Short- and Long-term Patient Satisfaction and Complications in 650 Endoscopic Forehead Lift Procedures.

PURPOSE: The aims are to compare short- versus long-term patient satisfaction and report temporary versus permanent complications in 650 patients with endoscopic forehead lift procedure (EFL). METHODS: This is a retrospective study on all of the consecutive patients with EFL. Patients with previous trauma and surgery and less than 2 years follow up were excluded. Short- (6 months) and long-term (≥2 years) patient satisfaction (visual analog score [VAS], 0-100) were recorded. Patients' perspectives on temporary versus permanent complications were also documented. RESULTS: Mean age and follow up were 46.4 and 7.1 (2-13) years, respectively. Long-term satisfaction (79.9) was significantly lower than the short term (96.6). The long-term satisfaction decreased in 95.7%, increased in 2.7%, and remained the same in 1.6% of the patients. Intraoperative skin laceration occurred in 3 patients (0.5%). Mean time of forehead numbness recovery was 2.3 months. Temporary complications were itching (13.7%), headache (6.3%), unilateral facial nerve palsy (5.8%), acne (3.2%), and remained staples (1.7%). Permanent complications included undercorrection (7.1%), alopecia (4.2%), forehead irregularities (2.3%), surprised look (2.2%), incision site complications (2%), and glabellar depression (0.9%). Reoperation (1.2%) was performed for undercorrection and alopecia. While short-term satisfaction was significantly lower in patients with temporary facial nerve paresis, long-term satisfaction was lower in patients with undercorrection and reoperation. CONCLUSION: A high satisfaction scores of 96.6 and 80 were observed in the short- and long-term follow up after the EFL. Frequency of temporary and permanent postoperative complications was 30.3% and 15.8%. Reoperation rate was 1.2%.

Endoscopic-Assisted Lateral Orbitotomy for Large Orbital Roof Dermoid Cysts With Dural Invasion.

PURPOSE: To demonstrate the technique and report the results of endoscopic-assisted lateral orbitotomy for 6 patients with huge intraorbital dermoid cyst causing orbital roof bone erosion and dural invasion. METHODS: Patients had unilateral cystic tumor with proptosis and hypoglobus for more than 6 months. There was no compressive optic neuropathy. Lateral orbitotomy procedure was performed from 2004 to 2016 by 1 surgeon. Cysts were dissected, and fluid content was aspirated to reduce the size. Solid contents were then suctioned, its cavity was repeatedly irrigated, and orbital part of epithelial lining was removed. The remained epithelial lining and keratinized content at the orbital roof (abutting the dura) were removed using the rigid endoscope lenses (4 mm, 0° and 30°) and curettage. Orbital tissue was pulled away from the roof (inferior) by an assistant surgeon to make a space for introducing the lens and curette. The surgical field was frequently irrigated. No orbital drain was used, and all the patients were discharged on the same day after 8-10 hours of observation. Skin sutures were removed 1 week later. RESULTS: They were 4 men and 2 women with age range of 19-48 years. A large superolateral orbital tumor with roof erosion and dural invasion was observed on imaging. Procedures were performed uneventfully. Dermoid was the pathological diagnosis. While one patient lost to follow up after 1 week, others had 6-18 months follow-up time with no recurrence. CONCLUSIONS: Endoscopic-assisted lateral orbitotomy approach provided a good field of view, illumination, and magnification to totally remove all the content and epithelial lining of very large orbital roof dermoid cysts with dural invasion.

Diabetic versus non-diabetic rhino-orbito-cerebral mucormycosis.

OBJECTIVE: To compare the characteristics and outcomes of rhino-orbito-cerebral mucormycosis (ROCM) in diabetic versus non-diabetic patients. METHOD: It is a retrospective comparative case series on consecutive patients with biopsy-proven ROCM. Systemic and ophthalmic manifestations, imaging, management and final outcomes were compared between diabetic versus non-diabetic ROCMs referred the eye clinic of a university-based hospital (2008-2016). RESULTS: Forty-three diabetics (55 eyes) with mean age of 54.6 (SD:12.5) years and 20 non-diabetics (24 eyes) with mean age of 57.5 (SD:13.8) years were enrolled. Patients' survival was observed in 51% of diabetics and 70% of non-diabetics (P = .1). The mortality rate was 7.4 times (CI95%: 1.85-29.96) higher in diabetic ROCM treated with non-liposomal amphotericin (P = .01). Exenteration did not significantly change the mortality rate in either group. Globe survival was 40% and 50% in diabetics and non-diabetics (P = 1), respectively. Vision survival was observed in 20% of diabetics and 37% of non-diabetics (P = .2). CONCLUSION: Patients', globe and vision survivals were not different between diabetic and non-diabetic patients with ROCM. They were 51%, 40% and 20% in diabetic and 70%, 50% and 37% in non-diabetic ROCM.

An insight of microRNAs performance in carcinogenesis and tumorigenesis; an overview of cancer therapy.

Importance of dysregulation and expression of microRNAs (miRNAs) has been confiemed in many disorders comprising cancer. In this way, different approaches to induce reprogramming from one cell type to another in oerder to control the cell normal mechanisem, comprising microRNAs, combinatorial small molecules, exosome-mediated reprogramming, embryonic microenvironment and also lineage-specific transcription agents, are involved in cell situation. Meaningly, besides the above factors, microRNAs are so special and have an impressive role in cell reprogramming. One of the main applications of cancer cell reprogramming is it's ability in therapeutic approach. Many insights in reprogramming mechanism have been recommended, and determining improvment has been aknolwged to develop reprogramming efficiency and possibility, permiting it to appear as practical therapy against all cancers. Conspiciously, the recent studies on the fluctuations and performance of microRNAs,small endogenous non-coding RNAs, as notable factors in carcinogenesis and tumorigenesis, therapy resistance and metastasis and as new non-invasive cancer biomarkers has a remarkable attention. This is due to their unique dysregulated signatures throughout tumor progression. Recognising miRNAs signatures capable of anticipating therapy response and metastatic onset in cancers might enhance diagnosis and therapy. According to the growing reports on miRNAs as novel non-invasive biomarkers in various cancers as a main regulators of cancers drug resistance or metastasis, the quest on whether some miRNAs have the ability to regulate both simultaneously is inevitable, yet understudied. The combination of genetic diagnosis using next generation sequencing and targeted therapy may contribute to the effective precision medicine for cancer therapy. Here, we want to review the practical application of microRNAs performance in carcinogenesis and tumorigenesis in cancer therapy.