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At least 541 records · Page 30Linked to original sources
PubMed1993

The biomechanics of brow and frontalis function and its effect on blepharoplasty.

Understanding the biomechanics and dynamics of eyebrow and frontalis function is essential to controlling the outcome of blepharoplasty. Ignoring the forehead in the pursuit of blepharoplasty excellence dooms to failure any eventual outcome. If, however, the principles laid out in this article become the basis for planning and execution, the final result, measured in the quality of aesthetic repair, will surely improve immensely.

Adult↗
PubMed1996

Facial interpretation and component consistency.

The issue of consistency, without regard to accuracy, of the facial component of focus (upper/eyebrows, middle/eyes, lower/nose and mouth) when interpreting facial expressions of emotion was examined. Eighty girls (average age, 7 years) chose, from an array of schematic faces, which face best represented various emotional scenarios (anger, disgust, fear, happiness, sadness, and surprise). The findings indicate that these children were remarkably consistent in facial area of focus. Across six trials for each emotion, children focused on the mouth (lower component) for happiness, sadness, surprise, and disgust, and on the eyebrows (the upper component) for anger and fear.

Attention↗
PubMed1976

[Sclerodermie en coup de sabre with spontaneous filtering bleb (author's transl)].

In a 43-year-old female patient with sclerodermie en coup de sabre on the right forehead, the following changes of the right eye were observed: Partial lack of hairs of the eyebrow; distortion of the upper eyelid, similar to a coloboma; paralysis of the inferior oblique and the superior rectus muscles; decrease of corneal sensibility; formation of a spontaneous filtering bleb in the upper limbal region; ocular hypotension with changes of the papilla.

Adult↗
PubMedDate not supplied

Clinical ocular study in leprosy patients at a sanitary dermatological hospital in Brazil.

This study is based upon the observation f 363 leprosy patients having different types of the disease. At the time of the examination, we did not have any previous knowledge about the type of leprosy the patients were having. Thus, the eye examination was done without the knowledge of clinical diagnosis. The ocular examination protocol covered the following: visual activity, facial muscle function, eyebrows, eyelashes, lacrimal system, pupil, eye motility, corneal sensitivity, Schirmir's test and study of the anterior segment of the ocular bulb with a slit-lamp. The study patients included 275 cases of lepromatous leprosy, 57 tuberculoid, 29 indeterminate and two dimorphous cases. The age of the patients ranged between 18 and 82 years, and 229 of them were males. Among those patients, 183 were whites, 23 were black and 157 were mulatto.

Adolescent↗
PubMed1989

Congenital smooth muscle hamartoma. A report of six cases and a review of the literature.

Congenital smooth muscle hamartoma (CSMH) represents a proliferation of randomly oriented dermal smooth-muscle bundles. Six patients with CSMH were observed, the largest series to date, and the literature was reviewed. Congenital smooth muscle hamartoma has presented as congenital patches or slightly indurated plaques with prominent overlying hair (88% of cases), or rarely as patches with perifollicular papules without prominent hair (12% of cases). Most lesions (61% of cases) have been somewhat hyperpigmented, but 39% of cases have been flesh colored. Congenital smooth muscle hamartoma has occurred on the torso and proximal extremities, except for one case on the eyebrow and eyelid (present study). A positive pseudo-Darier's sign (temporary induration or piloerection after rubbing) helped to differentiate CSMH from congenital hairy nevo-cellular nevus. Congenital smooth muscle hamartoma is a distinct entity that is at one end of a spectrum that includes Becker's nevus, and should be considered in the differential diagnosis of any congenital hairy lesion.

Biopsy↗
PubMed2005

Development of sarcoidosis in cosmetic tattoos.

BACKGROUND: The development of granulomatous lesions within tattoos is a well-recognized occurrence in individuals with sarcoidosis. The characteristic histopathological finding of sarcoidosis is the presence of noncaseating granulomas; however, similar histopathogical findings may be seen in foreign body granulomas. Several reports have challenged the assertion that the presence of foreign material within sarcoidal granulomas is incompatible with a diagnosis of sarcoidosis. OBSERVATIONS: We describe a patient who had multiple linearly arranged papules along her eyebrows and the vermillion border of her upper lip. She had had cosmetic tattooing performed on these areas 3 year prior to presentation. Histopathologic examination revealed sarcoidal granulomas, polarizable foreign material, and pigment granules. Hilar adenopathy was noted on a chest radiograph. After 4 months of treatment with a midpotency topical steroid and doxycycline, she experienced complete clearance of her cutaneous lesions and normalization of chest x-ray film findings. CONCLUSIONS: This case demonstrates a unique adverse result after cosmetic tattooing and highlights the concept that granulomatous histopathologic findings containing foreign material should not be an exclusionary criterion for the diagnosis of sarcoidosis. In this setting, further investigation for the presence of systemic disease is indicated.

Administration, Topical↗
PubMedDate not supplied

Radiofrequency ablation of the nerve to the corrugator muscle for elimination of glabellar furrowing.

Glabellar furrows are caused by hyperdynamic activity of the corrugator supercilii muscles. A minimally invasive, percutaneous technique for eliminating glabellar furrows is described. An insulated, bipolar needle is inserted vertically through the eyebrow skin to entrap the corrugator nerve plexus. To confirm proper positioning, a stimulating current is delivered to the needle during observation of corrugator supercilii muscle response. Radiofrequency energy is then delivered to the needle, thereby ablating the intervening nerve tissue. This technique is in the early stage of optimization and is being evaluated in an ongoing Stanford University Human Subjects protocol, Stanford, Calif. The preliminary results are reported herein.

Cosmetic Techniques↗
PubMedDate not supplied

Experiences with transconjunctival upper blepharoplasty.

Upper blepharoplasty remains a valuable procedure in rejuvenating the upper eyelid. An innovative technique was recently reported whereby medial fat is removed through a transconjunctival approach. This is a preliminary report of our experience with 60 patients treated over the past 10 months using this technique. The technique will be described in detail and cases will be reported. There were no perioperative or postoperative complications. All of the patients are satisfied with the results of their surgical procedure. The technique has the advantage of avoiding an incision of the medial upper eyelid and the inherent risks of excessive scarring in this area. We have found the technique especially useful in secondary blepharoplasty with an isolated prominence of residual medial fat. Other advantages include the following: primary cases in which the surgeon is able to avoid medial extension of the cutaneous incision, patients who possess deep tarsal folds with prominent medial fat, or as an adjunct to eyebrow lifting techniques where in both cases cutaneous excision is unnecessary. No disadvantages have been noted.

Blepharoplasty↗
PubMedDate not supplied

A retrospective comparison of open and endoscopic brow-lifts.

OBJECTIVES: To measure and compare surgical brow elevation with open and endoscopic techniques; to compare patients who did and did not undergo an eyelid procedure in the same setting as the brow-lift; and to determine whether a learning curve exists for a successful endoscopic brow-lift procedure. DESIGN: A retrospective review of patients who underwent coronal, trichophytic, and endoscopic brow-lift surgery from January 1, 1993, to December 31, 1997 (performed by K.A.L.). We analyzed preoperative and postoperative photographs obtained from 10 to 56 months after surgery while masked to the surgical technique used. Measurements included a horizontal baseline drawn through the midpoint of the right and left medial canthi, and extended laterally across the face; the distance from the baseline to the superior border of the medial eyebrow on the right and left sides; and the distance from the baseline to the highest point of the brow on the right and left sides. A second, nonbiased observer analyzed a random sampling of patient photographs to determine the degree of interobserver variation. SETTING: Private facial plastic and reconstructive surgery practice. All procedures were performed in an ambulatory surgery setting. PARTICIPANTS: We identified 125 patients (average age, 54 years) with greater than 10 months of postoperative photographic documentation. We excluded 41 patients owing to several inconsistencies between their preoperative and postoperative photographs and included 84. These patients were divided into 3 groups: those undergoing coronal, trichophytic, and endoscopic procedures. Of the patients undergoing concomitant eyelid procedures, 12 underwent upper lid blepharoplasties; 15, lower lid blepharoplasties; 16, bilateral upper and lower lid blepharoplasties; 6, periorbital laser resurfacing or chemical peel; 1, canthoplasty; and 1, ptosis repair. The endoscopic brow-lift procedure was not performed in this facial plastic surgery practice until 1995. To determine whether better results were obtained in the later half of the study, when the surgeon had more experience, this group was divided between the 14 patients who underwent the procedure from January 1, 1995, to June 30, 1996, and the 20 who did from July 1, 1996, to December 31,1997. MAIN OUTCOME MEASURE: Comparison of preoperative photographs with postoperative 10- to 32-month follow-up photographs and with final 35- to 56-month follow-up photographs. RESULTS: We found no statistically significant difference in: the distance of the medial brow (P =.89) or highest elevated point of the brow (P =.93) between the coronal, trichophytic, and endoscopic groups; the distance that the medial brow (P =.15) or the highest point of the brow (P =.11) was raised for those patients undergoing concomitant eyelid procedures; and the distance that the medial brow (P =.80) or highest point of the brow (P =.79) was raised between the 2 endoscopic brow-lift groups. Interobserver variation in brow measurements was 0.1 cm or less in more than 90% of cases. CONCLUSIONS: Both open and endoscopic brow-lift techniques described herein elevate the entire brow successfully. We found no statistical difference in patients undergoing concomitant eyelid procedures, and there was no identification of a "learning curve" for a successful endoscopic brow-lift with the surgical technique described.

Endoscopy↗
PubMed2004

Impaired volitional closure of the left eyelid after right anterior cerebral artery infarction: apraxia due to interhemispheric disconnection?

BACKGROUND: The inability of volitional unilateral eyelid closure is an uncommon symptom of a central nervous system disorder. When it occurs as the result of a localized brain lesion, it is debated to be a form of supranuclear facial palsy or an apraxic phenomenon. OBJECTIVES: To report and discuss a unilateral (left-sided) higher-order movement disorder of the facial periocular musculature bearing apraxic features. SETTING: University neurology department. PATIENT: A 78-year-old right-handed man was admitted to the hospital with a left-sided brachiofacial hemiparesis of sudden onset. After thrombolysis with intravenous recombinant tissue-type plasminogen activator, the hemiparesis, including the left-sided facial weakness, disappeared. Serial computed tomographic scans showed that the patient was left with a stroke in the right anterior cerebral artery territory, affecting the frontal commissural fibers of the corpus callosum. There were no signs of upper motor neuron facial paresis on the left side when gesturing in a natural context. Eyelid closure was complete during sleep. However, left eyelid closure and elevation of the left eyebrow were not possible on verbal command. In contrast, voluntary innervation of the perioral facial musculature was performed properly. CONCLUSIONS: The voluntary-automatic dissociation of our patient's eyelid closure was suggestive of an apraxic disorder. Disconnection from a praxis center caused by callosal damage may be assumed to be the underlying cause. The unilaterality of the symptom might imply that in a bilaterally organized corticonuclear system such as upper face innervation, it is the crossing fibers that are primarily involved in praxis tasks.

Aged↗
PubMed1994

Primitive neuroectodermal tumor of the orbit.

A 10-year-old girl developed a lump in the lateral aspect of the right eyebrow over a 3-week period. Computed tomography and magnetic resonance imaging revealed a soft-tissue mass in the superolateral aspect of the right orbit associated with zygo-maticofrontal bone erosion and hyperostosis. An incisional biopsy specimen was studied using light microscopy, immunohistochemical staining, and electron microscopy, resulting in a diagnosis of peripheral primitive neuroectodermal tumor. The results of an extensive evaluation for systemic involvement were negative. The patient was subsequently treated with chemotherapy and radiation therapy. Primary primitive neuroectodermal tumor of the orbit is rare. The differential diagnosis and the diagnostic features of this entity are discussed herein.

Child↗
PubMed1979

Delineating the cleft in upper blepharoplasty.

The subject of the esthetic qualities of the upper eyelid-eyebrow complex is discussed and how the cosmetic surgeon should diagnostically evaluate the problems occurring in this area. Emphasis is put on the other contributing factors that may contribute to blepharochalasis of the upper lid other than redundant skin limited to the upper lid space. A blepharoplasty technique with an incision at the supratarsal fold and evaluation of a skin muscle flap is discussed briefly.

Eyelids↗
PubMed1992

The anatomic basis for the design of forehead flaps in nasal reconstruction.

The detailed arterial anatomy of the medial forehead region was evaluated using roentgenographic examinations of injected cadaver heads, anatomic dissections of injected cadaver heads, and Doppler examination of normal subjects. The supratrochlear artery was seen to be the dominant artery of the medial forehead (not the supraorbital). The supratrochlear artery exited the orbit 1.7 to 2.2 cm from the midline, passing superficial to the corrugator and deep to the orbicularis and frontalis muscles. The supratrochlear artery then passes just medial to the eyebrow and pierces the frontalis muscle, ascending the rest of the forehead in a subcutaneous plane 1.5 to 2.0 cm from the midline (paramedian position). The implications of this vascular anatomy on forehead flap design and execution for nasal reconstruction are discussed and clinical cases are presented.

Arteries↗
PubMed1992

Bilobed flap reconstruction of the temporal forehead.

The temporal forehead is a particularly challenging area for reconstruction. Temporal forehead skin lies in a broad flat plane that varies in thickness. The eyebrow, scalp hairline, and lateral canthus comprise its aesthetic boundaries and limit the available tissue for repair of defects. Characteristically, skin tumors of the temporal forehead have extensive subclinical spread and their removal leaves large defects. The goal of temporal forehead reconstruction is to recreate the aesthetic boundaries of the forehead and to regain symmetry with the contralateral side. The temporal forehead bilobed flap is a single-stage procedure that takes advantage of the best color match of adjacent tissue and often allows primary closure of the donor sites in relaxed skin tension lines with minimal distortion. Several cases are presented for illustration of the technique.

Aged↗
PubMed1987

Autosomal recessive inheritance in the Setleis bitemporal 'forceps marks' syndrome.

We present the clinical findings in two children with the Setleis bitemporal "forceps marks" syndrome. The striking features include the following: (1) bitemporal scarring, an anomaly that resembles forceps marks; (2) periorbital puffiness with wrinkling of the skin; (3) abnormalities of the eyebrows; (4) anomalies of the eyelashes; (5) flattening of the nasal bridge with a bulbous nasal tip; (6) increased mobility of the skin, associated with severely redundant facial soft tissue; and (7) normal growth and development. The evidence that suggests that this unusual syndrome is inherited in an autosomal recessive fashion includes the following: (1) seven of the patients have come from the relatively isolated towns of San Sebastian and Aguadilla in Puerto Rico; (2) two sets of affected siblings have been described, and, in both cases, the siblings' parents were normal; and (3) one of the children described herein is the product of a consanguineous mating. Although the pathogenetic mechanism is unknown, Setleis syndrome is clearly inherited as an autosomal recessive trait.

Chromosome Aberrations↗
PubMed1996

New syndrome?: MCA/MR syndrome with multiple circumferential skin creases.

We describe a combination of multiple congenital anomalies, severe psychomotor retardation and symmetrical circumferential skin creases of arms and legs in a 4.5-year-old male. Craniofacial anomalies included: a high forehead, elongated face, bitemporal sparseness of hair, broad eyebrows, blepharophimosis, bilateral microphthalmia and microcornea, severe optic nerve hypoplasia, epicanthic folds, telecanthus, broad nasal bridge, puffy cheeks, microstomia, cleft palate, enamel hypoplasia, micrognathia, microtia with stenotic ear canals and posteriorly angulated ears. Head circumference was on the 10th centile and a CT scan showed dilated lateral ventricles. Intracranial pressure was not increased. Other abnormalities included: short stature, loose skin, hypotonia, pectus excavatum, inguinal and umbilical hernias, severe scoliosis, hypoplastic scrotum, long fingers and overlapping toes. Echocardiography showed tricuspid regurgitation. Chromosomes were apparently normal. Differentiation from "Michelin tire baby syndrome" and amniotic band sequence is discussed.

Abnormalities, Multiple↗
PubMed1996

Variant of Coffin-Siris syndrome or previously undescribed syndrome?

We describe a 23-year-old woman with growth and mental retardation, hypoplasia of the nails and distal phalanges, particularly of the fifth fingers and toes, hirsutism, and a "coarse" face with large mouth and large tongue, and bushy eyebrows. Follow-up from birth to adulthood showed that developmental delay and hypoplasia of nails and distal phalanges are permanent signs. Sparse scalp hair, hypotonia, and feeding difficulties were present in early infancy. Later, growth retardation, hirsutism, and a "coarse" face with midface hypoplasia, broad nose, and large mouth became more impressive. Differential diagnosis includes a number of conditions, particularly Coffin-Siris syndrome, which is the most likely but not completely convincing diagnosis. Therefore, this woman might represent a variant of Coffin-Siris syndrome or a new entity.

Abnormalities, Multiple↗
PubMed1996

Lethal neonatal mandibuloacral dysplasia.

We report on a case of lethal neonatal mandibuloacral dysplasia. Large confluent fontanelles, sparse fine hair and eyebrows, pseudo-exophthalmos, micrognathia, bulbar digits, and short clavicles were present. In addition, we describe for the first time the presence of glandular hypospadias in this disorder. We propose that this neonatally lethal case represents severe expression of mandibuloacral dysplasia.

Clavicle↗