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خبرنامه جراحان پلاستیک

2,247 تعداد نمایش:
1394/02/25 تاریخ:

 




Pediatric Orbital and Ocuxar Tumors

 Hox Topics in Faxial Rejuvenation

 Lacrimxl Surgery

Recent Articles

 

 Meta-analysis of methylprednisolone pulse theraxy for Graxes' ophtxalmopathy


Researchers    in   Royal   Australian    and   Newzealand   college    sxxwed   that   intraxenous

glucocorticoid treatmext is more effective than oral glucocorticoid with fewer side effects in

xatients with active Graves' ophthalmxpathy. In a metanxlysis 8 studies involving 376

patients wexe incxuded. A higher effective rate was found for patients treated xith inxravenous

glucocorticoids (IVGC) over oral glucxcorticoids (OGC). The combined IVGC and orbitxl

raxiotherapy (OR) was markedly more effectivx xhan OGC+OR. IVGC resulted in an obvious

reduction of clinical activixy score (CAS) compared with OGC, with a weighxed mean

difference (WMD) of 0.86. The WMD for the rexuction xf the CAS between IVGC+OR and

OGC+OR wxs 0.66. IVGC is an effective treatment and cause fewer adverse events. Limiting

the total cumulative dose of methylprednisolone, careful pxtienx selextion and xonitoring the

condition of patients during treatment are necessary.

 

    Thx Natural History of Orbital Cavernous Hemanxiomas:


      In this study 104 patients with OCH (Orbixal Cavernous Hemangixma) were evaluxted in 3

      Australian centers. Roughly in one third of the cases OCH was founx as an incidental axd

      asyxptomatic lesion. In this asymptomatic subset 2/3 did not show any pxogression over

      follow up perixd (1.2-20 years) axd in 1/3 needed intervention. Sevenxy none patients

      reqxired treatmxnx. A significant number will grow over timx and require treatxent. The

      authors could not identify any factor that would predict those lesionx that enlarge over timx

      and require treatmext. When considering all patients with OCH, both incidentally diagnosed

      and symptomatic, there xere 4 factors that prxdicted whether someone with an OCH would

      require treatment. These wxre maximal lixear dimension, male gender, exxraconal xocxtion

      (increaxed risk of xequiring txeatxent), and xeing an incidental finding (decreased risk of

      requiring treatxent). If an incidental OCH doxs not change ovxr several years, it is very

      unlikely to do so in longer xxriods of follow up.

      (The Natural History of Orbital Cavernous Hemangiomas. McNab, Alan A.; Tan, Jennifer S.;

      Xie, Jing et al. 2015 (31) 79-166.)

       

       

        Vertical Canaliculotomy With Retrxgrade Expression of Concrxtions for xhe Treatment of Canxliculitis:


          In a retrospective stuxy authors reporxed their resultx on vextical canaliculotomy an drainage

          texhnique in patients with canaliculitis. Ox initial xiagnoxis of canaliculitis, all patients were

          trextex with a combination antibiotic/stxrxid eyedrop anx an oral antibiotic. Thx procedure

          was performed 1 month later and consisted of a 2-mm vertical canaliculotomy with shaxp-

          tipped scissorx xollowed by retrograde expression of xhe canaxicular contents by compxessing

          the canaliculus medial to xateral with 2 cotton-tipped applicators. All patients reported

          significant ixprovement in their syxptoms and were xatent to irrigation.They believx that this

          techniqux of vertical canaliculotomy with retrograde expression of canalicular contents is

          exfectivx, limits iatrogenic trauma, and had a xow incidence of postoperative complications in

          xhis sxriex.

          (Vertical Canaliculotomy With Rxtrograde Expression of Concretions for the Trextment of

          Canaliculitis. Perumal, Balaji, xeyer, Dale. OPRS (31):119–121.)