Overaction of the inferior oblique muscles is the most common clinical form of the motility disturbance of oblique muscles which has been rarely studied in Vietnam. 150 patients aged of 4years old and older suffered from strabismus with disturbance of the oblique muscles (78.6% of them had overaction of the inferior obliquemuscle) were studied in National Institute of Ophthalmology. Objectives: to identify the clinical forms and characteristics, to evaluate the results of operation. Method: This study was designed belongs to prospective clinical trial in hospital. The operated patients were observed and evaluated during 2 years after surgery divided into three terms (short term, medium and long term). The results of surgery was optimistic. Conclusion: overaction of the inferior oblique is a clinical form of motility disturbance of the oblique muscles having the best surgical results.
Muscles, Therapeutics, Surgery

During 1996-1997, the Pediatric Dep. of the Institute of Opthamology operated the recession of the levator muscle for the treatment of upper eyelid retraction. All 10 patients experienced the moderate retraction (2-4 mm). There was no intraoperative complication. The postoperative complication comprised relapsed retraction (3), relapsed eyelid prolapsed and eyelid fold was bigger than normal (8).
Muscles ; Eyelids ; surgery

Dysphonia/therapy* ; Humans ; Laryngeal Muscles/surgery*

Endoscopy ; Female ; Humans ; Middle Aged ; Nose ; surgery ; Oculomotor Muscles ; surgery

PURPOSE: The purpose of our study was to evaluate the volume of pre- and post operative masseter muscle and bite force in mandibular prognathic patients treated with SSRO with the use of the 3D CT imaging technique and occlusal force meter. MATERIALS AND METHODS: The study group consisted of 12 patients with mandibular prognathism (5 males and 7 females) who underwent mandibular setback surgery (BSSRO) in the Department of Oral and Maxillofacial Surgery, Samsung medical center. Bite force was measured at pre op, post op 3, 6 and 12 months by occlusal force meter(GM10, Nagano Keiki, Japan) The preoperative CT examination of subjects was performed between one month prior to operation and one year after to operation. And muscle volume was measured. RESULT: As compared to preoperative measurements at 1 year postoperatively the masseter and internal pterygoid muscle volume were diminished (p<0.05) The bite force steadily recovered, so at postoperatively 6 months reached the preoperative level. And at 1 year after operation, the maximum bite force was significantly greater than preoperative levels. No significant correlation was presented between masseter muscle and bite force (p>0.05), internal pterygoid muscle and bite force (p>0.05). CONCLUSION: In this study, the results showed that volume and bite force of the masticatory muscles decresed significantly immediate after orthognathic surgery for mandibular set-back. However, reduction of maximum bite force disappears within 6 months after surgery.
Bite Force ; Bites and Stings ; Humans ; Male ; Masseter Muscle ; Masticatory Muscles ; Muscles ; Orthognathic Surgery ; Prognathism ; Pterygoid Muscles ; Surgery, Oral

OBJECTIVETo investigate the role of releasing the fibrous bundles across the levator muscle between the medial canthus and lateral canthsus near the top of tarsus in the correction of the congenital blepharoptosis.

METHODSTwenty-seven patients with 40 eyes of blepharoptosis were undergoing the treatment. It was performed by releasing the fibrous bundles across the levator muscle between the medial canthus and lateral canthsus near the top of tarsus to correct the mild and moderate blepharoptosis. A further procedure can also be added to by folding the levator aponeurosis if necessary. In the severe blepharoptosis, the frontalis aponeurose flap may be applied for the suspension as well during the operation.

RESULTSOf the 40 eyes in 27 cases with mild, moderate and severe blepharoptosis were treated by using this method, with 38 eyes corrected satisfactorily and 2 eyes corrected mostly in the following-ups from 3 months to 1 year.

CONCLUSIONThe above mentioned technique may be a good, simple and effect method to corret congenital blepharoptosis.

Adolescent ; Blepharoplasty ; methods ; Blepharoptosis ; congenital ; surgery ; Child ; Eyelids ; surgery ; Facial Muscles ; Humans ; Oculomotor Muscles ; surgery ; Surgical Flaps

OBJECTIVETo investigates the surgical treatment for congenital anophthalmia.

METHODSThe operation was performed in two steps. At first, the orbit was enlarged and the tarsus was reconstructed with cartilage transplantation. At the second step, blepharoptosis was corrected with levator shortening or frontalis muscle suspension.

RESULTSFive cases have been treated successfully with this method and satisfactory results were obtained.

CONCLUSIONOrbit amplification and tarsus reconstruction along with ptosis correction is an effective treatment for anophthalmia both aesthetically and functionally.

Anophthalmos ; surgery ; Blepharoplasty ; Blepharoptosis ; congenital ; surgery ; Cartilage ; transplantation ; Facial Muscles ; surgery ; Humans ; Oculomotor Muscles ; surgery ; Orbit ; surgery ; Reconstructive Surgical Procedures ; Surgical Flaps ; Treatment Outcome

BACKGROUND AND PURPOSE: Hemifacial spasm is clinically characterized by involuntary co-contraction of unilateral facial muscles innervated by facial nerve and presence of synkinetic response between facial muscles innervated by different branches of facial nerve is considered as the electrophysiological hallmark of this disease. We performed this study in order to analyse and thereby to approach the pathogenesis of these synkinetic responses in detail. METHODS: Blink reflex test was applied to the 21 patients with hemifacial spasm. With some modification of conventional blink reflex methodology, synkinetic responses between orbicularis oculi and orbicularis oris muscles were recorded on both affected and unaffected sides. RESULTS: Among 21 patients, 10( 47.6% ) showed synkinetic responses both on affected and unaffected side, 8( 38.1% ) only on affected side, and 3( 14.3% ) did not show any evidence of synkinesis on either side. CONCLUSION: These findings could be considered as additional supportive evidence that the facial neuronal hyperexcitability is working in hemifacial spasm as synkinesis on unaffected side cannot be explained solely by peripheral mechanism. Further research on change of synkinetic behavior after microvascular decompression surgery seems to be needed.
Blinking* ; Facial Muscles ; Facial Nerve ; Hemifacial Spasm* ; Humans ; Microvascular Decompression Surgery ; Muscles ; Neurons ; Synkinesis

OBJECTIVETo identify the factors that affect the safety and efficacy of peroral endoscopic myotomy (POEM) for treatment of achalasia.

METHODSData of consecutive patients undergoing POEM for confirmed achalasia between December, 2010 and December, 2015 were collected, including the procedure time, approach of tunnel entry incision, approach of myotomy, complications and follow-up data.

RESULTSAmong the total of 439 patients enrolled, the overall complication rate was 28.7% (126/439). Treatment success (Eckardt score≤3) was achieved in 94.5% of 364 patients followed up for a median of 6 months (1-48 months), and the mean score was reduced significantly from 6.7∓1.5 before treatment to 1.2∓1.1 after the treatment (P<0.05). Logistic regression revealed that the year when POEM was performed and the approach of entry incision were two significant factors contributing to complications: with the year 2015 as the reference, the odds ratio (OR) was 9.454 (95% CI: 2.499-35.76) for the years before 2011, 2.177 (95% CI: 0.794-5.974) for 2012, 3.975 (95% CI: 1.904-8.298) for 2013, and 1.079 (95% CI: 0.601-1.940) for 2014; with the longitudinal entry incision as the reference, the OR was 0.369 (95% CI: 0.165-0.824) for inverted T entry incision and 0.456 (95% CI: 0.242-0.859) for transverse entry incision. The approach of myotomy was the significantly associated with symptomatic relapse: with full-thickness myotomy combined with indwelling an anti-reflux belt as the reference, the OR was 0.363 (95% CI: 0.059-2.250) for gradual full-thickness myotomy, 2.137 (95% CI: 0.440-10.378) for circular muscle myotomy, and 4.385 (95% CI: 0.820-23.438) for circular muscle myotomy in combination with balloon shaping; the recurrence rate was 0 with a full-thickness myotomy.

CONCLUSIONThe complication rates of POEM appears to decrease over time, and an inverted T entry incision is the best choice for controlling the complications. Gradual full-thickness myotomy is an excellent approach for treatment of achalasia in terms of the relapse rate, procedure time and the incidence of reflux esophagitis.

Endoscopy ; Esophageal Achalasia ; surgery ; Esophagitis, Peptic ; surgery ; Gastroesophageal Reflux ; Humans ; Muscles ; surgery ; Recurrence ; Treatment Outcome

OBJECTIVETo evaluate the treatment effect of the two surgical methods for upper eyelid retraction with thyroid associated-ophthalmopathy.

METHODSTwenty-two patients (32 eyes) with inactive thyroid associated-ophthalmopathy were divided into 2 groups (11 for each group) randomly. 11 patients (18 eyes) in the group A were treated by central tenotomy of levator aponeurosis. Another 11 patients (14 eyes) in the group B were treated by lengthening of Mullers' muscle combined with levator muscle. The treatment effect was investigated in 6-month follow-up study.

RESULTSAll of the patients were improved with the two surgical methods, which there was very significant difference before and after the treatments (P < 0.01), but not between the two surgical methods (P > 0.05) by statistical analysis. There was recurrent retracting in 4 patients (6 eyes) of group A and in 1 patient (1 eye) of group B, which there was significant difference between the two groups (P < 0.05) by Chi-square test. None of the patients was overcorrected.

CONCLUSIONSThe two methods are both effective and safe in correcting upper eyelid retraction. The rate of recurrent retracting is lower in lengthening of Mullers' muscle combined with levator muscle than that in central tenotomy of levator aponeurosis.

Blepharoplasty ; methods ; Eyelid Diseases ; etiology ; surgery ; Female ; Graves Ophthalmopathy ; surgery ; Humans ; Male ; Oculomotor Muscles ; surgery