OBJECTIVETo evaluate the therapeutic effects of two anastomoses (canaliculus-to-lacrimal sac anastomosis and end-to-end anastomosis) on nasolacrimal laceration for over 7 mm from the broken end to the dacryon.

METHODSA total of 71 patients (44 males and 27 females, aged 16-55 years, mean equal to 34.32 years) with fresh canalicular laceration were treated in our hospital from March 2003 to April 2008. Under a microscope, 37 patients were treated with lacrimal sac anastomosis (the treatment group) and 34 with end-to-end anastomosis (the control group), detaining silicone tubes till 3 months later.

RESULTSThe cure rate of the treatment group (89.19%) was significantly higher than that of the control group (55.56%). Class I cure rates were 70.27% in the treatment group and 47.06 % in the control group, and the difference between the two groups was significant (P less than 0.05). Postoperative inflammatory reactions had significant influences on the two kinds of anastomosing methods, but no significant difference was found between the two groups (P larger than 0.05).

CONCLUSIONSWhen the distance from the broken end to the dacryon is over 7 mm, especially when it is necessary to find the paranasal broken end of the lacrimal canaliculus with dacryocystotomy, canaliculus-to-lacrimal sac anastomosis is a better treatment method than end-to-end anastomosis for laceration of lacrimal canaliculus.

Adolescent ; Adult ; Anastomosis, Surgical ; Female ; Humans ; Lacerations ; surgery ; Lacrimal Apparatus ; injuries ; surgery ; Male ; Middle Aged ; Postoperative Complications ; Treatment Outcome

We report four unusual cases of upper eyelid retraction following periorbital trauma. Four previously healthy patients were evaluated for unilateral upper eyelid retraction following periorbital trauma. A 31-year-old man (Case 1) and a 24-year-old man (Case 2) presented with left upper eyelid retraction which developed after blow-out fractures, a 44-year-old woman (Case 3) presented with left upper eyelid retraction secondary to a periorbital contusion that occurred one week prior, and a 56-year-old man (Case 4) presented with left upper eyelid retraction that developed 1 month after a lower canalicular laceration was sustained during a traffic accident. The authors performed a thyroid function test and orbital computed tomography (CT) in all cases. Thyroid function was normal in all patients, CT showed an adhesion of the superior rectus muscle and superior oblique muscle in the first case and diffuse thickening of the superior rectus muscle and levator complex in the third case. CT showed no specific findings in the second or fourth cases. Upper eyelid retraction due to superior complex adhesion can be considered one of the complications of periorbital trauma.
Accidents, Traffic ; Adult ; Eye Injuries/*complications/surgery ; Eyelid Diseases/*etiology/radiography ; Female ; Humans ; Lacerations/complications/surgery ; Lacrimal Apparatus/*injuries ; Male ; Middle Aged ; Oculomotor Muscles ; Orbital Fractures/*complications/surgery ; Tomography, X-Ray Computed

To report on an epithelial inclusion cyst of the iris that was successfully treated with needle aspiration and Ab externo laser photocoagulation. A 6-year-old boy was treated for a 6.0 mm fluid-filled cyst in the anterior chamber of the right eye. Thirteen months previously, he had undergone primary closure of a 6 mm full-thickness corneal laceration. The subsequent cyst was diagnosed as an epithelial inclusion cyst of the iris. His vision decreased to finger-count at 30 cm as the cyst grew over the pupil. We performed needle aspiration of the cyst and Ab externo laser photocoagulation of the cyst wall. The treated lesion was completely removed. The patient's visual acuity recovered to 20/40 without complications. There was no recurrence as determined by slit lamp examination up to 6 months after treatment. Needle aspiration and Ab externo laser photocoagulation can be used to effectively treat epithelial inclusion cysts of the iris.
Biopsy, Fine-Needle ; Child ; Cornea/injuries ; Cysts/etiology/*pathology/surgery ; Epithelial Cells/*pathology ; Eye Injuries, Penetrating/complications/surgery ; Humans ; Iris Diseases/etiology/*pathology/surgery ; Lacerations/complications/surgery ; Laser Coagulation ; Male ; Play and Playthings/injuries

Surgery, Chonnam University Hospital from Jan. 1, 1992 to Dec. 31, 1996. Results obtained were as follows : The patients age ranged between 3-73 years. The third decade age group revealed the highest incidence of the fracture (35.0%), followed by the second decade (20.2%) and the fourth (17.3%) in order. Two hundred and sixteen patients were male and 61 patients were female (the ratio of male to female was 3.7:1. The fracture was at the highest incidence in August (13.4%), followed by in October (12.3%) and September (11.9%). The most common cause of the fracture was traffic accidents (33.9%), followed by falling down (24.9%) and violence (17.7%). The most common site of the fracture was symphysis (44.3%), followed by condyle (27.3%) and angle(21.5%). The most commonly occurred concomitant facial injury was facial laceration (33.9%). Concomitant injuries of other parts of body were most commonly caused by traffic accident (75.7%) and head and neck were the most common site of the injury (41.7%). Of the 277 patients, 258 patients (93.1%) were treated by open reduction. The average period of intermaxillary fixation was 9.4 days. Postoperative complications were found in 24 (8.7%) of 277 patients in which local infection (5.4%) was the most common. These results suggest that the mandibular fracture is commonly associated with concomitant injury of other parts of body, so that team approaches with other medical departments are recommended for its appropriate diagnosis and treatment.]]>
Accidents, Traffic ; Diagnosis ; Facial Injuries ; Female ; Head ; Humans ; Incidence ; Inpatients ; Jeollanam-do ; Lacerations ; Male ; Mandibular Fractures ; Neck ; Postoperative Complications ; Social Environment ; Surgery, Oral ; Violence