Modifying brow position with botulinum toxin.
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Botulinum Toxins, Type A↗
Biomedical subjects
Jill A Foster
Publications and source records attributed to Jill A Foster.
Expression of sodium iodide symporter in the lacrimal drainage system: implication for the mechanism underlying nasolacrimal duct obstruction in I(131)-treated patients.
PURPOSE: Nasolacrimal outflow obstruction has been associated with high-dose (>150 mCi) radioactive iodine (I(131)) treatment. Commonly used for thyroid cancer treatment, I(131) is effectively transported in the targeted tissue by the Na(+)/I symporter (NIS). We hypothesized that NIS is expressed in the lacrimal sac and nasolacrimal duct and that active accumulation of I(131) is responsible for the clinical observations seen in these patients. METHODS: Reverse transcriptase-polymerase chain reaction and immunohistochemical analyses were used to evaluate NIS expression in both archived and fresh human tissues RESULTS: Reverse transcriptase-polymerase chain reaction analysis showed that NIS mRNA is present in the lacrimal sac. Immunohistochemical analysis indicated that NIS protein is expressed in the stratified columnar epithelial cells of the lacrimal sac and nasolacrimal duct. NIS protein was undetectable in the lacrimal gland, Wolfring and Krause glands, conjunctiva, canaliculus, and nasal mucosa. NIS-expressing columnar epithelial cells were absent and fibrosis was evident in the lacrimal sacs from I(131)-treated patients undergoing dacryocystorhinostomy. CONCLUSIONS: NIS is present in the lacrimal sac and nasolacrimal duct of humans, correlating to the anatomic areas of clinical obstruction that develop in patients treated with greater than 150 mCi of I(131). This suggests that NIS may be the vector of radiation-induced injury to the lacrimal system. To our knowledge, this is the first report of any ion transporter in the nasolacrimal outflow system and raises new questions as to the role the lacrimal sac plays in the modification of tears and in lacrimal outflow pathology.
Basement Membrane↗
Processed human pericardium barrier for gold weight implantation.
PURPOSE: To determine the safety and efficacy of processed human pericardium as a barrier material for gold weight implantation. METHODS: In this retrospective, noncomparative case series, all patients undergoing gold weight implantation with human pericardium barrier between November 2000 and May 2002 were studied. Charts were reviewed for surgical indications, gold weight size, follow-up interval, and complications. RESULTS: Twenty-three eyelids of 23 patients underwent gold weight implantation with processed human pericardium barrier material. There were 15 female and 8 male patients. Mean patient age was 53 years (range, 22 to 78 years). Indications for surgery included extruded implant (4 eyelids), thin tissues overlying existing implant (3 eyelids), thin anterior lamellar eyelid tissues (6 eyelids), radiotherapy (1 eyelid), and requirement for long-term gold weight therapy (9 eyelids). Mean follow-up was 11 months (range, 3 to 36 months). Acceptable tissue coverage was found in 23 of 23 eyelids. There were no complications of infection, extrusion, or thinning of overlying tissues. One patient had prolonged eyelid edema and erythema that resolved spontaneously 3 months after surgery. CONCLUSIONS: Human pericardium appears to be well tolerated on at least a short-term basis within the eyelid when used as a barrier material for gold weight implantation.
Adult↗
Pediatric canaliculitis and stone formation.
A 5-year-old girl with a remote history of idiopathic thrombocytopenic purpura presented with a history of partial nasolacrimal duct obstruction unresolved with standard treatments of probing, irrigation, and lacrimal system intubation. Surgical exploration revealed canaliculitis with dacryolith formation within the inferior canalicular system. After punctoplasty and removal of the dacryoliths, the patient had full resolution of symptoms. Although the diagnosis is uncommon in this age group, it should be included in the differential diagnosis of chronic or recurrent pediatric nasolacrimal obstruction.
Bacterial Infections↗
Television viewing and snacking.
With the rise in obesity in America, the search for potential causes for this epidemic has begun to include a focus on environmental factors. Television (TV) viewing is one such factor, partially due to its potential as a stimulus for eating. The current study investigated the relationship between food intake and self-reported TV viewing in an effort to identify the impact of TV viewing on specific eating behaviors. Seventy-four overweight women seeking obesity treatment completed questionnaires assessing dietary habits and TV viewing behaviors. Results suggest that snacking, but not necessarily eating meals, while watching TV is associated with increased overall caloric intake and calories from fat. Therefore, interventions targeting stimulus control techniques to reduce snacking behavior may have an impact on overall caloric intake.
Journal Article↗
Transcaruncular orbital decompression for dysthyroid optic neuropathy.
PURPOSE: To determine the efficacy of transcaruncular approach orbital apex decompression for treatment of dysthyroid optic neuropathy. METHODS: In this retrospective noncomparative interventional case series, charts for all patients undergoing orbital decompression surgery for dysthyroid optic neuropathy performed by one author between October 1999 and September 2001 were included in the study. Primary outcome measures included visual acuity, static perimetry, pupillary testing, and color plate testing before and after surgery. Records were also reviewed for changes in extraocular motility and proptosis after surgery and for surgical complications. RESULTS: Sixteen consecutive patients (6 unilateral, 10 bilateral, for a total of 26 cases) underwent orbital apex decompression for dysthyroid optic neuropathy through a transcaruncular approach. In each orbit, the optic neuropathy was refractory to oral corticosteroid therapy. Preoperative visual acuity remained stable or improved in each case. Preoperative Humphrey visual field testing revealed an average mean deviation of -10.3 +/- 6.5 (range, +0.76 to -25.45). Average postoperative mean deviation was -2.79 +/- 2.4 (range, +0.94 to -9.82). Before surgery, 7 of 23 eyes (30%) had full color plates. After surgery, 22 of 23 eyes (96%) had full color plates. Follow-up ranged from 2 to 26 months (mean, 10 months). New-onset diplopia developed in 2 of 10 (20%) patients without preexisting diplopia. CONCLUSIONS: Transcaruncular approach orbital apex decompression effectively treats dysthyroid optic neuropathy.
Adult↗
Colobomatous microphthalmia and orbital neuroglial cyst: case report.
We present the case of a boy with a congenital right orbital cyst with bilateral colobomatous microphthalmia. Neuroimaging studies excluded communication between the cyst and the eye and between the cyst and the central nervous system. Analysis of cyst fluid obtained by aspiration detected beta 2-transferrin by high resolution immunofixation (IFE). The cyst recurred two months following aspiration. It was then completely excised and histopathologic studies demonstrated a cyst containing neuroglial tissue. No recurrence was observed for 12 months following excision.
Coloboma↗
A new algorithm for ptosis repair using conjunctival Müllerectomy with or without tarsectomy.
PURPOSE: To determine the predictability of a new algorithm for determining the amount of tissue resection for conjunctival Müllerectomy with or without tarsectomy blepharoptosis repair. METHODS: Consecutive case series of all patients undergoing conjunctival Müllerectomy with or without tarsectomy ptosis repair from October 1999 to September 2001. Each patient underwent excision according to a new algorithm for determining the amount of tissue excision. The amount resected was determined by the following formula: 9 mm of conjunctiva and Müller muscle + x mm of tarsus, where x = distance of undercorrection after phenylephrine testing. RESULTS: Sixty-eight consecutive patients underwent 70 cases of conjunctival Müllerectomy with or without tarsectomy ptosis repair on 117 eyelids, using a new algorithm for tissue excision. Forty-seven cases were bilateral and 23 were unilateral. Postoperative symmetry was found in 58 of 67 patients (87%) after 1 surgery. Patient satisfaction based on symmetry, contour, and height after 1 repair was achieved in 64 of 67 patients. There were no overcorrections. Two patients underwent successful reoperation with a second conjunctival Müllerectomy with or without tarsectomy operation. CONCLUSIONS: This modified algorithm and technique quantifies conjunctival Müllerectomy with or without tarsectomy ptosis surgery and yields predictable results.
Algorithms↗
Advances in cosmetic oculoplastic surgery.
According to the American Society for Aesthetic Plastic Surgery, in the year 2000 over 5.7 million cosmetic surgical and nonsurgical procedures were performed in the United States. This was a 25% increase above the total number performed in 1999. The most popular of these procedures was botulinum toxin injection, followed by chemical peels and microdermabrasion. As the field of plastic and reconstructive surgery changes, so does the scope of the oculoplastic surgeon. This review article summarizes those developments in aesthetic surgery that are recent additions to the practice of aesthetic oculoplastic surgery. It highlights the most recent literature discussing brow and midface lifts, skin lasers, microdermabrasion, upper and lower blepharoplasty, chemical peels, botulinum toxin, and fat sculpturing.
Blepharoplasty↗
Nasolacrimal drainage system obstruction from radioactive iodine therapy for thyroid carcinoma.
Ophthalmic complications of (131)I therapy, including ocular dryness, have been recently investigated and described. However, nasolacrimal drainage system obstruction (NDSO), complicating (131)I therapy, has not been previously well appreciated or characterized. One of our patients developed bilateral complete nasolacrimal duct obstruction after (131)I therapy that prompted awareness of this potential complication. Over 16 months, 423 patients with epithelial-derived thyroid cancer were provided routine clinical care; 390 of these patients had received (131)I ablation or therapy, and 10 patients subsequently reported epiphora. All had evidence of NDSO disease after a mean cumulative (131)I dose of 17,279 +/- 2,923 MBq (467 +/- 79 mCi), with a mean individual (131)I dose of 6,660 +/- 555 MBq (180 +/- 15 mCi). Symptoms appeared 6.5 +/- 1.4 (range, 3-16) months after the last (131)I dose, whereas the mean time from symptom onset to correct diagnosis was 18 +/- 5 months. A causal relationship between (131)I administration and NDSO is strongly suspected. Patients reporting epiphora should be evaluated promptly by an oculoplastic surgeon.
Adolescent↗
General principles of disease transmission.
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Child↗
Fibrin sealant for Müller muscle-conjunctiva resection ptosis repair.
PURPOSE: To determine the safety and efficacy of fibrin sealant for use in Müller muscle-conjunctiva resection ptosis repair. METHODS: This was a retrospective review of a consecutive case series. All patients underwent Müller muscle-conjunctiva resection ptosis repair with fibrin sealant used for wound closure. Surgery was performed in a manner similar to a previously described technique, using fibrin tissue sealant rather that suture for wound closure. Postoperative symmetry was defined as MRD1 of each eyelid within 0.5 mm. RESULTS: Müller muscle-conjunctiva resection ptosis repair with fibrin sealant used for wound closure was performed on 53 eyelids of 33 patients. There were 27 female patients and 6 male patients. Twenty patients underwent bilateral ptosis repair and 13 patients underwent unilateral ptosis repair. Average follow-up was 17 weeks (range, 3 to 45 weeks). Mean preoperative MRD1 was 1.22 mm (range, -1.5 to 2.5 mm) in the right upper eyelid and 1.50 mm (range, 0 to 2 mm) in the left upper eyelid. Mean postoperative MRD1 was 3.11 mm (range, 2 to 4.5 mm) in the right upper eyelid and 3.12 mm (range, 1 to 4.5 mm) in the left upper eyelid. Postoperative symmetry was found in 32 of 33 patients (97%). We found no evidence of keratopathy or other complications attributable to the fibrin sealant. CONCLUSIONS: Müller muscle-conjunctiva resection ptosis repair with fibrin sealant used for wound closure may allow for predictable results with few complications and appears to be an acceptable alternative to traditional suture techniques.
Blepharoptosis↗
Altering TV viewing habits: an unexplored strategy for adult obesity intervention?
OBJECTIVES: To review literature evaluating whether television (TV) viewing reduction is a promising behavioral target for obesity treatment programs for adults. METHODS: Studies examining associations between TV viewing and obesity in adults were reviewed, as well as relevant pediatric literature. Interventions to reduce TV viewing among children were examined to inform adult interventions. RESULTS: Adult TV viewing has been consistently associated with greater obesity risk in cross-sectional and longitudinal studies. Strategies to alter TV viewing have been demonstrated effective among children but have not been tested in adults. CONCLUSIONS: Evaluation of the efficacy of targeting TV viewing among adults on weight outcomes is warranted.
Adult↗