Klippel-Trenaunnay syndrome is characterized by three typical clinical manifestations; 1) Capillary malformations (port-wine stains), 2) bony and soft tissue hypertrophy, 3) varicosities or venous malforamation, but many other clinical manifestations can be presented. Although many associated clinical manifestations were reported in Klippel-Trenaunay syndrome, peripheral polyneuropathy or any other results of electrodiagonostic study were not reported previously. We experienced a 22 year old male who was transfered in rehabiliation program after surgical management of intra cerebral hemorrhage. During rehabilitation program we diagnosed him as Klippel-Trenaunay syndrome by three typical clinical manifestations associated with dilated cardiomyopathy. He also presented sensory impairment in distal part of all extremites. Electrodiagonostic study revealed peripheral polyneuropathy. We concluded that the possibility of peripheral polyneuropathy should be considered in Klippel-Trenaunnay syndrome.
Capillaries ; Cardiomyopathy, Dilated ; Cerebral Hemorrhage ; Humans ; Hypertrophy ; Klippel-Trenaunay-Weber Syndrome* ; Male ; Polyneuropathies* ; Rehabilitation ; Young Adult

No abstract available.
Neurofibroma ; Orbit ; Peripheral Nerves

Purpose: To evaluate the results of the frontalis sling operation using a silicone rod for the correction of ptosis in patients with third nerve palsy with a focus on corneal safety. Methods: Patients with third nerve palsy who underwent the frontalis sling operation using a silicone rod between 2008 and 2019 were included in this study. The medical records of all patients were reviewed, and their clinical characteristics and postoperative outcomes were analyzed. In this retrospective, interventional case series, the main outcome measures were eyelid contour, eyelid height by margin reflex distance, and corneal status. Results: Twenty-four eyes of 18 patients (12 male and six female patients) were included. The mean age at the time of surgery was 35.1 years (range, 5–64 years). Twelve patients underwent a unilateral ptosis operation, and six patients received a bilateral ptosis operation. The mean follow-up period was 32.1 months (range, 2–87 months). Most patients (21 of 24 eyes, 88%) showed poor Bell’s phenomenon on preoperative examination. Satisfactory eyelid height and eyelid contour were achieved in almost all patients (mean postoperative margin reflex distance, +1.2 mm) postoperatively. Although corneal erosions were detected for several months in eight of 24 eyes after surgery, these findings were well controlled medically with artificial tear eye drops and ointments. Conclusions Frontalis sling surgery using a silicone rod can safely and effectively correct ptosis without severe corneal complications in patients with third nerve palsy. Our study outlines a new method to define the postoperative safety outcome by specifically focusing on categorized corneal status.

OBJECTIVE: To investigate the effect of cervical orthosis upon swallowing and the differences of bracing effect between normal people and spinal cord injured patients. METHOD: 12 normal adults and 32 cervical cord injured patients who were wearing one of the three common cervical orthoses (soft neck collar, Philadelphia brace, and Minerva brace) were recruited. Swallowing function was evaluated by videofluoroscopic swallowing study (VFSS) without cervical bracing for the baseline data and with cervical bracing to compare with baseline data. The parameters observed were oropharyngeal diameter, initiation point of swallowing, hyoid bone movement, laryngeal penetration, aspiration, and residual volume after swallowing. RESULTS: Cervical orthoses decreased oropharyngeal diameter, reduced hyoid bone movement, increased residual volume, and changed initiation point of swallowing. Minerva brace revealed to give more influence than other braces. Normal adult group and patient group showed no difference in cervical bracing effect. CONCLUSION: Attention should be paid to swallowing function when cervical bracing is needed because cervical bracing itself can increase the risk of aspiration.
Adult ; Braces ; Deglutition* ; Humans ; Hyoid Bone ; Neck ; Orthotic Devices* ; Residual Volume ; Spinal Cord

PURPOSE: To report a case of eyeball displacement into the ethmoid sinus followed by early surgical intervention and good visual recovery. CASE SUMMARY: A 46-year-old female visited our hospital after she injured the right side of her face. Her visual acuity could not be measured and computed tomography revealed displacement of the right eyeball into the ethmoid sinus, as well as right medial orbital wall fracture and rupture of the right medial rectus muscle. She underwent surgical reduction of the herniated eyeball and surgical correction of the medial orbital wall fracture within 20 hours after the accident. Eighteen months after the surgery, visual acuity of the right eye improved from light perception to 20/28, and her color vision and visual field of the right eye improved to normal range. CONCLUSIONS: Displacement of the eyeball in the orbital wall fracture is very rare, and eyeball displacement into the ethmoid sinus is even rarer. We achieved good visual outcome through early surgical intervention. The early anatomical reduction of the displacement and wall fracture may promote improved final visual outcome in other similar cases.
Color Vision ; Ethmoid Sinus* ; Female ; Humans ; Middle Aged ; Orbit ; Reference Values ; Rupture ; Visual Acuity ; Visual Fields

PURPOSE: To report the outcomes of acquired lower eyelid epiblepharon after various surgeries in thyroid associated ophthalmopathy (TAO) patients. METHODS: A retrospective review of the medical records of 53 TAO patients with acquired lower eyelid epiblepharon between October 1999 and June 2011 was performed. Data were collected on demographics, type of lower eyelid epiblepharon, the detailed surgical history such as orbital decompression, retraction repair, or epiblepharon repair and surgical outcomes including follow-up period, recurrence of epiblepharon, and post-operative complications. RESULTS: Among the 53 TAO patients with acquired lower eyelid epiblepharon, 25 eyes of 17 patients underwent surgical management; 6 eyes of orbital decompression, 1 eye of orbital decompression followed by retraction repair, 2 eyes of orbital decompression followed by epiblepharon repair, 6 eyes of lower eyelid retraction repair, and 10 eyes of epiblepharon repair. Twenty two lower eyelid epiblepharons (88%) were resolved after final surgical treatment without complication during mean 16.2 months (SD, +/-29.9 months) of follow up period; three of 6 epiblepharons that remained after orbital decompression underwent subsequent surgical management of retraction repair or epiblepharon repair, and epiblepharons were well-corrected. Mean amount of lower eyelid retraction was decreased from 1.68 mm (SD, +/-1.17 mm) to 0.29 mm (SD, +/-0.44 mm) after surgery, regardless of the type of surgery (n = 25, p < 0.000, Wilcoxon signed rank test). CONCLUSIONS: Acquired lower eyelid epiblepharon of TAO should be managed sequentially according to the general serial order of surgical managements in TAO; orbital decompression, correction of lower eyelid retraction and epiblepharon repair. Acquired lower eyelid epiblepharon was well resolved after surgical management in consecutive order, especially after repair of the lower eyelid retraction with a graft, or lower eyelid epiblepharon repair. Decreased lower eyelid retraction with a resolution of epiblepharon after surgery implied that lower eyelid retraction was associated with lower eyelid epiblepharon.
Adult ; Decompression, Surgical ; Eyelid Diseases/*surgery ; Female ; Graves Ophthalmopathy/*surgery ; Humans ; Male ; Retrospective Studies ; Statistics, Nonparametric ; Treatment Outcome

No abstract available.
Blindness* ; Sweet Syndrome*

No abstract available.
Eyelids ; Mucocele ; Neurothekeoma