injury locations, associated additional ocular injuries, and surgical outcomes at follow-up. The main outcome measures were anatomic success rate, functional success rate, and complications of surgery. RESULTS The mean patient age was 42.07 years (ranging from 1 to 75 years). Among the 142 patients, 112 (78.87%) were males. Upper and lower canalicular lacerations were found in 14 (9.86%) and 112 (78.87%) patients, respectively. Meanwhile, both upper and lower canalicular lacerations were found in 16 (11.27%) patients. Electric bike accidents comprised the leading cause of injury, accounting for 76 (53.52%) cases. There were 100 (70.42%) patients who had lid lacerations without tarsal plate fracture and 42 (29.58%) patients who had lid lacerations with tarsal plate fractures. The anatomic success rate was 98.59% and the functional success rate was 83.8%. The functional reconstruction failure rates were higher in patients with indirect injuries, lid lacerations with tarsal plate fractures, and those with punctum splitting (P < 0.05). Surgical complications were detected in the form of lacrimal punctum ectropion in 3 (2.11%) patients, punctum splitting in 2 (1.41%) patients, and stent extrusion and loss in 2 (1.41%) patients. CONCLUSIONS Electric bike accidents have become the leading cause of injury instead of motor vehicle accidents because of the changes in the lifestyles of people. Indirect injuries, lid lacerations with tarsal plate fractures, and those with punctum splitting were significantly more likely to lead to poor prognosis, as confirmed by the lower functional success rate of surgery.
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Affiliation(s)
- Tao Guo
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No 639 ZhiZaoJu Road, Shanghai, 200011, China
| | - Xiuhong Qin
- Department of Ophthalmology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, Liaoning Province, China
| | - Hongwei Wang
- Department of Ophthalmology, Jingjiang People's Hospital, Jingjiang, 214500, Jiangsu Province, China
| | - Yang Lu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No 639 ZhiZaoJu Road, Shanghai, 200011, China
| | - Li Xu
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No 639 ZhiZaoJu Road, Shanghai, 200011, China
| | - Jiali Ji
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No 639 ZhiZaoJu Road, Shanghai, 200011, China.
| | - Caiwen Xiao
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No 639 ZhiZaoJu Road, Shanghai, 200011, China.
| | - Zhenzhen Zhang
- Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No 639 ZhiZaoJu Road, Shanghai, 200011, China.
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Shim WS, Cho MJ, Kim J, Jung HJ. Epiphora after nasolacrimal duct fracture in patients with midfacial trauma: A retrospective study. Medicine (Baltimore) 2019; 98:e18120. [PMID: 31770240 PMCID: PMC6890326 DOI: 10.1097/md.0000000000018120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to identify the factors related to occurrence of epiphora or requirement of dacryocystorhinostomy (DCR) in patients with midfacial trauma.We performed a retrospective analysis of the medical records of 1038 patients with midfacial trauma from January 2005 to December 2015. Fifty-one patients (55 cases) diagnosed with nasolacrimal duct (NLD) fracture using facial bone computed tomography were enrolled. Correlation analysis was performed of patient- and injury-related factors, including age, sex, facial trauma etiology, accompanying injury, type and level of the NLD fracture, and time from injury to initial surgery, with the occurrence of epiphora and requirement for DCR.Epiphora occurred in 14.5% and DCR was performed in 5.5% of the patients with NLD fracture. The correlation analysis revealed no significant relationship among the factors with the occurrence of epiphora and requirement for DCR.In patients with midfacial trauma and NLD fracture, epiphora occurred in 14.5% and endoscopic DCR was performed due to persistent epiphora in 5.5% and its result was all successful.
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Affiliation(s)
- Woo Sub Shim
- Department of Otorhinolaryngology-Head and Neck Surgery
| | - Min Jai Cho
- Department of Neurosurgery, Chungbuk National University College of Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Jisung Kim
- Department of Otorhinolaryngology-Head and Neck Surgery
| | - Hahn Jin Jung
- Department of Otorhinolaryngology-Head and Neck Surgery
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Tsai MJ, Lin IW, Lee SS, Lai CS. Stitch guide technique for bicanalicular nasal intubation in single canalicular laceration reconstruction. Kaohsiung J Med Sci 2018; 34:529-534. [PMID: 30173783 DOI: 10.1016/j.kjms.2018.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/09/2018] [Accepted: 04/26/2018] [Indexed: 11/26/2022] Open
Abstract
Various surgical techniques for canalicular laceration reconstruction have been described in previous study. But there are still two difficult points which may take time in the operation even with the assistance of magnification. We present a simple and effective way to achieve the bicanalicular nasal intubation for the single canalicular laceration. From Jan 2005 to Dec 2015, 20 patients (21 eyes) with upper or lower canalicular laceration were treated with the Crawford lacrimal intubation set by this stitch guide method. We used the eye pigtail probe and the steel probe of the intubation set to dispose a 4-0 Nylon suture as a guide to pull down the silicone tube to the nostril. The functional and anatomic success rates in the 20 eyes are 90% (18/20) and 85% (17/20) respectively. The average time for bicanalicular nasal intubation by this method is 6.87 ± 1.83 min. The result of stitch guide technique to achieve bicanalicular nasal intubation in single canalicular laceration reconstruction is almost the same as the traditional method. Our anatomic and functional success rates are 85% and 90% respectively which are comparable to the previous studies. But this new method takes less time to complete the intubation with little variation. The magnification with microscopy could be omitted and no new instrument is needed. The stitch guide technique for bicanalicular nasal intubation with Crawford intubation system is a reliable and easy way to perform in single canalicular laceration reconstruction.
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Affiliation(s)
- Ming-Jer Tsai
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - I-Wen Lin
- Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Su-Shin Lee
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Chung-Sheng Lai
- Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Traumatic Nasolacrimal Duct Obstruction: Clinical Profile, Management, and Outcome. Eur J Ophthalmol 2018; 23:615-22. [DOI: 10.5301/ejo.5000256] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2013] [Indexed: 11/20/2022]
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Zhuang A, Jin X, Li Y, Fan X, Shi W. A new method for locating the proximal lacerated bicanalicular ends in Chinese preschoolers and long-term outcomes after surgical repair. Medicine (Baltimore) 2017; 96:e7814. [PMID: 28816979 PMCID: PMC5571716 DOI: 10.1097/md.0000000000007814] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This report is to explore the long-term outcomes of surgical repair of bicanalicular lacerations in Chinese preschool patients. In this report, 12 patients with bicanalicular lacerations were studied between September 2010 and September 2015. The distance from the punctum to the distal canalicular lacerated end was recorded before surgery to classify different types of trauma. All patients underwent surgical repair of the lacerated canaliculi by 1 surgeon within 48 hours after the trauma occurred. After treatment, the lesions were divided into 3 types according to the distance from the punctum to the distal lacerated canalicular end as follows: lateral, medial, and the central. Based on this classification, each lacerated canaliculus was successfully repaired. Nearly half of the lesions (46%) were lateral, 42% were central, and 12% were medial. The average time for locating the proximal lacerated end of the canaliculus was 3.33 ± 1.52 minutes (range, 1.0-7.0 minutes). The follow-up time ranged from 6.0 months to 4.5 year (median, 25 months). Our study showed that 96% (23) of the canaliculi were completely patent. One lateral lesion presented with residual outdoor epiphora in cold weather secondary to left lower canalicular stenosis. All 12 patients had excellent cosmetic results. Our study displayed a surgical management based on the 3 types of lesions helped to find the proximal lacerated end of the canaliculus, and provided excellent long-term outcomes of drainage function.
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14
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Abstract
Reconstruction of the upper eyelid is complicated because the eyelid must retain mobility, flexibility, function, and a suitable mucosal surface over the delicate cornea. Defects of the upper eyelid may be due to congenital defects or traumatic injury or follow oncologic resection. This article focuses on reconstruction due to loss of tissue. Multiple surgeries may be needed to reach the desired results, addressing loss of tissue and then loss of function. Each defect is unique and the laxity and availability of surrounding tissue vary. Knowing the most common techniques for repair assists surgeons in the multifaceted planning that takes place.
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Affiliation(s)
- Gabriela Mabel Espinoza
- Department of Ophthalmology, Saint Louis University Eye Institute, Saint Louis University School of Medicine, 1755 South Grand Boulevard, St Louis, MO 63104, USA.
| | - Angela Michelle Prost
- Department of Ophthalmology, Saint Louis University Eye Institute, Saint Louis University School of Medicine, 1755 South Grand Boulevard, St Louis, MO 63104, USA
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Surgical management of traumatic nasolacrimal duct obstruction. Eur J Ophthalmol 2016; 26:517-519. [PMID: 26833234 DOI: 10.5301/ejo.5000754] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate etiologies, demographics, and surgical outcomes in cases of traumatic nasolacrimal duct obstruction (NLDO). METHODS Charts of 35 patients with the diagnosis of traumatic NLDO were reviewed retrospectively. Patient demographics, type of trauma, previous lacrimal surgery history, surgical treatment, follow-up time, and anatomical and functional outcomes were evaluated. RESULTS Forty eyes of 35 patients were included in this study over 12 years. Twenty-four patients were male (68.5%) and the mean age of the patients was 31.52 ± 14.58 years (range 9-68). The most common etiology was motor vehicle accidents (52.5%), followed by high velocity blunt injury (27.5%), accidental fall (7.5%), occupational trauma (5%), iatrogenic surgical trauma (5%), and animal bite (2.5%). A total of 21 eyes (52.5%) were treated with external dacryocystorhinostomy (DCR), 30% with conjunctival DCR, 15% with endoscopic DCR, and 2.5% with diode laser-assisted DCR. Mean follow-up time was 23.02 ± 13.53 months. Functional and anatomical success was recorded in 37 out of 40 eyes (92.5%). CONCLUSIONS Naso-orbitoethmoidal fracture is the main etiology of traumatic NLDO. The majority of the injuries occurred in male participants from motor vehicle accidents and high-velocity blunt injury. Dacryocystorhinostomy provides anatomical and functional success in 92.5% of cases of traumatic NLDO.
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Intraoperative use of the lacrimal endoscope for accurate reduction of bony nasolacrimal duct fracture. Plast Reconstr Surg 2013; 130:761e-762e. [PMID: 23096651 DOI: 10.1097/prs.0b013e318267da0f] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Iwai T, Yasumura K, Yabuki Y, Omura S, Matsui Y, Kobayashi S, Fujimaki R, Okubo M, Tohnai I, Maegawa J. Intraoperative lacrimal intubation to prevent epiphora as a result of injury to the nasolacrimal system after fracture of the naso-orbitoethmoid complex. Br J Oral Maxillofac Surg 2012; 51:e165-8. [PMID: 22853979 DOI: 10.1016/j.bjoms.2012.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Accepted: 07/10/2012] [Indexed: 10/28/2022]
Abstract
Treatment of fracture of the naso-orbitoethmoid (NOE) complex is difficult. There are not only aesthetic issues but also functional consequences related to the lacrimal system. Because prophylactic lacrimal intubation for such fractures remains controversial, we have assessed the effectiveness of intraoperative lacrimal intubation to prevent epiphora as a result of such injuries. Thirteen patients diagnosed with craniomaxillofacial fractures including fractures of the NOE complex were included in the study; 10 had unilateral fractures and 3 bilateral. Computed tomography (CT) showed all patients had displaced fragments that had the potential to damage the lacrimal duct. In 7 patients the fractures included the canthal region and in 6 they did not. All patients were treated by open reduction and internal fixation under general anaesthesia, followed by intraoperative lacrimal intubation unilaterally or bilaterally as required. Lacrimal intubation with a silicone tube was successful in all 13 patients (16 sides). The tube was removed 2-9 months (mean 3.8) postoperatively and no subsequent epiphora were seen during follow-up (mean (3-29 months) 11.3 months). Lacrimal intubation for at least 2 months may prevent epiphora caused by injury to the nasolacrimal system after fractures of the NOE complex.
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Affiliation(s)
- Toshinori Iwai
- Department of Oral and Maxillofacial Surgery, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
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McVeigh K, Bhatt V, Green J, Monaghan A, Dover MS. The contemporary management of midface and craniofacial trauma. TRAUMA-ENGLAND 2011. [DOI: 10.1177/1460408611418767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The successful management of midface and craniofacial trauma requires a thorough understanding of the anatomy and functional demands of this complex region. To achieve optimal outcomes, it is necessary that these injuries are accurately diagnosed and managed in a multi-disciplinary environment at the appropriate time. This review article discusses an overview of these injuries and highlights some of the key principles of management.
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Affiliation(s)
- K McVeigh
- Oral and Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, UK
- Oral and Maxillofacial Surgery, Royal Gwent Hospital, Newport, South Wales, UK
| | - V Bhatt
- Oral and Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, UK
| | - J Green
- Oral and Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, UK
| | - A Monaghan
- Oral and Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, UK
| | - MS Dover
- Oral and Maxillofacial Surgery, Queen Elizabeth Hospital Birmingham, UK
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20
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Czyz CN, Cahill KV, Foster JA, Michels KS, Clark CM, Rich NE. Reconstructive options for the medial canthus and eyelids following tumor excision. Saudi J Ophthalmol 2010; 25:67-74. [PMID: 23960904 DOI: 10.1016/j.sjopt.2010.10.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2010] [Accepted: 10/06/2010] [Indexed: 11/30/2022] Open
Abstract
General principles provide the framework for eyelid and periorbital reconstruction following tumor excision. Eyelid tumors involving the medial canthus region and/or lacrimal system add to the complexity of reconstructive planning. The nature of the tumor, patient and tissue factors, and surgeon preference guide repair design choices. Reconstructive considerations and options following medial canthal tumor resection are described.
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Affiliation(s)
- Craig N Czyz
- Division of Ophthalmology, Section of Oculofacial Plastic Surgery, Ohio Health Doctor's Hospital, Columbus, OH, USA
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21
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Madge SN, Malhotra R, Thaller VT, Davis GJ, Kakizaki H, Mannor GE, Selva D. A systematic approach to the oculoplastic reconstruction of the eyelid medial canthal region after cancer excision. Int Ophthalmol Clin 2009; 49:173-194. [PMID: 20348864 DOI: 10.1097/iio.0b013e3181b88c6a] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Simon N Madge
- The Dorall, Lyde, Herefordshire, HR4 8AD, United Kingdom
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