Periocular Region Research Articles

A 10/14 French silicone urinary catheter with inflatable balloon used as novel expansion device in lid reconstruction surgery.

To describe the surgical technique using a 10/14 French silicone urinary catheter as a novel tissue expander for repair of defects after removal of eyelid tumors. This device recruits additional tissue by tissue expansion for repair of large eyelid defects. A prospective noncomparative, interventional case study was conducted over a period of 3 years in which 30 patients were enrolled. All the 30 patients were selected for upper or lower lid Tenzel rotational flap after removal of large malignant tumor, using the tissue expander. A 10/14-French silicone urinary catheter was placed in the periocular region and expanded by graded inflation with normal saline to a total volume of 10 or 14 ml, respectively, over a period of 3 days. On the fourth day before the planned surgery, the catheter balloon was deflated and a modified Tenzel rotational flap was performed to close the defect. Postoperative blink reflex was preserved. There were no cases of wound dehiscence. There was a significant reduction of incision length in upper and lower lid reconstruction with modified Tenzel flap reconstruction. This approach allows for temporary tissue expansion, permitting the closure of large eyelid defects, typically not possible with a conventional Tenzel flap. This also provides excellent functional outcomes without closing patients' eyelids (which limits vision for weeks to months) as is typical of other reconstructive modalities (e.g. Cutler Beard procedure). The device is cost-effective and readily available. The authors believe it is an excellent alternative in the developing world where access to more expensive options is limited.

Analysis of anthropometric measurements taken from the periocular region in healthy young individuals with different somatotypes.

Anthropometric parameters related with the periocular region (PR) have gained great importance with the optical technology used in the treatment of eye defects. They have also become important parameters that determine the limits of treatment in aesthetic surgery procedures in PR and the treatment of orbital diseases. The aim of this study was to examine the relationship of PR measurements with somatotype. Somatotypes were determined by using the Heath-Carter method. Ten indirect anthropometric measurements, namely nasal root (mf-mf), outer chantal distance (ex-ex), inner chantal distance (en-en), interpupillary distance (p-p), right and left palpebral fissure width (ex-en), palpebral fissure height (ps-pi), and orbital height (os-oi), were taken from PR with Image J program. Kruskal-Wallis H test was used to compare data with each other. Post-hoc Mann-Whitney U test was used to find out which group caused statistically significant differences according to the results of the Kruskal-Wallis H test. A statistically significant difference was found between some indirect anthropometric measurements taken from PR and somatotypes (P < 0,05). This difference was found to result from central group somatotype, in which no somatotype component has different effects from another one, for both genders. In almost all of the indirect anthropometric measurements, it was found that balanced ectomorph somatotypes reached the highest median values, while central group somatotypes had the lowest median values. As a result of this study, somatotype affects the appearance of PR. It will be possible to obtain more accurate and reliable results in aesthetic surgery interventions and identification studies. Our study is the first and a pioneer in its field in the literature. It will inspire and guide future researchers, surgeons, anthropologists, and forensic doctors who will work in this field.

Sebaceous carcinoma of nasal ala: a case report

Nasal sebaceous carcinoma is an extremely rare adnexal skin tumor representing 0.2%-4.6% of all malignant neoplastic cutaneous lesions. It is seen most affecting the meibomian glands in the periocular region. Here we share a case of 65-year-old female patient with nasal mass over the right alar region, diagnosed as sebaceous carcinoma and managed with wide local excision of the mass was done defect was reconstructed with a nasolabial flap. Sebaceous carcinoma being very rare in nasal region we want to share the case details.

Do Botulinum Toxin Injections for Upper Face Rejuvenation and Lateral Canthal Rhytids Have Unintended Effects on Tear Production?

To report the influence of botulinum toxin A (BoNTA) injections on basal tear production, as measured by Schirmer's test with anesthesia in patients seeking eyelid surgery. A retrospective cohort of patients requesting esthetic eyelid surgery reviewed by a single clinician between January 2021 to April 2024, assessed with Schirmer's test with anesthesia. Demographic data, history of BoNTA treatment in the periocular region, ocular surface disease index dry eye symptom frequency, and requirement for ocular lubricants were recorded. Patients with no history of BoNTA were designated as group 1. Patients with a positive recent history of periocular BoNTA were designated as group 2. The proportions of eyes with Schirmer's test with anesthesia (basal tear production) test result <5 mm ("low"), 5 to 9 mm ("borderline"), and ≥10 mm ("normal") were compared between groups. Seven hundred twenty-two eyes (361 patients) were assessed, of which 670 eyes (335 patients) met the inclusion criteria. Mean age was 55.1 (range, 17-93) years, with 71.3% female. Schirmer's data in group 1 were "low" at 32.9%, "borderline" at 26.4%, and "normal" at 40.7%. In contrast, group 2 had significantly lower results (P ≤ 0.05), with readings "low" at 48.3%, "borderline" at 26.7%, and "normal" at 25.0%. However, there were no significant differences between groups in ocular surface disease index symptom frequency scores or ocular lubricant requirements. Patients who had received BoNTA injections had significantly lower basal tear production compared with patients who had never received BoNTA. Esthetic BoNTA treatment may be associated with an unintended effect of decreased basal tear production and subsequent risk of dry eye.

Ocular Manifestations in Seborrheic Dermatitis Epidemiology, Clinical Features, and Management: A Comprehensive Review.

Seborrheic dermatitis (SD) often leads to ocular manifestations (OM) that are frequently overlooked. This study comprehensively explains the genesis of these ocular issues, which involves a combination of Malassezia overgrowth, changes in sebum production, and inflammatory responses in the body. The periocular region is rich in sebaceous glands, allowing Malassezia to thrive, which can lead to an inflammatory reaction that spreads to the eye surface, causing disorders such as blepharitis, conjunctivitis, keratitis, and ocular surface diseases. Although epidemiological data are limited, it is well established that ocular involvement occurs in approximately 10%-40% of individuals with SD. Early detection and treatment are crucial to prevent potential vision-threatening complications. A comprehensive diagnostic approach is necessary, including clinical examination, slit-lamp biomicroscopy, tear film analysis, and corneal imaging. Managing these conditions requires a multidisciplinary strategy involving collaboration between dermatologists and ophthalmologists. The treatment should involve topical and systemic medications to address the skin and ocular components. Patient education is critical for improving adherence to therapy, self-management, and the early identification of problems. In the future, it will be essential to investigate the intricate interactions between Malassezia species and host immunological processes. This collective effort will involve creating new biomarkers and diagnostic tools, investigating targeted immunomodulatory drugs and novel lipid-based medicines as potential treatments, and conducting large-scale longitudinal studies to understand the epidemiological patterns and prognostic variables better. By raising awareness, encouraging collaboration across disciplines, and advancing research, healthcare practitioners can significantly improve patients' quality of life with SD and OM.

Comparison of the Skin Microbiota in the Periocular Region between Patients with Inflammatory Skin Diseases and Healthy Participants: A Preliminary Study.

(1) Background: Periocular or periorbital dermatitis is a common term for all inflammatory skin diseases affecting the area of skin around the eyes. The clear etiopathogenesis of periocular dermatitis is still not fully understood. Advances in molecular techniques for studying microorganisms living in and on our bodies have highlighted the microbiome as a possible contributor to disease, as well as a promising diagnostic marker and target for innovative treatments. The aim of this study was to compare the composition and diversity of the skin microbiota in the periocular region between healthy individuals and individuals affected by the specific entity of periocular dermatitis. (2) Methods: A total of 35 patients with periocular dermatitis and 39 healthy controls were enrolled in the study. After a skin swab from the periocular region was taken from all participants, DNA extraction and 16S rRNA gene amplicon sequencing using Illumina NovaSeq technology were performed. (3) Results: Staphylococcus and Corynebacterium were the most abundant bacterial genera in the microbiota of healthy skin. Analysis of alpha diversity revealed a statistically significant change (p < 0.05) in biodiversity based on the Faith's PD index between patients and healthy individuals. We did not observe changes in beta diversity. The linear discriminant analysis effect size (LEfSe) revealed that Rothia, Corynebacterium, Bartonella, and Paracoccus were enriched in patients, and Anaerococcus, Bacteroides, Porphyromonas, and Enhydrobacter were enriched in healthy controls. (4) Conclusions: According to the results obtained, we assume that the observed changes in the bacterial microbiota on the skin, particularly Gram-positive anaerobic cocci and skin commensals of the genus Corynebacterium, could be one of the factors in the pathogenesis of the investigated inflammatory diseases. The identified differences in the microbiota between healthy individuals and patients with periocular dermatitis should be further investigated.

Utility of facial thermography in the recognition of acute pain in hospitalized cats (Felis catus)

Different clinical conditions have been associated with the presence of pain in animals, so understanding the pathophysiological changes associated with their response is essential in in-hospital clinical monitoring. The objective of this study was to describe the usefulness of facial thermography in the recognition of acute pain in hospitalized cats (Felis catus), for which 71 cats were studied with an average weight of 4.3±1.4 Kg and an age average of 4.4±3.5 years. Facial temperature values were obtained in different region of interest (ROI) and compared according to the values of the Grimace pain scale in cats according to the following subclassification: Group 1, control animals (n=10); Group 2, animals classified with score 0-3 (n=21); Group 3, animals classified with score 4-6 (n=30) and Group 4, animals classified with score 7-10 (n=10). The global average temperature of the facial (F), auricular (A), periocular (PO), nasal (N) and rectal (R) regions was 33.7±1.9; 31.4±3.6; 32.1±0.9; 28.9±4.5 and 38.3±0.8 oC respectively. A difference (p&lt;0.05) was observed between the temperature of A and PO as well as between PO and N, but not between A and N. The present study allowed us to show an increase (p=0.0484) in the temperature mean PO ROI in G4 animals compared to G1 and a correlation with R temperature and peak temperature in the PO region in all groups. It is concluded that the increase in temperature of the periocular region and the nasal plane observed through infrared thermal imaging of the facial surface of hospitalized cats suggests the presence of clinically relevant acute pain. Facial thermography is a safe and non-invasive diagnostic method that complements other methods of identifying pain in cats.

Comparison of Ophthalmologists versus Dermatologists for the Diagnosis and Management of Periorbital Atypical Pigmented Skin Lesions.

Background/Objectives: Lentigo maligna (LM) and lentigo maligna melanoma (LMM) are significant subtypes of melanoma, with an annual incidence of 1.37 per 100,000 people in the U.S. These skin tumors, often found in photo-exposed areas such as the face, are frequently misdiagnosed, leading to delayed treatment or unnecessary excisions, especially in the elderly. Facial melanocytic skin tumors (lentigo maligna-LM/lentigo maligna melanoma-LMM) and their simulators (solar lentigo, pigmented actinic keratosis, seborrheic keratosis and lichen planus-like keratosis) often affect the periocular region. Thus, their diagnosis and management can involve different medical figures, mainly dermatologists and ophthalmologists. This study aimed to evaluate the ability of ophthalmologists to diagnose and manage pigmented skin lesions of the periorbital area. Methods: A multicentric, retrospective, cross-sectional study on a dataset of 79 periorbital pigmented skin lesions with both clinical and dermoscopic images was selected. The images were reviewed by six ophthalmologists and two dermatologists. Descriptive statistics were carried out, and the accuracy, sensitivity, and specificity, with their 95% confidence interval (95% CI), were estimated. Results: Ophthalmologists achieved a diagnostic accuracy of 63.50% (95% CI: 58.99-67.85%), while dermatologists achieved 66.50% (95% CI: 58.5-73.8). The sensitivity was lower for ophthalmologists in respect to dermatologists, 33.3% vs. 46.9%, respectively. Concerning the case difficulty rating, ophthalmologists rated as "difficult" 84% of cases, while for dermatologists, it was about 30%. Management was also consistently different, with a "biopsy" decision being suggested in 25.5% of malignant lesions by ophthalmologists compared with 50% of dermatologists. Conclusions: Ophthalmologists revealed a good diagnostic potential in the identification of periorbital LMs/LMMs. Given progressive population ageing and the parallel increase in facial/periorbital skin tumors, the opportunity to train new generations of ophthalmologists in the early diagnosis of these neoformations should be considered in the next future, also taking into account the surgical difficulty/complexity of this peculiar facial area.

Multimodal optical imaging of the oculofacial region using a solid tissue-simulating facial phantom.

Spatial frequency domain imaging (SFDI) applies patterned near-infrared illumination to quantify the optical properties of subsurface tissue. The periocular region is unique due to its complex ocular adnexal anatomy. Although SFDI has been successfully applied to relatively flat in vivo tissues, regions that have significant height variations and curvature may result in optical property inaccuracies. We characterize the geometric impact of the periocular region on SFDI imaging reliability. SFDI was employed to measure the reduced scattering coefficient ( ) and absorption coefficient ( ) of the periocular region in a cast facial tissue-simulating phantom by capturing images along regions of interest (ROIs): inferior temporal quadrant (ITQ), inferior nasal quadrant (INQ), superior temporal quadrant (STQ), central eyelid margin (CEM), rostral lateral nasal bridge (RLNB), and forehead (FH). The phantom was placed on a chin rest and imaged nine times from an "en face" or "side profile" position, and the flat back of the phantom was measured 15 times. The measured and of a cast facial phantom are accurate when comparing the ITQ, INQ, STQ, and FH to its flat posterior surface. Paired tests of ITQ, INQ, STQ, and FH and concluded that there is not enough evidence to suggest that imaging orientation impacted the measurement accuracy. Regions of extreme topographical variation, i.e., CEM and RLNB, did exhibit differences in measured optical properties. We are the first to evaluate the geometric implications of wide-field imaging along the periocular region using a solid tissue-simulating facial phantom. Results suggest that the ITQ, INQ, STQ, and FH of a generalized face have minimal impact on the SFDI measurement accuracy. Areas with heightened topographic variation exhibit measurement variability. Device and facial positioning do not appear to bias measurements. These findings confirm the need to carefully select ROIs when measuring optical properties along the periocular region.

Fat or fillers: The dilemma in eyelid surgery

The aging of the periocular region has always aroused great interest. A fresh, young, and attractive sight determined an ever-greater attention to surgical and non-surgical techniques to obtain this result. In particular, the change in the concept of a young look, considered then “full”, led to the increasing use of surgical (fat grafting) or medical (hyaluronic acid) filling techniques. Eyelid rejuvenation became increasingly popular in the field of cosmetic treatments, with a focus on achieving a youthful and refreshed appearance. Among the various techniques available, the choice between using fat grafting or fillers presented a clinical dilemma. In particular, what surgery considered of fundamental importance was a long-lasting result over time. On the other hand, aesthetic medicine considered it fundamental not to have to resort to invasive treatments. But what was the reality? Was there one path better than the other, and above all, was there a better path for patients? The minireview aims to explore the physiopathology, diagnosis, treatment options, prognosis, and future studies regarding this dilemma. We analyzed the literature produced in the last 20 years comparing the two techniques. Current literature reveals advancements in biomaterials, stem cell research and tissue engineering held promise for further enhancing the field of eyelid rejuvenation. The choice between fat grafting and fillers in eyelid cosmetic treatments presented a clinical dilemma. Understanding physiopathology, accurately diagnosing eyelid aging, exploring treatment options, assessing prognosis, and conducting future studies were essential for providing optimal care to patients seeking eyelid rejuvenation.

Person Authentication System Using Multimodal Biometrics

Biometrics is the automated process used to recognize human by measuring their behavioural and physiological characteristics. Biometrics are generally used either for verification The use of biometric for identification purposes requires that a particular biometric factor be unique for each individual that it can be calculated, and that it is invariant over time. Biometrics such as signatures, photographs, fingerprints, voiceprints and retinal blood vessel patterns all have noteworthy drawbacks. Although signatures and photographs are cheap and easy to obtain and store, they are impossible to identify automatically with assurance, and are easily forget. Human iris on the other hand as an internal organ of the eye and as well protected from the external environment, yet it is easily visible from within one meter of distance makes it a perfect biometric for an identification system with the ease of speed, reliability and automation Iris recognition is an automated method of biometric identification that uses mathematical pattern-recognition techniques on images of the irises of an individual’s eyes, whose complex random patterns are unique. Proposed system provides a comprehensive implementation of periocular biometrics and a deep insight of various aspects such as utility of peri-ocular region In this project face and eye points are captured using Grassmann algorithm and Gabor filter for eye features extraction. Each trait is analysed separately and given its own score. The results are combined using deep leaning algorithm to provide a single decision in real time environments.

Periocular Asymmetry Index in Caucasian Populations Using Three-dimensional Photogrammetry Assessment.

To quantitatively assess the periocular asymmetry and investigate its sex and age-related differences in a Caucasian population using three-dimensional (3D) stereophotogrammetry. Standardized 3D photos of the periocular region of 301 Caucasians were taken using the VECTRA M3 3D Imaging System. Standardized landmarks were positioned, and data measurements in the periocular region were obtained from these images using VAM software and assessed using intraclass correlation coefficients (ICC) for reliability. Absolute differences and asymmetry index between the right and the left periocular region were calculated with a focus on gender and age-related differences. Fissure height asymmetry was positively correlated with age (p < 0.01). Furthermore, reflex distance asymmetry was positively correlated with age in the elderly group (p < 0.05). Absolute differences of upper eyelid crease were 0.65 ± 0.79 mm for females and 0.90 ± 0.94 mm for males (p < 0.05). In the elderly group, the absolute differences of reflex distance were 0.664 ± 0.471 mm for males and 0.470 ± 0.408 mm for females (p < 0.05), while the absolute differences of fissure height were 0.619 ± 0.469 mm and 0.436 ± 0.372 mm, respectively (p < 0.05). All measurements had an inter-rater ICC and intra-rater ICC between 0.761 and 0.957. Periocular asymmetry is more prominent in older and male people. 3D photogrammetry is a reliable tool to detect periocular asymmetry and might provide an accurate and effective reference for periocular cosmetic, plastic, and reconstructive surgery in the clinical routine. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors. www.springer.com/00266 .

Correlation of udder thermogram and somatic cell counts as a tool for detection of subclinical mastitis in buffaloes.

This study aimed to monitor the mammary health of 37 multiparous Murrah buffaloes through infrared thermography (IRT). Based on the California Mastitis Test (CMT) and milk somatic cell counts (SCC), buffaloes were grouped into healthy (H, n = 16), subclinical mastitis (SCM, n = 10), and clinical mastitis (CM, n = 11). Buffaloes were milked twice daily in the morning (5:00-6:00 AM) and evening (5:00-6:00 PM). Rectal temperature and respiratory rates were recorded, CMT was performed and thermal images of the mammary gland of all the buffaloes were taken before and after each milking. Milk samples were analysed after each milking for SCC, fat, Solids-Not-Fat (SNF), density, protein, lactose, salts, conductivity, and pH immediately in the laboratory from fresh milk samples. The surface temperature of the periocular region of both the eyes, muzzle, flank, and vagina were also taken. Thermal images were used to assess the surface temperature of the udder (USST), teat apex (TAT), teat barrel (TB1T), teat base (TB2T), and teat skin surface (TSST). Eye and USST showed significantly higher temperatures (p < 0.05), whereas skin surface temperatures (SST) of different body parts were non-significant in both SCM and CM animals than buffaloes in the H group. Milk SCC showed a positive correlation with conductivity (r > 0.7), salts, and pH (r < 0.6) and a negative correlation with fat, SNF, density, protein, and lactose. TAT, TB1T, TB2T, TSST, and USST were positively correlated with milk SCC. Receiver Operating Characteristic (ROC) analysis of H and SCM groups showed that USST before milking had optimum sensitivity (Se = 0.80) and specificity (Sp = 0.906) among the various skin temperatures recorded. Thermal images captured during the morning showed higher sensitivity compared to images taken in the evening. Results indicate IRT can be used to monitor the mammary health of buffaloes but using IRT in conjunction with milk SCC can help in the accurate prediction of SCM in dairy buffaloes.

ShellNeRF: Learning a Controllable High‐resolution Model of the Eye and Periocular Region

AbstractEye gaze and expressions are crucial non‐verbal signals in face‐to‐face communication. Visual effects and telepresence demand significant improvements in personalized tracking, animation, and synthesis of the eye region to achieve true immersion. Morphable face models, in combination with coordinate‐based neural volumetric representations, show promise in solving the difficult problem of reconstructing intricate geometry (eyelashes) and synthesizing photorealistic appearance variations (wrinkles and specularities) of eye performances. We propose a novel hybrid representation ‐ ShellNeRF ‐ that builds a discretized volume around a 3DMM face mesh using concentric surfaces to model the deformable ‘periocular’ region. We define a canonical space using the UV layout of the shells that constrains the space of dense correspondence search. Combined with an explicit eyeball mesh for modeling corneal light‐transport, our model allows for animatable photorealistic 3D synthesis of the whole eye region. Using multi‐view video input, we demonstrate significant improvements over state‐of‐the‐art in expression re‐enactment and transfer for high‐resolution close‐up views of the eye region.

The effect of traction force on eyelid blood perfusion during closure of defects

ABSTRACT Purpose In oculoplastic surgery the eyelid tissue is frequently stretched in order to repair defects after tumor surgery. However, there is a paucity of research regarding how stretching affects eyelids. The purpose of this study was to gain insight into how traction force affects eyelid stretch as well as tissue perfusion, using a laser-based in vivo monitoring technique. Method Lower-lid pentagonal resections were performed in eight patients and a total of nine eyelids. The medial section of the eyelid was then stretched using a dynamometer up to a force of 2.3 Newtons (N), and eyelid stretching and blood perfusion were continuously measured using laser speckle contrast imaging. Results Tissue perfusion decreased exponentially when eyelid tissue was stretched, with an initial sharp decline followed by a more gradual reduction. Perfusion approached zero at a force of approximately 2.0 N. The length of the eyelid increased with increasing force up to 1.5 N, after which there was only a very slight increase in length. Conclusions Eyelid tissue seems to respond to traction in a non-linear fashion, where the initial force results in the greatest eyelid stretching and reduction in blood perfusion. The results provide information on the effects of a large force for direct closure of large eyelid defects. Considering how quickly perfusion approaches zero, the high success rate of eyelid reconstruction surgery is likely a testament to the extensive vascularization of the periocular region.

Frozen Section Histoanatomy of the Peritarsal Eyelid.

Mohs surgery of eyelid skin cancers requires detailed knowledge of anatomy for precise surgery and accurate evaluation of histology. To review the histology of the peritarsal eyelid using frozen sections as encountered intraoperatively by Mohs surgeons. The authors review the literature describing the anatomy and histology of the peritarsal eyelid from the lens of a Mohs surgeon. Histology from select Mohs cases is used to frame the discussion of the microanatomy of this region. The peritarsal eyelids contain a unique mixture of skin, muscle, tarsus, glandular tissue, and conjunctiva. The histologic appearance of many of these structures differs from skin found outside of this anatomic region. Tumors of the eyelid and periocular region may mimic normal histologic structures found within the peritarsal eyelid. The peritarsal eyelids have unique anatomy and associated histologic structures. Knowledge of the detailed histoanatomy is required for confident execution of Mohs surgery in this anatomic region.

Basal cell carcinoma at the pinna

Basal cell carcinoma (BCC) is the most common type of non melanoma cutaneous malignancy BCC usually present on sun exposed area such as nose, mandibular, periocular region. A review of the literature revealed only a few reports of BCC on the auricle or conchal bowl. Objectives were to report a case of BCC of right pinna. A 62 year old man presented to ENT OPD with a painless blackish lesion in the right pinna appreciated since 6 months and progressively increased to the present size. On local examination of the pinna a blackish plaque with irregular margins was appreciated in the cocha, helical crus and incisura. It was soft to firm in consistency and tenderness absent. Wide excision of the lesion with healthy margin done under local anesthesia. Histopathology of excised specimen confirmed the lesion as BCC. BCC of pinna is an uncommon external ear pathology which should be kept as a differential diagnosis of lesions of the pinna by the otorhinolaryngologist.

E2F-Net: Eyes-to-face inpainting via StyleGAN latent space

Face inpainting, the technique of restoring missing or damaged regions in facial images, is pivotal for applications like face recognition in occluded scenarios and image analysis with poor-quality captures. This process not only needs to produce realistic visuals but also preserve individual identity characteristics. The aim of this paper is to inpaint a face given periocular region (eyes-to-face) through a proposed new Generative Adversarial Network (GAN)-based model called Eyes-to-Face Network (E2F-Net). The proposed approach extracts identity and non-identity features from the periocular region using two dedicated encoders have been used. The extracted features are then mapped to the latent space of a pre-trained StyleGAN generator to benefit from its state-of-the-art performance and its rich, diverse and expressive latent space without any additional training. We further improve the StyleGAN's output to find the optimal code in the latent space using a new optimization for GAN inversion technique. Our E2F-Net requires a minimum training process reducing the computational complexity as a secondary benefit. Through extensive experiments, we show that our method successfully reconstructs the whole face with high quality, surpassing current techniques, despite significantly less training and supervision efforts. We have generated seven eyes-to-face datasets based on well-known public face datasets for training and verifying our proposed methods. The code and datasets are publicly available.11https://github.com/fatemejamalii/E2F-Net

Review of recent advances in managing periocular skin malignancies.

Management of cutaneous malignancies can be particularly challenging when they are located in the periocular region. The standard of care for localized disease is complete surgical excision, but this may not be possible without significant disruption to visual structures and facial appearance. Definitive radiation may be an option for some patients who cannot or do not wish to undergo surgery. Advances in systemic treatment options for locally advanced and metastatic skin cancers in the past 10 years have prompted investigation into neoadjuvant treatment of periocular cancers. The use of chemotherapy, immune checkpoint inhibitors, and targeted therapies have all been reported with varying degrees of success. For many patients, targeted therapies or immune checkpoint inhibitors should be considered depending on the cancer type, symptoms, and goals with the input of a multidisciplinary cancer care team. In this article, we systematically review the latest updates in surgical, radiotherapeutic, and medical management of periocular malignancies.

Long-term results after surgical basal cell carcinoma excision in the eyelid region: revisited.

The aim of the study was to readdress basal cell carcinoma (BCC) in the periocular region to prove the efficacy of histologically controlled surgical treatment and to identify high-risk characteristics.Retrospective analysis of 451 microscopically controlled BCC excisions in the periocular region. Tumor location, tumor size, AJCC 7 classification, and histological results were recorded. The same procedure was followed for recurrences.Arecurrence rate of 5.0% was observed after the first microscopically controlled excision. Recurrent BCCs show ashift from nodular to sclerosing BCC as the primary histological type as well as achange in primary location from lower eyelid to medial canthus. The frequency of BCC with deep extension increased from 7.3% to 24.7%, and 57.1% after the second and third operations, respectively. The recurrence rate increased to 9.5% and 42.9%, after the second and third operations, respectively.In conclusion, we are facing the same challenges in surgical BCC treatment as 30years ago. The distribution of periocular BCC location, histologic subtype and recurrence rates mirror the literature und the general consensus. The recurrence rate increases with every operation needed. Sclerosing BCCs with deep extension at the medial canthus bear the greatest risk for recurrence. In such cases, centers of expertise should be consulted and additional treatment options should be considered.