RESUMEN
Lagophthalmos is one of the most unpleasant and dangerous conditions that affect patients with facial palsy. The lack of ocular protection leads to corneal problems (such as conjunctival infections, acute and chronic keratitis, corneal ulcerations, and blindness). A dynamic reanimation of blinking eyelids is the therapeutic gold standard. However, success is not guaranteed with these dynamic techniques; even if results are good, blinking is usually restored within a year of the initial operation. Procedures that act more rapidly and have a higher success rate are needed. We proposed that lipofilling of the upper eyelid would improve eye closure, exploit the advantages of using autologous fat, and avoid the risks of exposure or migration associated with loading the lid with gold. Between 2012 and September 2018, we did upper eyelid lipofilling procedures for 75 patients with unilateral facial palsy. The main favourable result of lipofilling of the upper lid was the immediate improvement in corneal discomfort. Everybody described a partial to total increase in corneal comfort postoperatively. In the treatment of paralytic lagophthalmos, lipofilling of the upper eyelid produces favourable aesthetic and functional results, ocular health is restored, and the patients' quality of life is improved.
Asunto(s)
Implantes Dentales , Enfermedades de los Párpados , Parálisis Facial , Estética Dental , Enfermedades de los Párpados/cirugía , Párpados/cirugía , Parálisis Facial/cirugía , Humanos , Prótesis e Implantes , Calidad de VidaRESUMEN
This paper examines a complex argument such as stress, focusing on those elements of the work environment that play a significant role in the generation of its symptomatology or exercising a protective function against it. Two factors have to be examined in order to understand and predict stress at work: the individuals' behavior and the organizational and environmental context. The scientific-pragmatic approach proposed by Behavior Analysis is examined. This approach emphasizes the need to evaluate the presence of coherent contingencies for each work group and, above all, the typology and the quality of consequences.