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Файл:Ординатура / Хирургия / @xirurgi_2025 / @xirurgi_2025 - 343 - файл
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120 / Index
https://t.me/medicina_free
Hematoma/hemorrhage, postsurgical (continued)
diagnosis and treatment algorithm for, 94f
lateral canthopexy-related, 39
levator aponeurosis advancement-related, 85, 86
lower blepharoplasty-related, 27
treatment for, 93
retro-orbital, 6
upper blepharoplasty-related, 21–22, 22f
as wound dehiscence cause, 98
Hemifacial spasm, as ptosis cause, 78
Herbal remedies, 91, 92, 95
Herpes zoster virus infections, 98
Herring’s law, 20, 79, 100–101
High-risk patients, identifi cation of, 92, 92t
Hollow-eyed appearance, 107f
Homeopathic medications, 92
Hooding appearance, 99
Horner’s muscle, anatomy of, 2f, 7
Horner’s syndrome, 7, 78
Humphrey automated static testing, 79
Hyaluronic acid fi llers, 70, 108–109
Hyperpigmentation
lower blepharoplasty-related, 33, 34f, 109
skin rejuvenation procedures-related, 71
Hypertension, 91
Hypopigmentation, skin rejuvenation procedures-related, 71
Hypotropia, 78
I
Infections, postoperative, 71, 98
Inferior lid retractor, disinsertion of, 35
Inferior oblique muscle
anatomic relationship to fat pads, 27, 28f
surgical injury to, 5–6
Inferior rectus muscle, entrapment of, 28, 29f
Inferior tarsal muscle
anatomy of, 91f
innervation of, 7
Informed consent, 26
Infraorbital nerve
anatomy of, 7f, 8
in lower blepharoplasty, 28
Infraorbital rim, in lower blepharoplasty, 23, 28, 29, 29f
Infratrochlear nerve, anatomy of, 7f, 8
Intense pulsed-light skin rejuvenation, 70, 71
Intraocular pressure measurement, 93
Intrapalpebral distance, 90f, 99
J
Jaeger lid plates, 28f
Juvederm, 70
K
Keloid scars, 98
Kim, Young-Kyoon, 58
Korean patients, 51, 61f
L
Lacrimal gland, anatomy and function of, 5, 89
Lacrimal nerve, anatomy of, 7–8, 7f
Lacrimal system, anatomy and function of, 8, 10f, 89
Lagophthalmos
blepharoplasty-related, 20, 21–22, 101
chemosis-related, 95t, 96
as dry eye cause, 96
levator aponeurosis repair-related, 84
treatment for, 101
defi nition of, 101
Laser skin resurfacing, 70, 71, 72
complications of, 106
LASIK (laser-assisted in situ keratileusis) surgery
as dry eye risk factor, 79, 96–97
prior to blepharoplasty, 20
ptosis repair after, 85
Lateral canthal ligament, anatomy of, 90
Lateral canthal tendon
anatomy of, 4, 5
in horizontal eyelid laxity, 37
tightening of, 107–108
Lateral canthus
anatomy of, 89
anatomy relationship with medial canthus, 90
in Asians, 50
Lateral retinaculum, 36
Lateral rounding, 109
Laxity, of eyelid
evaluation of, 38, 38f
horizontal, 35
of lower eyelid, 17, 103–104, 103f
mild laxity, 39, 39f
moderate laxity, 40, 40f, 41f
surgical management of, 38–42
of upper eyelid, 15, 15f
Levator aponeurosis
anatomic landmark for, 76
anatomic relationship with orbital septum, 5
anatomy of, 2f, 5, 6, 76
in Asian eyelids, 11, 12f, 58, 59, 59f
dehiscence of, 99
differentiated from orbital septum, 5
excursion of, 101
measurement of, 76–77
integrity evaluation of, 6
surgical injury to, 3, 6
Levator aponeurosis advancement, 82–85, 83f, 84f, 85f
Levator complex, 6
Levator palpebrae superioris muscle
anatomy of, 2f, 6, 6f, 75
injury to, 77
innervation of, 7
Lid crease. See Eyelid crease
Lid distraction test, 103, 103f
Lid margins
anatomy of, 90
below the corneal light refl ex, 76
in youth, 13–14
Lid retraction, contralateral, 78
Lid retractors
horizontal, 37
of lower eyelid, 35–36
anatomy of, 2f, 6f, 7, 91f
scarring of, 43
of upper eyelid, 35
anatomy of, 2f, 6–7, 6f, 75, 91f
Index / 121
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Lockwood’s ligament, anatomy of, 7, 35, 36, 36f, 76f
Lower eyelid
aesthetic evaluation of, 17, 17f
aging of, 23
anatomy of, 35–36, 36f, 37f, 90, 91f, 102–103, 107f
blepharoplasty-related complications of, 102–109
edema of, 17
malpositioning of, 103–108, 103f, 104f, 105f, 106f,
107f, 108f
malposition of, 42
“negative vector,” 104, 104f, 105f
retraction of, 35
evaluation of, 43–44, 44f
postoperative, 42–46, 43f, 44f, 45f
preoperative, 42
surgical correction of, 44–46, 45f
“Lumps and bumps,” 68, 69
Lymphatic drainage, of the eyelids, 8, 9f
Lymphoma, of the eyelid, 78
M
Malar bulges, 17
Malar depression, 17
Malar fat pads, descent of, 108
Malar fold, anatomy of, 1, 2f
Malar region, in Asians, 51
Margin refl ex distance (MRD), 90f, 99–100
Margin refl ex distance-1 (MRD-1), 20, 75, 76, 77f, 99–100,
100f, 101
Marking, preoperative, 90
improper, 98
Massage therapy, for chemosis, 95, 95f
Maxillary nerve, zygomaticotemporal branch of, 7, 7f, 8
Mean refl ex distance-2 (MRD-2), 100
Medial canthal ligament, anatomy of, 90
Medial canthal tendon
anatomy of, 3f, 4, 90
laxity of, 35
evaluation of, 38, 38f
in horizontal eyelid laxity, 37
Medial canthus
anatomic relationship with lateral canthus, 90
anatomy of, 89
Medical conditions, preoperative review of, 91
Medications. See also specifi c medications
as dry eye risk factor, 96
preoperative review of, 92–93
Meibomian glands, anatomy of, 2f, 4
Methylprednisolone, 93
Middle lamella
anatomy of, 103
disruption of, 105
infl ammation of, 42–43, 106
Mikamo, 49
Milia, 97
Möbius syndrome, 36, 37f
Motor nerves, of the eyelids, 7, 7f
Mucocutaneous junction (gray line), anatomy of, 2f, 4
Müller’s muscle
anatomy of, 2f, 7, 75, 91f
in Horner’s syndrome, 78
innervation of, 7
phenylephrine-induced stimulation of, 79
in ptotic eye, 20
surgery-related injury to, 7
Müller’s muscle-conjunctival resection, 80–81, 81f
Myasthenia gravis, 77
Myotonic dystrophy, 77
N
Nasojugal fold, anatomy of, 1, 2f
Nasojugal groove
anatomy of, 23, 23f, 24
depth of, 32f
with tear trough deformity, 103
Nasolacrimal duct, anatomy of, 8, 10f
Nd:YAG laser skin resurfacing, 70, 71, 72
“Negative vector,” 104, 104f, 105f
Neo-Synephrine, 96
Neurofi bromas, of the eyelid, 78
O
Ocular irritation, blepharoplasty-related, 96
Ocular muscles, evaluation of, 14
Oculomotor nerve, 6
Ophthalmic nerve, terminal branches of, 7–8, 7f
Orbicularis oculi muscle
anatomy of, 3, 3f, 5f, 10f, 75, 90, 111
Asians, 11, 12f, 57, 57f, 58f
function of, 112f
hypertrophic, 24, 24f
innervation of, 7, 7f
in lower blepharoplasty, 30
overresection of, 3, 6
paresis of, 35
in patients with dry eye, 96
in upper blepharoplasty, 21, 21f
Orbital complex, aesthetics of, 112–113, 112f, 113f
Orbital rim ligament, anatomy of, 17f
Orbitomalar ligament, anatomy of, 91f
Osmotic agents, 93
Overcorrection
excessive fat excision-related, 108–109, 108f
fat grafting-related, 69–70
levator aponeurosis advancement-related, 85
P
Palpabrae. See Eyelids
Palpebral fi ssure, 2f
in Asians, 50
height and width of, 1, 79, 89, 90f
Palpebral sulcus, anatomy of, 1, 2f
Patient expectations, unrealistic, 92
Patient history, 90–92
Periorbital region
aesthetic evaluation of, 13–18
of the eyebrow, 13, 16, 111–115
general evaluation, 14
global-orbital relationship, 18
of the lower eyelid, 17, 17f
photodocumentation in, 18
for upper blepharoplasty, 19, 20f
of the upper eyelid, 15–16, 15f, 16f, 19, 20f
in younger patients, 13–14, 13f
122 / Index
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Periorbital region (continued)
aesthetic procedures for, 65–74
fat grafting, 65–70
injection of fi llers, 70, 108–109
skin rejuvenation, 70–73, 72f, 73f
Phenol peels, 71
Phenylephrine testing, of ptosis, 79, 79f, 80
Photodocumentation, pre- and postoperative, 90
of Asian blepharoplasty patients, 61f
of fat graft patients, 69f
of lower blepharoplasty patients, 24, 25f, 31–33f
in periorbital aesthetic evaluation, 18
of ptosis patients, 80, 90
Photothermolysis, fractional, 70, 71, 72
Phthisis, as ptosis cause, 78
Physical examination, preoperative, 90–92
Pigmentary changes. See also Hyperpigmentation;
Hypopigmentation
on upper eyelid, 15
Pinch test, 99
Posterior lamella, anatomy of, 103
Povidone-iodine solution, 97
Pred Forte, 96
Pretarsal fi bers, 3
Procerus muscle, anatomy and function of, 111, 112f
Pseudoelevator, 58, 59f
Pseudoherniation, of orbital fat, 90
differentiated from hypertrophied orbicularis oculi
muscle, 24, 24f
of lower eyelid fat, 23, 23f
preoperative evaluation of, 102
undertreatment of, 109
Pseudoptosis, 78
Ptosis, 75–87
acquired, 75
aponeurotic, 75, 78, 78f, 100, 100t
bilateral, 100–101
of the brow, 15, 78, 98
with lateral hooding, 111f
congenital, 75, 77
defi nition of, 75
differential diagnosis of, 98–99
dry eye syndrome associated with, 86–87
evaluation of, 78–80, 79f, 90, 99–101
Horner’s syndrome-related, 7
iatrogenic, 77
measurement of, 76–77
mechanical, 75, 78, 100, 100t
myogenic, 75, 77, 100, 100t
neurogenic, 75, 77–78, 100, 100t
patient history of, 78–79
photographic documentation of, 80, 90
postoperative, 3
of upper eyelid, 6
pseudoptosis, 78, 78f, 100, 100t
reverse, 78
of suborbicularis fat pad (SOOF), 11
surgical anatomy of, 75–76, 76f
surgical repair of, 80–84
Fasanella-Servat procedure (tarsomyectomy), 79, 80,
81, 82f
levator aponeurosis advancement, 82–85, 83f, 84f, 85f
Müller’s muscle-conjunctival resection, 80–81, 81f
posterior lamella procedures, 80
traumatic, 77, 78
of upper eyelid, 15, 15f
pre-blepharoplasty evaluation of, 20, 20f
“Puffy” eyes, 23
Pulsed dye laser skin rejuvenation, 70
Pulsed-light skin rejuvenation, 70
Punctum
malposition of, 35
in medial canthal tendon laxity, 38
R
“Raccoon eyes,” 90
Radiofrequency skin rejuvenation, nonablative, 70, 71–72
Refractive error, 85
Refractive surgery. See also LASIK (laser-assisted in situ
keratileusis) surgery
patient history of, 91
Retro-orbicularis oculi fat (ROOF), anatomy of, 3, 8, 10f, 91f
Rhytids
of the brow, 114
differentiated from eyelid laxity, 15, 15f
on lower eyelid, 17
periorbital, 14, 14f
on upper eyelid, 15, 15f
S
“Sad-looking” eyes, 42
Scalp, layers of, 111
Scars, postoperative
in Asian patients, 62–63
hypertrophic, 98
keloid, 98
on lower eyelid, 23, 26, 33, 109
middle lamella infl ammation-related, 106
skin rejuvenation procedures-related, 71
on upper eyelid, 20
Schirmer test, 96, 97
Scrub solutions, adverse effects of, 97
Sensory nerves, of the eyelids, 7–8, 7f
Septum, orbital
aging-related weakening of, 4, 4f
anatomy of, 4–5, 4f, 5f, 10f, 75, 76f, 90, 91f
in Asians, 50
in Asian blepharoplasty, 57, 58f
contracture with capsulopalpebral fascia, 106, 107f
differentiated from levator aponeurosis, 5
Shingles, 98
Skeletonization, iatrogenic facial, 65
Skin-muscle fl ap approach, 105–106
Skin pinch excision, 24, 28
Skin rejuvenation, 70–73
ablative resurfacing, 70, 71, 72
botulinum toxin injections, 72–73, 72f, 73f
chemical peels, 71
complications of, 71
nonablative radiofrequency, 70, 71–72
nonablative resurfacing, 70, 71–72
Skin tags, on upper eyelid, 15
“Smile lines,” 19
Snapback test, 38, 39, 103
Index / 123
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Snap test, 13
Solu-Medrol, 93
Steatoblepharon, 90
Strabismus, blepharoplasty-related, 109
Subciliary approach, with or without fat repositioning, 24,
28–30, 29f, 30f, 33, 33f
Submuscular areolar tissue, anatomy of, 2f, 3
Suborbicularis oculi fat (SOOF)
anatomy of, 3, 8, 10f, 11, 11f, 91f
in Asians, 51
descent of, 108
ptosis of, 11
resection of, 11
Subperiosteal pockets, in lower blepharoplasty, 28, 28f, 29, 29f
Superior orbital nerve, blepharoplasty-related injury to, 8
Supraorbital hollow, 15, 15f
Supraorbital nerve, anatomy of, 7–8, 7f, 10f
Supratarsal crease, 6
absence of, 11
in Asian eyelids, 11
asymmetry of, 62
inappropriate height of, 62
loss of, 62
low, 53
Supratarsal crease formation, in Asian patients. See Asian
blepharoplasty
Supratarsal fold, gender differences in, 99
Supratrochlear nerve, anatomy of, 7–8, 7f
Suture line complications, 97–98
Systemic diseases, with ocular effects, 91
Thyroid eye disease, 20
“Tired” appearance, 19, 69f, 78, 98
Tob r ad ex , 9 6
Transconjunctival approach, in lower blepharoplasty, 26–28
benefi ts of, 23
comparison with skin-muscle fl ap approach, 105–106
complications of, 33, 33f
with fat excision, 26–28, 26f, 27f, 28f
with fat pad repositioning, 32f
with fat pad transposition, 32f
with fat preservation, 28, 29f
postoperative photographs of, 31f, 32f
for tarsal suspension, 30–31, 31f
Trans-suborbicularis oculi fat midface lifts, 105
Trauma, as ptosis cause, 77, 78
Trichloroacetic acid peels, 71
Trigeminal nerve, anatomy of, 7, 7f
Tumors, of the eyelid, 36, 78
U
Undercorrection
fat grafting-related, 69, 70
levator aponeurosis advancement-related, 84
“Unhappy” appearance, 98
Upper eyelid. See also Blepharoplasty, upper
aesthetic evaluation of, 15–16, 15f, 16f
anatomy of, 89–90, 90f, 91f
in Asians, 50–51
medial fat pad bulging in, 16, 16f
ptosis of, 6
T
Tarsal crease, inferior, 13–14, 13f, 16
Tarsal glands, anatomy of, 4
Tarsal plates, anatomy of, 2f, 3–4
Tarsal strip, lateral, 40–41, 40f
Tarsal suspension, in lower blepharoplasty, 33f
via skin-muscle fl ap approach, 31, 31f
via transconjunctival approach, 30–31, 31f
Tarsoligamentous sling, 36
laxity of, 103f
Tarsomyectomy (Fasanella-Servat procedure), 79, 80, 81, 82f
Tarsus, 90
blepharoplasty-related injury to, 101
Tear fi lm
distribution of, 8, 96
lateral movement of, 3
maintenance of, 1
Tears, production of, 8, 10f
Tear trough deformity, 23, 23f, 24, 26f, 66, 66f, 103, 109
as fi ller injection site, 70
Technicare, 97
Telecanthus, 77
Third-nerve palsies, 77–78
V
Venous blood supply system, of the eyelids, 8, 9f
Vision changes. See also Blindness
upper blepharoplasty-related, 20
Visual acuity testing, 91
Visual fi eld testing, 79, 91
Volume fi llers, 70, 108–109
W
Westcott scissors, 28, 29, 29f
Whitnall’s ligament, anatomy of, 5, 6f, 36, 75
Whitnall’s tubercle, 90
Wound healing complications, 98
W-plasty, 99
Y
Young, Philip A., 113
Young-Kyoon Kim, 58
Z
Z-plasty, 50, 98
Zygomaticofacial nerve, anatomy of, 7f, 8
Zygomatictemporal nerve, anatomy of, 7, 7f, 8
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