RESUMEN
Orbital region may be divided into four sectors: medial canthus, lateral canthus, lower lid and upper lid. A vertical section of a lid shows 5 layers: skin, subcutaneous tissue with orbicularis muscle, fibrous layer (tarsus-aponeurosis), plain fibers muscle layer (Muller's), conjunctiva. The first two layers form the "anterior lamella" and the other ones the "posterior lamella", divided by the grey line. In this review Authors describe with all details the orbital region and the eyelid layers, considering the most important concepts for surgery. Finally they resume basics of local anesthesia in ophthalmoplastic surgery.
Asunto(s)
Párpados/cirugía , Procedimientos Quirúrgicos Oftalmológicos/métodos , Anestesia Local/métodos , Anestésicos Locales/administración & dosificación , Párpados/anatomía & histología , Párpados/irrigación sanguínea , Párpados/inervación , Humanos , Aparato Lagrimal/anatomía & histología , Aparato Lagrimal/cirugía , Bloqueo Nervioso/métodos , Procedimientos de Cirugía Plástica/métodosRESUMEN
In the orbital region the variety of tumors is so vast that even an expert oculoplastic surgeon may be deceived. The various tumors may be classified as benign, precancerous and malignant. Approximately 5-10% of all skin cancers occur in the eyelids. Incidence studies indicate that basal cell carcinoma is the most frequent malignant eyelid tumor, followed by squamous cell carcinoma, sebaceous gland carcinoma and malignant melanoma. Malignant neoplasms represent the leading cause of plastic reconstruction in orbital region, followed by cicatricial retraction, post-traumatic loss of tissue, congenital colobomas. Aim of this review is to classify benign and malignant lesions; to consider the surgical removal approach to the lesion (Mohs micrographic surgery, frozen sections, biopsy, immediate removal and reconstruction with permanent sections) and finally to consider reconstruction techniques with grafts and flaps.
Asunto(s)
Neoplasias de los Párpados/cirugía , Procedimientos Quirúrgicos Oftalmológicos/métodos , Procedimientos de Cirugía Plástica/métodos , Anestesia Local/métodos , Biopsia , Quistes/patología , Quistes/cirugía , Enfermedades de los Párpados/patología , Enfermedades de los Párpados/cirugía , Neoplasias de los Párpados/clasificación , Neoplasias de los Párpados/epidemiología , Neoplasias de los Párpados/patología , Secciones por Congelación , Humanos , Cirugía de Mohs/métodos , Trasplante de Piel/métodos , Colgajos Quirúrgicos , Técnicas de SuturaRESUMEN
Aim of this review was to describe ectropion, entropion and trichiasis and their therapy. These eyelid pathologies are characterised by common symptoms (redness, excessive tearing and irritation of the eye) and by altered balance of the anterior and posterior lamellae of the eyelids. They involve more frequently the inferior eyelid and the therapy is mainly surgical. Parasurgical therapy may play a role as a temporary measure.
Asunto(s)
Ectropión/cirugía , Entropión/cirugía , Procedimientos Quirúrgicos Oftalmológicos/métodos , Procedimientos de Cirugía Plástica/métodos , Triquiasis/cirugía , Ectropión/diagnóstico , Entropión/diagnóstico , Enfermedades de los Párpados/congénito , Enfermedades de los Párpados/cirugía , Párpados/anomalías , Párpados/cirugía , Humanos , Trasplante de Piel/métodos , Colgajos Quirúrgicos , Técnicas de Sutura , Triquiasis/diagnósticoRESUMEN
Blepharoptosis of the upper eyelid is a common condition among patients presenting for oculoplastic surgery. Although there are many types of ptosis, the two most frequent clinical cases are simple congenital ptosis in young patients and senile ptosis in adults. Patient examination is important to distinguish these from other more infrequent types of ptosis, such as those neurogenic, myogenic and posttraumatic. These latter cases may require specific therapeutic strategies. Ptosis can usually be corrected surgically. The article discusses guidelines for the choice of intervention. Various different surgical techniques are also presented, together with results and complications.
Asunto(s)
Blefaroptosis , Procedimientos Quirúrgicos Oftalmológicos/métodos , Procedimientos de Cirugía Plástica/métodos , Adulto , Anciano , Envejecimiento/patología , Blefarofimosis/diagnóstico , Blefaroptosis/congénito , Blefaroptosis/diagnóstico , Blefaroptosis/etiología , Blefaroptosis/patología , Blefaroptosis/cirugía , Niño , Diagnóstico Diferencial , Cardiopatías Congénitas/diagnóstico , Síndrome de Horner/complicaciones , Síndrome de Horner/diagnóstico , Humanos , Anomalías Maxilomandibulares/diagnóstico , Miastenia Gravis/complicaciones , Enfermedades del Sistema Nervioso/diagnóstico , Enfermedades Neuromusculares/complicaciones , Oftalmoplejía/complicaciones , Oftalmoplejía/diagnóstico , Complicaciones Posoperatorias/prevención & control , Reflejo AnormalRESUMEN
In the periorbital the major aging changes are a drooping of the brow (brow ptosis), excessive accumulation of skin in the upper lid (dermatochalasis), and a prolapse of orbital fat, in the upper and lower lids caused by weakening of the septum and orbital connective tissues. The specific anatomical abnormalities of each individual patients should be identified and the relationship between each other should be identified in order to determine a correct surgical plan. In this review we will analyze different surgical techniques.
Asunto(s)
Blefaroptosis/cirugía , Procedimientos Quirúrgicos Oftalmológicos/métodos , Procedimientos de Cirugía Plástica/métodos , Envejecimiento/patología , Conjuntiva/cirugía , Cejas/patología , Párpados/patología , Párpados/cirugía , Humanos , Envejecimiento de la Piel , Grasa Subcutánea/patología , Grasa Subcutánea/cirugíaRESUMEN
PURPOSE: Serotonin is biochemically present in the iris and ciliary body of animals and humans. Controversial findings are reported about the concentrations of serotonin in aqueous humor with respect to plasma in humans. The aim of this study was to evaluate the levels of serotonin both in aqueous humor and plasma in human subjects. METHODS: In 50 patients with glaucoma or cataract, plasma and aqueous humor serotonin levels were measured by HPLC with electrochemical detection. Serotonin plasma levels were also measured in 25 healthy subjects as controls. RESULTS: In all patients with cataract or glaucoma, the aqueous humor serotonin concentration is significantly lower than that in plasma [1.14+/-0.29 (SEM) vs. 5.33+/-1.03 ng/ml, p<0.01]. Furthermore, in the same patients and in 25 healthy controls, serotonin plasma levels were similar. CONCLUSION: Our study shows that serotonin is present in human aqueous humor and its concentration is 4 times lower than in plasma.