Portion Of Orbicularis Oculi Muscle Research Articles

Efficacy of tightening of orbicularis oculi muscle in patients with functional nasolacrimal duct obstruction

ABSTRACTPurpose: To evaluate the efficacy of tightening of lateral portion of orbicularis oculi muscle in patients with functional nasolacrimal duct obstruction (FNLDO).Methods: This is an interventional cross-section study for evaluation of effect of orbicularis oculi tightening procedure in patients with FNLDO. Patients with unexplained epiphora, open lacrimal system in syringing and evidences of lacrimal pump weakness in lacrimal scintigraphy underwent surgery. In this procedure, a stripe of preseptal and pretarsal orbicularis muscle was dissected, slightly resected and secured to the periosteum of lateral orbital rim. Each subject completed a questionnaire about the intensity of epiphora before surgery and 1, 3 and 6 months after surgery. Furthermore, fluorescein dye disappearance test (FDDT) was performed before surgery and repeated in the follow-up visits. At last visit, the pre- and post-operative data were analyzed and compared.Results: Fifteen eyes of 12 patients (5 males and 7 females) with the mean age of 56.7 years included in the study. Severity of epiphora and tearing effect on daily life were significantly improved following the operation. FDDT result was improved significantly after 1 month follow-up in all eyes (15 eyes), at 3 months follow-up in 80% of eyes (12 eyes) and at the end of the 6th month in 66.7% of eyes (10 eyes). Subjective and objective success rates were 87% and 80%, respectively. No significant complications or side-effects were observed.Conclusion: Tightening of lateral portion of preseptal and pretarsal orbicularis muscle seems an effective, safe, and easy procedure to decrease epiphora in patients with FNLDO.

The Quantitative Effect of Botulinum Toxin A Over Brow Height

Botulinum toxin type A (BTX-A) is currently used in temporal brow lifting. Reducing the activity of the superolateral portion of orbicularis oculi muscle causes lateral brow elevation. The objective of this study was to determine the quantitative brow elevation after paralysis of the superolateral portion of orbicularis oculi muscle. This study includes 10 female patients. Six units of BTX-A were injected into the superolateral portion of the orbicularis oculi in a serial manner into 3 points, below the lateral half of the brow at each side. Bilateral measurements were obtained by using calipers, immediately before and 2 weeks after the treatment. The medial canthus to the medial brow margin (AB), the lateral brow margin to the lateral canthus (CD), the medial brow margin to the lateral brow margin (BC), the brow apex to upper lid margin at the level of the lateral limbus (EF), the brow apex to the medial brow margin (EB), the brow apex to the lateral brow margin (EC), and upper eyelid margin to lower eyelid margin at the level of the pupil (GH), were measured. There were no statistically significant differences found between pretreatment and posttreatment left and right measurements. There were statistically significant increases in CD, EF, and GH measurements, which are point out brow elevation. There were no statistically significant differences found in other measurements. Same doses of BTX-A application did not disrupt symmetry. Applications of 6U BTX-A to the superolateral portion of orbicularis oculi provide brow elevation and increased interpalbebral distance and upper eyelid distance. Our study has confirmed that BTX-A treatment of superolateral portion of the orbicularis oculi muscle produces quantitative temporal brow elevation.

Surgical facial rejuvenation in younger patients

Gordon H. Sasaki, MD Nicanor G. Isse, MD Thomas A. B. Bell, MD Gregory L. Ruff, MD Dr. Sasaki: I am pleased to moderate this panel about surgical facial rejuvenation in younger patients. We will focus solely on surgical procedures, ignoring treatments such as radiofrequency, laser, chemical peels, soft tissue fillers, and Botox. Aesthetic plastic surgeons are seeing an increased number of younger patients for surgical facial rejuvenation. This trend is related to greater personal and societal acceptance of aesthetic surgical procedures and to more acceptable and available surgical options for the younger patient. Another factor has been the increase in discretionary income to meet such goals. Younger patients present unique demands, including the request for procedures that produce less visible scars and have a quicker recovery time. They may also expect the less invasive procedures to yield the same long-lasting effects that are observed after more extended procedures. These patients are also concerned about the impact of surgeries performed when they are young on their aging and on future surgical procedures. The first patient is a 31-year-old woman who has concerns about her angry appearance, lower lid puffiness, midface irregularities, and weak chin (Figure 1). She has had no prior surgical procedures, Botox, or soft tissue fillers. Dr. Isse, how would you evaluate and treat this patient? Figure 1 This 31-year-old woman has had no previous surgeries. She is concerned with her angry appearance, lower lid puffiness and hollow deepening of the nasolabial line, flattened cheeks, and lack of chin definition. Dr. Isse: In general, the patient has symmetrical facial structures. The “angry” appearance results from a low-medial brow position in relation to the central and lateral brow. This condition is due to overactive glabella muscles (medial portion of orbicularis oculi muscle, depressor supercilli, and procerus). My treatment of choice would …

Scleral show.

"Scleral show" is an anatomical condition in which the sclera area is visibly exaggerated due to constitutional, evolutive, or endocrine etiology. It can also occur because of iatrogenies, and is considered one of the most complex blepharoplasty complications. Its evolution and poor response to treatment are questionable. The defect is not always linked to an ectropion, and the basic differences between the two are explained. During blepharoplasties, in order to avoid iatrogenic "scleral show," among other complications, one should take special precautions with the quantity and the exact location of the tarsal portion of orbicularis oculi muscle to be resected.