Background/aim-Isolated stenosis of the lacrimal punctum is a frequent cause of epiphora. Treatment relies on surgical opening or dilatation with bi-or monocanalicular prosthesis. Recently, silicone perforated punctum plugs (PPP) were proposed. The drawback with these silicone PPP was that secretions accumulate in the central orifice blocking the spontaneous flow of tears. A modification of the surface of the PPP using polyvinylpyrrolidone (PVP) was thus proposed. The aim was to compare silicone PPP with new PVP surface treated PPP. Methods-A prospective study was conducted of 20 patients with dilatable stenosis of the lacrimal puncta who developed epiphora. Epiphora, tolerance, implantation of the PPP, and lacrimal drainage were evaluated using scintigraphy of the lacrimal ducts. Results-The raw data and statistical analysis showed evidence of a superior performance of PVP surface treated PPP. Conclusion-Long term evaluation of the advantages or risks of PVP plugs and comparison with microsurgical punctoplasty are warranted.
This investigation was designed to extend our present knowledge of the supraorbital n. (SO n.) distal to the supraorbital notch. It is based on 40 dissected hemi-faces and the position of the notch and the periosteal and frontalis cutaneous branches of the SO n. were studied. The notch was 33.05 mm from the midline on the right side and 30.70 mm on the left. The periosteal branch arises from the lateral frontalis cutaneous branch. Its ascends in an oblique direction laterally and ends in two terminal branches. The frontalis cutaneous branch, after a very short trunk, divides into two branches, medial and lateral. The medial or deep branch enters the corrugator supercilii m. between its fibers. Most frequently, it passes under the inferior fasciculus and superficial to the middle and superior ones. Leaving the corrugator m., it ascends medially into the frontalis m., supplying the median cutaneous frontalis region. The lateral or superficial branch crosses superficial to the corrugator supercilii m. to penetrate the frontalis m. in an ascending and lateral direction, supplying the lateral frontalis region. The two branches enter the frontalis m., displaying a zigzag pattern in order to adapt its length during expressive movements. They cross the frontalis region together with the SO a. and two veins supplying the nerve and the frontalis m. These anatomic data may explain some of the complications after surgery for ptosis and blepharospasm.
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