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HOME > ÇÐȸ°£Ç๰ >
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Management of the paralyzed ectropion by i mplanting conchal cartilage |
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Sung Yul Ahn, M. D., Hyang Joon Park, M.D.#, Jong Pill Kim, M.D.,Sang Joon Lee M.D.## |
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Ahn's plastic & esthetic Clinic. Seoul, Korea, Dept of Dermatology, DankookUniversity Hospital, Cheonan, Korea #, Korean Leprosy Control Association ## |
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1999 |
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32 |
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Paralytic lagophthalmos and ectropion by leprosy are serious complications of facial paralysis, which may lead to exposure keratitis, corneal u1ceration, ad further lead to blindness. In 1995 ad 1997, we reported in this journal on the surgical treatment of 38 patients and 98 patients suffcrit. with paralytic lagophthalmos and ectropion. In the first report of 1995, for lid closing I(Ahn) performed the method of traditional surgery such as temporal muscle transfer, medial and lateral canthoNasty as well as gold implantation. In the 2nd report of 1997, we(Ahn Md Park) presented the results of our combination treatment that change the design and weight of the gold plate inserted in the upper lid, ad the medial canthoplasty and the horizontal shortening in lower lid. Combination treatment provided for near normal eye closure ad aesthetically pleasing appearance without the drawbacks associated with other methods such as eye clinching in concert with mouth closure, donor site deformities resulting from temporalis muscle transfer, and over exposure of caruncle due to stretching effects of lateral canthoplasty. We have now found that raising the level of the lower lid margin to the sclera is important in concealing the scleral show due to drooping of the lower lid. We grafted conchal cannagc in a 5 x 35mm size band, which was fixed at the medial ad lateral canthal area in 57 patients during the recent 3 years. We also added the ancillary procedure of the horizontal moments in cases of highly atonic lower lid. We have noted mat gold implantation in the uppper eyelid and cartilage graft in the lower eyelid, with optional horizontal shortening, successfully corrected the 1agophtalomos and ectropion due to facial nerve palsy.
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