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1.
HNO ; 64(6): 417-23, 2016 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-27193235

RESUMO

BACKGROUND AND AIM: The lacrimal system (LS) crosses regions of ocular adnexa, the nose, and the paranasal sinuses. Surgery of disorders requires a targeted ophthalmologic and otolaryngologic examination. Since 2013, an Interdisciplinary Conference on Lacrimal System Disorders (ICLSD) has existed at the University Hospital Halle. First results of our experiences with this cooperation between ophthalmic and ENT surgeons are presented. METHODS: In a retrospective study at the Department of Ophthalmology, University Hospital Halle, all patients aged 22-80 years (n = 43, 10 with bilateral manifestation; mean age 65.1 years) having had a consultation in ICLSD between February 2013 and May 2015 were analyzed. Thereby, 53 LS were included in the descriptive evaluation. RESULTS: The main relevant pathology in terms of ophthalmologic manifestation was chronic dacryocystitis and its complications (n = 42), whereas nasal septum deviation (n = 11) and chronic rhinosinusitis (n = 10) were the most frequent otorhinolaryngologic pathologies. Prior to consultation, ENT (n = 34) and/or ophthalmic surgery (n = 40) had been performed. During ICLSD, an individualized therapeutic regime for each patient was developed. Surgery was required in 43 out of 53 LS. Of these, 32 were mainly ophthalmic, 11 mainly ENT interventions. At the time of evaluation (median 3 months; range 1 to 24 months), 29 out of 38 patients (76.3 %) were free of complaints. CONCLUSION: Since 2013, competences of ophthalmic and ENT surgeons have been integrated in ICLSD for advanced diagnosis and therapy of lacrimal disorders at the University Hospital Halle. Encouraging functional results are shown in this study, as most patients have had a long and complicated history of lacrimal system disorders. ICLSD enables interdisciplinary patient care.


Assuntos
Dacriocistorinostomia/estatística & dados numéricos , Doenças do Aparelho Lacrimal/epidemiologia , Doenças do Aparelho Lacrimal/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos/estatística & dados numéricos , Equipe de Assistência ao Paciente/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Congressos como Assunto , Feminino , Alemanha/epidemiologia , Humanos , Doenças do Aparelho Lacrimal/diagnóstico , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Resultado do Tratamento
2.
Orbit ; 35(5): 258-61, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27399840

RESUMO

Dacryocystitis-related orbital cellulitis is a relatively rare condition, and large case series of this clinical entity have been reported. This study was undertaken to identify a larger cohort of patients with this ailment, with the intent of defining its clinical and microbiologic features. Case logs from four institutions were reviewed to identify patients that suffered from dacryocystitis-related orbital cellulitis. A retrospective chart review was then performed to identify clinical features, management strategies, microbiologic features, and outcomes. A dedicated statistical software package was utilized to identify correlations between these variables. 13 patients (7 females, 6 males; mean age = 57.2 years, range = 7-89 years) were identified. One patient carried a diagnosis of immunosuppressive disease. All patients underwent emergent surgical drainage and received intravenous antibiotics. Primary acquired nasolacrimal duct obstruction was found to be the underlying etiology in nine cases (69.2%), whereas four patients suffered from specific causes of their obstructions. An average of 1.07 organisms/patient (standard deviation = 0.49 organisms/patient) were recovered from microbiologic cultures, and Gram-positive bacteria represented the majority of cultured organisms. All patients experienced either stable or improved vision upon discharge. The relationships between a specific etiology and the possibility of vision loss or the number of organisms cultured, between the number of organisms cultured and vision loss, and immunosuppression and vision loss or the number of organisms cultured were all not statistically significant (p > 0.05). Dacryocystitis-related orbital cellulitis most commonly occurs in adult patients who do not carry immunosuppressive diagnoses and suffer from primary obstructions. Multiple microbiologic species may cause this problem, although Gram-positive organisms are most common. With appropriate management, stable or improved vision can be achieved.


Assuntos
Dacriocistite/diagnóstico , Infecções Oculares Bacterianas/diagnóstico , Celulite Orbitária/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Bactérias/isolamento & purificação , Criança , Terapia Combinada , Dacriocistite/microbiologia , Dacriocistite/terapia , Infecções Oculares Bacterianas/microbiologia , Infecções Oculares Bacterianas/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Oftalmológicos , Celulite Orbitária/microbiologia , Celulite Orbitária/terapia , Estudos Retrospectivos , Adulto Jovem
3.
Polymers (Basel) ; 16(3)2024 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-38337241

RESUMO

The application of biopolymers in the reconstruction of the posterior lamella of the eyelid and the lacrimal system marks a significant fusion of biomaterial science with clinical advancements. This review assimilates research spanning 2015 to 2023 to provide a detailed examination of the role of biopolymers in reconstructing the posterior lamella of the eyelid and the lacrimal system. It covers the anatomy and pathophysiology of eyelid structures, the challenges of reconstruction, and the nuances of surgical intervention. This article progresses to evaluate the current gold standards, alternative options, and the desirable properties of biopolymers used in these intricate procedures. It underscores the advancements in the field, from decellularized grafts and acellular matrices to innovative natural and synthetic polymers, and explores their applications in lacrimal gland tissue engineering, including the promise of 3D bioprinting technologies. This review highlights the importance of multidisciplinary collaboration between material scientists and clinicians in enhancing surgical outcomes and patient quality of life, emphasizing that such cooperation is pivotal for translating benchtop research into bedside applications. This collaborative effort is vital for restoring aesthetics and functionality for patients afflicted with disfiguring eyelid diseases, ultimately aiming to bridge the gap between innovative materials and their clinical translation.

4.
J Fr Ophtalmol ; 47(3): 104076, 2024 Mar.
Artigo em Francês | MEDLINE | ID: mdl-38368761

RESUMO

Among lacrimal system injuries, canalicular lacerations are at the top of the list. Men are more affected than women, but children are most likely to experience such trauma. The cause depends on the patient's age: in young children, there is a higher prevalence of animal bites (dogs and cats); in young adults, fights predominate, since motor vehicle accidents have become less common; in the elderly, falls are among the most frequent causes. Tetanus vaccination is required in all cases, but assessment for rabies exposure is necessary in the case of dog or cat bites. Diagnosis is very simple: it is based on examination or wound probing. Other head, facial, or ocular injuries must be excluded; for example, an injury to the globe must take precedence over a canalicular laceration. In the absence of an ocular injury, the canalicular wound should be managed surgically within 48hours under an operating microscope: identification of both severed ends of the injured canaliculus, suture of the severed canaliculus with monofilament suture, and appropriate lacrimal intubation if indicated. Other trauma to the lacrimal system, such as sharp or blunt trauma to the lacrimal sac or nasolacrimal duct, are much rarer.


Assuntos
Doenças do Gato , Doenças do Cão , Traumatismos Oculares , Lacerações , Aparelho Lacrimal , Criança , Idoso , Masculino , Adulto Jovem , Feminino , Humanos , Animais , Gatos , Cães , Pré-Escolar , Aparelho Lacrimal/cirurgia , Traumatismos Oculares/diagnóstico , Traumatismos Oculares/epidemiologia , Traumatismos Oculares/cirurgia , Lacerações/diagnóstico , Lacerações/epidemiologia , Lacerações/etiologia
5.
Clin Ophthalmol ; 17: 2309-2322, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37593358

RESUMO

Purpose: Congenital nasolacrimal duct obstruction (CNLDO) is fairly common in newborns. The main aim of this cross-sectional study is to assess the preferred practice patterns of CNLDO among ophthalmologists in Jordan. Methods: This cross-sectional study was conducted across all ophthalmological practices in Jordan, using convenience sampling. An online questionnaire, designed through Google Forms, was distributed through social media. The survey contained four domains: baseline characteristics of participants and the diagnosis (7 items), medical management (3 items), and surgical management (11 items) of CNLDO. Descriptive statistics were conducted using SPSS (IBM SPSS Corp, SPSS Statistics ver. 26, USA). Results: Eighty-three physicians responded to the survey, with an average age of 40.6 ± 8.6. More than half of the participants (53.0%, n = 44) were general ophthalmologists. Only 37.3% of our sample (n = 31) regularly evaluated the refraction of a child presenting with epiphora suggestive of CNLDO. Criggler's nasolacrimal duct massage was recommended by 62.7% of respondents (n = 52) for up to 12 months. In addition, 72.3% of respondents (n = 60) recommended 12 months as the minimum age for primary probing of CNLDO. Silicon intubation was considered for primary probing starting at 24 months by 31.3% of ophthalmologists (n = 20). Monocanalicular stent was preferred by 42.2% of respondents (n = 27) while 31.3% (n = 20) preferred bicanalicular stent. Conclusion: There is considerable variability in preferred practice patterns regarding the diagnosis and management of CNLDO in Jordan. Our findings highlight the gaps in optimum practices which need to be addressed for better management.

6.
Beyoglu Eye J ; 8(1): 45-49, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36911222

RESUMO

Objectives: The aim of the study was to evaluate etiological and demographic characteristics of the adult patients referred to the oculoplastic surgery clinic of the tertiary care center with the complaint of epiphora. Methods: The medical records of the patients who applied to the oculoplastic surgery clinic with a complaint of epiphora between January 2014 and July 2021 were reviewed retrospectively. Etiology of epiphora, age, gender, duration of symptom, and follow-up period were evaluated. According to the etiological factors, nasolacrimal system disorders such as punctal stenosis, canalicular stenosis, canaliculitis, and acquired nasolacrimal system obstruction, respectively; the causes of epiphora were grouped as eyelid abnormalities such as entropion and ectropion, and hypersecretory tear secretion due to causes such as dry eye, allergy, and inflammation. The patients with epiphora over the age of 18 with at least 6 months of follow-up were included in the study. Patients with congenital or tumor-related nasolacrimal duct obstruction (NLDO) and epiphora due to trauma-related eyelid or canaliculi injury were not included. Results: A total of 595 medical fields were evaluated. Epiphora was present in 747 eyes of 595 patients. Of the patients, 221 (37%) were male and 376 (63%) were female. According to etiological evaluation of frequency, 372 (62.5%, 432 eyes) patients with NLDO, 63 (10.5%, 123 eyes) patients with punctal stenosis, 44 (7.3%) patients with ectropion, 38 (6.3%) patients with entropion, 37 (6.2%, 69 eyes) patients hypersecretory causes (dry eye, allergy, inflammation, etc.), 24 (4%) patients had primary canaliculitis, and 17 (2.8%) patients had epiphora due to canalicular occlusion. Conclusion: Epiphora is an important complaint that may occur due to different etiologies. A detailed examination of the anterior segment, lacrimal system and eyelids, and taking a history are the most important steps in the management of the patient.

7.
Cureus ; 15(1): e33470, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36713816

RESUMO

Introduction This is a comparative cross-sectional study done to compare the curative outcome of endonasal dacryocystorhinostomy (DCR) done with and without a silicon stent in patients with chronic dacryocystitis due to nasolacrimal duct obstruction. Methods This study was carried out in central India, involving 60 patients who were diagnosed with chronic dacryocystitis and underwent endonasal DCR (with zero-degree and 45-degree endoscopes from Olympus, with an Olympus camera and monitor) between October 2021 and September 2022. All patients were over the age of 18, with major exclusion criteria of previous DCR and sinonasal disease. All the surgeries were done by the same senior surgeon, in which 30 patients were stented (with a Prison silicone nasolacrimal duct stent) and 30 of them were non-stented. The follow-up duration for these was 12 months after the surgery.  Results The outcome was evaluated at the end of three months, six months, and 12 months for both groups (patients with and without stents) using the Chi-square test. The success rate at the end of six months was 90% with stented patients and 93.3% with non-stented patients (p-value - 0.64); at six months, it was also the same (p-value - 0.64); and at the end of 12 months, it was 80% and 76.6% (p-value - 0.71) for patients with and without a stent, respectively. The final endoscopy at the end of 12 months showed 93.3% of patients who underwent stenting had a patent rhinostomy opening, and 90% of those who were not stented had a patent opening. Conclusions Our observational comparative study showed that patients with chronic dacryocystitis who underwent endonasal DCR with and without stenting had almost similar results. There was no significant difference in the outcome. So, we concluded that generally all the patients should be considered for endonasal DCR without a stent, except in special cases like revision endonasal DCR, lacrimal gland cysts, fistulas, and patients with sinonasal pathology, in whom silicon stents can be preferred.

8.
Am J Ophthalmol Case Rep ; 29: 101766, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36544754

RESUMO

Purpose: To report a case of lacrimal system agenesis in a patient with Goldenhar syndrome. Observations: A one-month-old female preterm twin with Goldenhar syndrome presented with left upper eyelid coloboma, left central corneal ulcer and inferotemporal epibulbar dermoid. The corneal ulcer was treated and healed to a mild stromal scar. Examination under anesthesia prior to surgery revealed agenesis of the upper and lower eyelids canaliculi. Surgery was performed to correct left upper eyelid coloboma. At a second stage, the epibulbar dermoid was excised and ocular surface was repaired with amniotic membrane graft. Conclusion and importance: Goldenhar syndrome is a rare congenital anomaly arising from the abnormal development of the first and second branchial arches. Anomalies of lacrimal drainage system are uncommon in Goldenhar including nasolacrimal duct obstruction and common canalicular obstruction. Agenesis of the lacrimal system has not been described in cases of Goldenhar syndrome. This case represents a unique and uncommonly seen feature.

9.
Eur J Ophthalmol ; 33(3): 1287-1293, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36254409

RESUMO

Endoscopic (END-DCR) and external dacryocystorhinostomies (EXT-DCR) are nowadays considered the gold standard techniques for non-oncologic distal acquired lacrimal disorders (DALO). However, no unanimous consensus has been achieved on which of these surgeries is the most suitable to the individual patient. Herein, we review the available literature of the last 30 years with the aim of defining a simple and reproduceable treatment algorithm to treat DALO. A search of PubMed, EMBASE, Scopus and Cochrane databases was last performed in December 2021 to examine evidence regarding the role of END-DCR and EXT-DCR in primary and revision surgeries. If considered primary surgeries, END-DCR should be preferred in case of intranasal comorbidities, given the possibility to directly visualize and treat potential intranasal pathologies. Conversely, EXT-DCR should be chosen in case of need/preference for local anesthesia, given the major historical experience and wider surgical field that helps to resolve intra-operatory complications (e.g., bleeding) in an uncollaborative patient. In the absence of the abovementioned conditions, the decision of one or other approach should be discussed with the patient. In recurrent cases, END-DCR should be considered the treatment of choice given the major likelihood to visualize the causes of primary failure and directly resolve it. In conclusion, END-DCR should be considered the treatment of choice in revision cases or in primary ones associated with intranasal pathologies, whereas EXT-DCR should be chosen if local anesthesia is needed. In the absence of these scenarios, it is still open to debate which of these two approaches should be used.


Assuntos
Dacriocistorinostomia , Doenças do Aparelho Lacrimal , Aparelho Lacrimal , Obstrução dos Ductos Lacrimais , Ducto Nasolacrimal , Humanos , Dacriocistorinostomia/métodos , Endoscopia/métodos , Doenças do Aparelho Lacrimal/cirurgia , Reoperação , Resultado do Tratamento , Ducto Nasolacrimal/cirurgia , Obstrução dos Ductos Lacrimais/terapia
10.
Cureus ; 14(12): e32552, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36654606

RESUMO

BACKGROUND: Dry eye disease is a multifactorial chronic disorder of the ocular surface, which leads to symptoms of discomfort and distress. Dry eye disease is a global health concern and is one of the most frequent ocular diseases encountered in an ophthalmology clinic. The estimated prevalence of dry eye disease in the literature ranged from 7.4% to 93.2%. Saudi Arabia's population, especially in the eastern province, is at great risk of developing dry eye disease, however, there is hardly any nationwide study that assesses the prevalence of dry eye disease among the general population and its risk factors. AIM: The aim is to estimate the prevalence of dry eye disease and determine its risk factors among the general population of Saudi Arabia. METHODS: This study was a cross-sectional study conducted on the general population of Saudi Arabia between September 2022 and November 2022. A convenient sampling technique was deployed for participant recruitment, where a self-administered questionnaire was created and dispersed to the general population all over the country with an invitation to participate in the study. Dry eye disease prevalence was assessed using Ocular Surface Disease Index survey. The Chi-square test was used to test for factors associated with the prevalence of dry eye disease, and undiagnosed dry eye disease. Multivariate logistic regression was also used to determine risk factors for dry eye disease. RESULTS: A total of 1,381 participants were included in this study. The prevalence of dry eye disease among the general population of Saudi Arabia was observed to be (17.5%). Among the participants (11%) had mild dry eye disease, (4.7%) had moderate dry eye disease, and (1.7%) had a severe dry eye disease. Among those observed to have a dry eye disease, (58.09%) were not previously diagnosed. The following factors were observed to be significantly associated with having dry eye disease, being female, having thyroid disease, having systemic lupus erythematosus/rheumatoid arthritis, using antidepressants, using antihistamine/decongestants, using electronic devices for a prolonged time, using contact lenses, having a history of eye surgery, history of conjunctival/eyelid infection, and history corneal abrasions/erosions/ulceration. CONCLUSION:  This study revealed that the prevalence of dry eye disease among the general population of Saudi Arabia is notably lower than what was observed in other local studies and similar to what was found in some global studies. Adjusted binary multivariate logistic regression revealed that the risk factors were only: being female, using antidepressants, using antihistamines/decongestants, and prolonged use of electronic devices.

11.
Taiwan J Ophthalmol ; 12(3): 330-333, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36248083

RESUMO

PURPOSE: Dacryoliths of the canalicular pathway are classically attributed to Actinomyces species as the most common organism. However, global shifts toward Streptococcus and Staphylococcus species have been reported. The objective of this article is to update the American Midwest epidemiology of lacrimal system dacryoliths for targeted clinical treatment. MATERIALS AND METHODS: A retrospective chart review from January 2015 to 2021 of patients with a history of surgical procedure for lacrimal removal of dacryolith for canaliculitis, canalicular obstruction, dacryocystitis, and nasolacrimal duct obstruction was included. Specimens were sent for histopathological evaluation and microbial culture. RESULTS: A total of 48 specimens were included. The most common organism isolated for canalicular pathology was Actinomyces spp (23%), followed by Staphylococcus spp (21%) and Streptococcus spp (19%). Histopathological staining accounted for 45% of Actinomyces isolation when culture data inconclusive. In a subgroup analysis of lacrimal sac dacryoliths, the most common organism was Staphylococcus spp (29%). Actinomyces species were not isolated from the lacrimal sac or nasolacrimal duct. CONCLUSION: Actinomyces maintains a microbial predominance in canalicular dacryoliths and requires careful culture and histopathological analysis for its fastidious nature. Lacrimal sac and nasolacrimal duct dacryolith found no isolates of Actinomyces, and the most common organism was Staphylococcus.

12.
Vet Med Sci ; 8(5): 1867-1871, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35667039

RESUMO

BACKGROUND: A 10-year-old castrated male Maltese dog was presented with chronic swelling that had been present for at least 5 years in the medial canthus of the right eye (OD). OBJECTIVES: To describe the treatment outcome of dacryops with dacryolithiasis. METHODS: Bilateral patency of the nasolacrimal system was confirmed by flushing of both upper and lower puncta. Ocular ultrasonography revealed a well-defined, oval-shaped, heterogeneous mass with several hyperechoic foci. Dacryocystorhinography revealed no connection between the mass and lacrimal canaliculus. Gentle blunt dissection of the fibrous connective tissue around the cystic mass was performed. The mass was removed, which intraluminally contained multiple calculi. RESULTS: Histopathologically, the cystic structure was lined by simple cuboidal epithelium and surrounded by smooth muscle actin positive myoepithelial cells consistent with dacryops derived from the lacrimal glandular ductal system. In addition, several spherical basophilic minerals were observed in the lumen, which were identified as dacryoliths. CONCLUSION: Surgical removal of this dacryops with dacryolithiasis was curative without recurrence after four months.


Assuntos
Cistos , Doenças do Cão , Doenças do Aparelho Lacrimal , Aparelho Lacrimal , Actinas , Animais , Cistos/cirurgia , Cistos/veterinária , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/cirurgia , Cães , Doenças do Aparelho Lacrimal/cirurgia , Doenças do Aparelho Lacrimal/veterinária , Masculino , Minerais
13.
Taiwan J Ophthalmol ; 12(2): 198-201, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35813802

RESUMO

To investigate if larger punctum size links to the severity of dry eye disease (DED) and perhaps, punctum size inspection can be adopted to become one of the DED evaluations for practitioners. The records of 200 eyes of 114 patients that had temporary collagen punctum plugs due to severe DED (Level 2 to Level 4) from January 1, 2017, to July 31, 2018, were reviewed for the size of the plugs. Lacrimal punctum size of those eyes was approximated according to the size of vertical canalicular soft collagen plug (from 0.3 to 0.5 mm diameter, Oasis, Lacrimedics, Glendora, CA, USA). The dry eye severity grading from the International Dry Eye WorkShop was used to grade the level of the severity of DED. Those eyes classified as Level 2 and above were considered as severe due to the presentation of moderate-to-diffuse corneal staining and symptomatic. To assess if there is a correlation between punctum size and the severity of DED, the Spearman's rank correlation coefficient was calculated. Of the 200 Level 2 and above eyes, 131 (66%) eyes had a large punctum (≥0.5 mm). Punctum size larger than 0.4 mm was 95%. The estimated Spearman's ρ was 0.16. This indicates a statistical significant positive correlation (P = 0.02) between larger punctum size and higher level of DED. The larger size of lacrimal punctum may link to the severity of DED. Punctum inspection may be adopted to become one parameter for DED evaluation for practitioners.

14.
J Fr Ophtalmol ; 45(3): 306-313, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35123815

RESUMO

OBJECTIVES: To analyze postoperative CT dacryography features in patients with persistent epiphora after endonasal surgery. METHODS: We conducted a retrospective study of 76 patients with a history of persistent epiphora after endonasal ENT surgery who underwent CT dacryography between January 2014 and February 2020. Volume acquisition of sub-millimeter sections allowed 2D and 3D reconstructions with virtual endoscopy of the nasosinusal cavities and the lacrimal canal. RESULTS: The postsurgical appearance of the nasosinusal cavities revealed a middle meatal antrostomy in 37% of cases, less frequently an ethmoidectomy or an inferior meatal antrostomy, sometimes completed by a middle or inferior turbinectomy. In thirty-five patients (46%), the lacrimal canal was distant from the endonasal ENT procedure. Epiphora was related to mucosal hypertrophy, constricting all or part of the lacrimal canal. Thirty-three patients (43%) showed changes in the lacrimal canal at the surgical site. In the inferior meatus, the nasolacrimal orifice was sometimes involved in the inferior turbinectomy or meatotomy, but most of the time, in the middle meatus, resection of the uncinate process prior to ethmoidectomy or middle meatotomy was associated with a lesion of the contiguous lacrimal canal. CONCLUSION: As a rare cause of persistent tearing, involvement of the nasolacrimal duct at the edge of the endonasal ENT surgery highlights the importance of intraoperative localization of the nasolacrimal duct before resection of the uncinate process or the inferior turbinate, ideally predicted by preoperative CT imaging.


Assuntos
Dacriocistorinostomia , Doenças do Aparelho Lacrimal , Aparelho Lacrimal , Ducto Nasolacrimal , Dacriocistorinostomia/métodos , Endoscopia/métodos , Humanos , Aparelho Lacrimal/diagnóstico por imagem , Aparelho Lacrimal/cirurgia , Doenças do Aparelho Lacrimal/diagnóstico por imagem , Doenças do Aparelho Lacrimal/etiologia , Ducto Nasolacrimal/diagnóstico por imagem , Ducto Nasolacrimal/patologia , Ducto Nasolacrimal/cirurgia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
15.
Saudi J Ophthalmol ; 35(3): 263-265, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35601846

RESUMO

Canaliculitis is defined as infection of the canalicular part of the lacrimal system. Despite usual presenting clinical characteristics such as pouting of the lacrimal punctum, discharge, and redness at the medial canthus area, it is usually misdiagnosed and overlooked. The presence of punctal ulceration and tissue necrosis is an uncommon presentation in these patients. We report a case of a 35-year-old female with a 3-day history of left lower eyelid medial swelling, tenderness, and discharge. She was found to have left lower eyelid diffuse conjunctival injection and swelling involving the lower lacrimal punctum with whitish necrotic tissue. The patient was taken to the minor treatment room and debridement of the necrotic tissue was done and swabs were taken for culture and sensitivity. The punctum was found to be open with deroofing of the proximal canalicular system due to the severe nature of the infection; this was followed by irrigation using moxifloxacin and povidone-iodine. The patient was started on systemic antibiotics, topical antibiotic eye drops, and povidone-iodine sticks to clean the affected area. Few days later, the microbiology results revealed infection by Pseudomonas aeruginosa, and the patient was improving gradually until she had complete resolution of the infection.

16.
J Craniomaxillofac Surg ; 47(10): 1608-1616, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31400844

RESUMO

AIMS: One of the most commonly performed operations in aesthetic, plastic, and reconstructive surgery is rhinoplasty, the aim of which is to construct an altered nasal shape, either for aesthetic or functional reasons. The lateral osteotomy is the most traumatic step of rhinoplasty, and is generally difficult to perform. The lacrimal system can be damaged during the lateral osteotomy procedure. In this study, we aimed to measure the distance between the lacrimal system and the lateral osteotomy line, and to determine the safe and ideal osteotomy level, which is very important in rhinoplasty procedures. We also evaluated the safe relationship of this osteotomy level with the lacrimal system by constructing a three-dimensional model. MATERIALS AND METHODS: The three-dimensional models were constructed on axial planes using paranasal computed tomographic (CT) images of 40 male and 40 female patients. The 'lateral osteotomy model' was designed in three dimensions. The axial CT images were obtained from the model. On the CT images, the distance between the lateral osteotomy line and the lacrimal system was assessed by measuring three distances. The first was the distance between the anterior lacrimal crest and the lateral osteotomy line. The second was the distance from the midpoint between the anterior lacrimal crest and the inferior meatus to the lateral osteotomy line. The third was the distance between the opening of the lacrimal canal to the inferior meatus and the lateral osteotomy line. RESULTS: No lacrimal system injury was seen on any of the models. The shortest distance was found between the anterior lacrimal crest and the lateral osteotomy line, measured at 4.5 mm and 5.0 mm in the female and male patients, respectively. CONCLUSION: Performing the lateral osteotomy meticulously while paying attention to remaining anterior to the medial canthal ligament will not lead to any lacrimal system injury.


Assuntos
Aparelho Lacrimal , Osteotomia , Rinoplastia , Estética Dentária , Feminino , Humanos , Masculino , Nariz
17.
Facial Plast Surg Clin North Am ; 27(1): 105-118, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30420064

RESUMO

Options for periorbital reconstruction include primary wound closure, local flaps, regional/distant flaps, or full-thickness skin grafts. Optimal aesthetic and functional outcomes are achieved by assessing regional contours, skin type, and facial aesthetic units. Like tissue should replace like tissue; for example, skin with skin, tarsus with tarsus (or equivalent material, eg, hard palate, ear cartilage, or autologous substitute), and conjunctiva with mucous membrane or like substitute (buccal mucous membrane, amniotic membrane). Patient characteristics including wound care needs, transportation needs, smoking status, and history of radiation can influence the reconstruction plan. Techniques most commonly used in our practice are reviewed.


Assuntos
Procedimentos Cirúrgicos Dermatológicos/métodos , Pálpebras , Neoplasias Faciais/cirurgia , Órbita , Neoplasias Cutâneas/cirurgia , Retalhos Cirúrgicos , Neoplasias Faciais/patologia , Humanos , Neoplasias Cutâneas/patologia
19.
Ann Anat ; 224: 113-116, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31102704

RESUMO

Punctal agenesis is defined as the absence of the punctum occurring secondary to a failure of embryogenesis. This review synthesizes existing data on the embryology, anatomy, clinical presentation, symptomatology, management options and treatment outcomes of punctal agenesis. A foundational knowledge of the underlying embryologic and anatomical abnormalities is fundamental to understanding its clinical presentation and assists in choosing an appropriate management strategy. Existing outcomes data is generally favorable and suggests management with a step-wise approach can alleviate symptoms in patients across a spectrum of disease.


Assuntos
Doenças do Aparelho Lacrimal , Aparelho Lacrimal/anormalidades , Aparelho Lacrimal/embriologia , Humanos , Aparelho Lacrimal/anatomia & histologia , Doenças do Aparelho Lacrimal/embriologia , Doenças do Aparelho Lacrimal/etiologia , Doenças do Aparelho Lacrimal/terapia , Resultado do Tratamento
20.
Mali Med ; 33(3): 5-9, 2018.
Artigo em Francês | MEDLINE | ID: mdl-35897193

RESUMO

Esthetic and functional surgeries in the periocular region fall into the domain of oculoplastic, or plastic and reconstructive surgery and otorhinolaryngology. Oculoplasty is the largest surgical spectrum in ophthalmology including eyelids, orbits and the lacrimal system. Our purpose was to study the frequency of eyelid, lacrimal and orbital (oculoplastic) surgery at the CHU IOTA. MATERIAL AND METHODS: Retrospective medical chart review of all the patients who underwent oculoplastic surgery was conducted from October 2015 to September 2016. RESULTS: A total of 233 patients were included with 52% female and 48% male. Patients were 37 years old on average. In total, the surgery was performed on the eyelids in83 cases (35.6%), the orbits in 113 cases (48.5%) and the lachrymal system in 37 cases (15.9%).Eyelid surgery commonly resulted from eye trauma (43,3%), followed by malpositions (30,2%). Mutilating surgery accounted for 92% of the orbital surgery. External dacryocystorhinostomy was the main lacrimal surgery (42%) followed by canalicular lacerations 25%. CONCLUSION: Oculoplasticsurgeryoccupies an important place in the surgical activities of the ophthalmologic University hospital despite a larger volume for cataractsurgery. Our studydoesn't highlight the outcome of the surgery itself but the epidemiology to help decision makers in their eye health policy including the reduction of mutilating surgery and oculoplastic training.


La chirurgie esthétique et fonctionnelle de la région périoculaire est du domaine de l'oculoplastie, ainsi que de la chirurgie plastique et reconstructive et de l'otorhinolaryngologie. L'oculoplastie constitue le plus large éventail chirurgical en ophtalmologie regroupant la paupière, l'orbite et le système lacrymal. OBJECTIF: Etudier la fréquence des procédures chirurgicales orbito-palpébrales et lacrymales (oculoplasties) dans un centre de troisième référence. MATÉRIELS ET MÉTHODES: Il s'agissait d'une étude rétrospective des dossiers de patients opérés pour pathologies oculoplastiques d'octobre 2015 à septembre 2016. RÉSULTATS: Au total 233 patients ont été inclus dont 52% de sexe féminin et 48% de sexe masculin avec un âge moyen de 37 ans ; parmi lesquels 83 cas (35,6%) de chirurgie palpébrale, 113 cas (48,5%) de chirurgie orbitaire et 37 cas (15,9%) chirurgie lacrymale.La chirurgie palpébrale était dominée parréparationdesplaies traumatiques (43,3%), suivi des malpositions (30,2%). La chirurgie mutilante constituait 92% de la chirurgie orbitaire. La dacryocystorhinostomie par voie externe était la principale chirurgie lacrymale soit 42%, suivie des lacérations canaliculaires 25%. CONCLUSION: Notre étude ne met pas en exergue le résultat de la chirurgie elle-même, mais l'épidémiologie du traitement chirurgical afin d'aider les décideurs dans leur politique de santé oculaire notamment sur la réduction de la chirurgie mutilante et la formation oculoplastique.

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