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Wang Z, Zhang S, Qi Y, Cao L, Li P, Zhang Q. Excision of Greater Superficial Petrosal Nerve Schwannoma Via a Pure Endoscopic Endonasal Approach. Ear Nose Throat J 2024; 103:13-18. [PMID: 34281408 DOI: 10.1177/01455613211026397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Greater superficial petrosal nerve (GSPN) schwannomas are an exceedingly rare nerve sheath tumor. The current literature search was conducted using Medline and Embase database by key search terms. Only 31 cases have been reported in the literature so far. Facial palsy, hearing loss, and xerophthalmia accounted for 48.4% (15), 41.9% (13), and 29% (9) of all cases, respectively. The middle cranial fossa approach was used in all previous reports. A retrospective review of 2 GSPN schwannomas patients treated by endoscopic endonasal approach (EEA) in our center was collected. Clinical records, including clinical features, pre- and postoperative images, surgery, and follow-up information, were reviewed. In all cases, clinical features including facial numbness and headache were found, with tinnitus in case 1, hearing loss, xerophthalmia in case 2. Imaging studies showed a solid mass that originated in the anterior of the petrous bone. Two patients were treated by EEA. Furthermore, no recurrence was found during the follow-up period (15-29 months) in both of the 2 cases after the operation. Complete resection of GSPN schwannomas can be achieved via the pure EEA. Endoscopic endonasal approach for radical removal of tumors is safe and feasible.
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Affiliation(s)
- Zhenlin Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Siyuan Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yan Qi
- Department of Otorhinolaryngology Head and Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lianjie Cao
- Department of Otorhinolaryngology Head and Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Pu Li
- Department of Otorhinolaryngology Head and Neck Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Qiuhang Zhang
- Department of Neurosurgery, Skull Base Surgery Center, Xuanwu Hospital, Capital Medical University, Beijing, China
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Vaishnav YJ, Singh R, Didwania P, Lehrer EJ, Bakaeva T, Harris TJ, Migliori ME, Sheehan JP, Trifiletti DM. Radiotherapy and Radiosurgery in the Management of Optic Nerve Sheath Meningiomas: An International Systematic Review and Meta-Analysis of Twenty Studies. World Neurosurg 2022; 164:e929-e944. [PMID: 35609728 DOI: 10.1016/j.wneu.2022.05.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND Optic nerve sheath meningiomas (ONMs) are often managed with radiotherapy (RT) with the goal of achieving radiographic local control (LC) and preventing deterioration of visual acuity (VA). We aimed to perform a systematic review and meta-analysis of outcomes for patients with ONM treated with RT. METHODS The PICOS/PRISMA/MOOSE selection criteria were used to identify studies. Primary outcomes were stable or improved VA and radiographic LC at last follow-up. The secondary outcomes were incidences of radiation-induced retinopathy and xerophthalmia and stable or improved visual fields (VFs). Weighted random-effects meta-analyses using the DerSimonian and Laird methods were conducted to characterize effect sizes. Mixed-effects regression models were used to examine potential correlations between gross tumor volume (GTV) and outcomes. RESULTS In total, 444 patients with ONM across 20 published studies were included. The estimated LC rate was 99.8% (95% confidence interval [CI], 98.3%-100%), and the estimated proportion of patients with stable or improved VA or VF was 89.7% (95% CI, 86.2%-92.4%) and 93.3% (95% CI, 89.5%-95.8%), respectively. Estimated incidences of radiation-induced retinopathy and xerophthalmia were 7.2% and 10.1%, respectively. GTV was significantly associated with VA (P = 0.014) with estimated VA rates of 96.4%, 91.4%, and 80.5% for GTVs of 2.0, 3.0, and 4.0 cm3, respectively. CONCLUSIONS RT was well tolerated, with excellent LC achieved. Nearly 90% of patients noted either stability or improvement in VA and VF. Larger ONMs were associated with poorer VA.
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Affiliation(s)
- Yash J Vaishnav
- Department of Ophthalmology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
| | - Raj Singh
- Department of Radiation Oncology, Virginia Commonwealth University Health System, Richmond, Virginia, USA
| | - Prabhanjan Didwania
- Rady School of Management, University of California San Diego, San Diego, California, USA
| | - Eric J Lehrer
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Tatiana Bakaeva
- Department of Ophthalmology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Timothy J Harris
- Department of Radiation Oncology, Virginia Commonwealth University Health System, Richmond, Virginia, USA
| | - Michael E Migliori
- Department of Ophthalmology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Jason P Sheehan
- Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA
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Høngaard SK, Hjortdal J. [Vision jeopardizing xerophthalmia in Denmark]. Ugeskr Laeger 2010; 172:51-52. [PMID: 20056097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A 54-year-old alcoholic was admitted with keratomalacia in 2001. The right cornea had an ulceration and the left cornea had stromal necrosis and a perforation. Serum retinol and serum betacaroten were extremely low. Treatment consisted of high-dose retinol and left sided cornea transplantation. The right eye healed with little scarring, vision: 0.5. The left eye was stabilized after a second cornea transplantation and covering with conjunctiva, vision: hand movement at a distance of 1 m. This proves the existence of symptomatic vitamin A deficiency among socially exposed subjects in Denmark.
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Mao C, Yu GY, Zhang L, Cai ZG, Wang Y, Peng X. [Reliability of venae comitant of facial artery as the donor vein in microvascular autologous submandibular gland transfer]. Zhonghua Kou Qiang Yi Xue Za Zhi 2009; 44:147-149. [PMID: 19576018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To analyse the reliability of concomitant venae of facial artery as the donor vein in microvascular autologous submandibular gland transfer. METHODS One hundred and seventeen cases with severe keratoconjunctivitis sicca treated by microvascular transfer of autogenous submandibular gland transfer from August of 1999 to November of 2007 were reviewed. The cases were divided into three groups according to their different donor veins, with group A using facial veins, group B using concomitant venae of facial artery, and group C using a vein near the duct. Group A and B were compared in terms of venous thrombosis rate and failure rate related to venous thrombosis. RESULTS Among 117 cases, there were 122 sides of submandibular gland transfers, with 93 in group A, 27 in group B, and 2 in group C. Postoperative venous thromboses rate was 15% in group A and 7% in group B, with significant difference (P < 0.01). The failure rate of transferred gland related to venous thrombosis was 8% in group A, and 7% in group B, with no significant difference (P > 0.05). CONCLUSIONS Concomitant venae of facial artery can be used as reliable donor vein in microvascular autologous submandibular gland transfer.
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Affiliation(s)
- Chi Mao
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100081, China.
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Habot-Wilner Z, Spierer A, Barequet IS, Greenbaum A. Use of Amniotic Membrane Graft and Corneal Transplantation in a Patient With Bilateral Keratomalacia Induced by Uncontrolled Phenylketonuria. Cornea 2007; 26:629-31. [PMID: 17525666 DOI: 10.1097/ico.0b013e31803d1617] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To report a patient with a rare complication of bilateral keratomalacia induced by uncontrolled phenylketonuria (PKU) that was successfully treated with amniotic membrane transplantation in 1 eye and penetrating keratoplasty in the second eye. METHODS Case report and literature review. RESULTS A 9-month-old girl with uncontrolled PKU was referred to our clinic because of bilateral keratomalacia. Slit-lamp examination of the right eye revealed 2 large corneal erosions with stromal thinning on the nasal and inferior regions of the right cornea. Left eye examination revealed a large area of melting involving two thirds of the cornea with corneal perforation and iris bulging on the temporal side and no anterior chamber. She underwent amniotic membrane transplantation on her right cornea and penetrating keratoplasty on her left cornea. Treatment after surgery included antibiotic and steroid eye drops and a special diet regimen with partial phenylalanine intake. Examination under anesthesia 4 months after surgery revealed intact cornea in her right eye and a clear corneal graft with a deep anterior chamber on her left eye. Intraocular pressure was normal in both eyes. CONCLUSIONS Bilateral keratomalacia, although a rare ophthalmic manifestation of PKU, can cause a severe corneal injury that may threaten the eyeball integrity. Surgical treatments with amniotic membrane graft and corneal transplantation, along with the appropriate diet treatment, were found to be effective procedures, yielding rapid healing of the corneal surface.
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Affiliation(s)
- Zohar Habot-Wilner
- Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel.
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Abstract
OBJECTIVE To report early clinical experience with a new microvascular reconstructive procedure for patients with severe xerophthalmia. STUDY DESIGN Retrospective clinical series. METHODS Patients with severe xerophthalmia were referred for treatment after having exhausted all conventional means of treatment. The ipsilateral submandibular gland was transferred to the temporal fossa, as described by Macleod et al., and revascularized using the superficial temporal artery and appropriate vein(s). The submandibular duct was directed to the superolateral fornix so that the saliva produced moistened the eye. Results and complications were reviewed. RESULTS Seven microvascular submandibular gland transfer procedures were performed in five patients, ages 6 to 54. The etiology of severe xerophthalmia was Stevens-Johnson syndrome in four and chemical burn in one. Follow-up time was 4 to 20 months. Successful transfer with revascularization was achieved in six of seven (86%) cases. Schirmer's test scores improved from 1.3 pretransfer to 8.1 posttransfer (P = .005). Patients experienced symptomatic relief within 1 month, and the microenvironment of the eye surface improved enough to make them candidates for visual restorative eye surgery. There were no major complications. CONCLUSIONS Microvascular submandibular gland transfer is an effective approach for correcting severe xerophthalmia. The procedure should be within the skills of any reconstructive microsurgeon. This procedure offers a unique opportunity for otolaryngologist-head and neck reconstructive surgeons to help restore vision to this unfortunate group of patients.
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Affiliation(s)
- Randal C Paniello
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
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Abstract
PURPOSE To study the clinical effects of the secretion of transplanted labial glands used as ocular lubricant to treat severe dry-eye cases, to evaluate the duration of the results and to simplify the surgical technique. METHODS Thirty-seven surgeries were performed in twenty-one patients during the period of July 2000 to January 2004. The graft, consisting of labial mucosa and underlying salivary glands, was transplanted to the previously prepared area in the conjunctival fornix. All procedures were recommended in severe dry-eye cases, that is, eyes with total or nearly total xerophthalmia. The preoperative and postoperative protocols are presented emphasizing the items which were used in the comparative analysis of the results as well as the technical description of the surgical procedure. RESULTS The graft survival and integration into the host tissues were observed in 97.2% of the cases. The clinical improvement, demonstrated by the disappearance of the symptoms, better biomicroscopic aspect of the ocular surface, better vision and disuse of lubricant drops, was observed in 91.9% of the cases. The follow-up showed not only persistence but also stability of the results. Infection represented one case and ptosis represented three cases of the only four observed complications. CONCLUSION The improvement of severe dry-eye cases detected after the transplantation of labial salivary glands is significant. It demonstrates that the lubricant ocular surface produced by the salivary secretion is efficient and well-tolerated. The follow-up shows that the result persists in the long term from which it is concluded that the production of the secretion is permanent. The surgical technique of transplanting the labial salivary gland to the conjunctival fornix is very simple and easily accessible to any ophthalmic surgeon.
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Schröder C, Hakim SG, Collin JRO, Sieg P, Geerling G. Mehrjahresverlauf nach Autotransplantation der Unterkieferspeicheldr�se bei vernarbender Keratokonjunktivitis mit absolutem Tr�nenmangel. Ophthalmologe 2003; 100:1079-84. [PMID: 14704823 DOI: 10.1007/s00347-003-0861-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION An autologous submandibular gland can be transplanted to the temporal fossa and following microvascular anastomosis to the temporal artery and vein and implantation of the secretory duct into the superotemporal conjunctival fornix to provide continuous substitute lubrication. Here we report our experiences with this procedure. PATIENTS AND METHODS In a prospective, controlled clinical cohort study, we investigated the development of the Schirmer- test, fluorescein-break up time (F-BUT), degree of discomfort, use of pharmaceutical tear substitutes, visual acuity, Rose Bengal staining and conjunctival hyperemia in 14 eyes with a successful submandibular gland transplant and 11 dry eyes without salivary lubrication. RESULTS Over a mean postoperative period of 3.3 years the transplantation group showed significant improvements of the Schirmer-Test, FBUT, use of pharmaceutical tear substitutes, discomfort and Rose Bengal staining up to the last follow-up when compared to the preoperative and control groups. CONCLUSION Transplantation of an autologous submandibular gland can improve the lubrication and discomfort of absolute tear deficiency on a long term basis, but the salivary tear film only partially stabilises the ocular surface. The procedure is however able to provide symptomatic relief in extreme cases of absolute dry eyes.
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Affiliation(s)
- C Schröder
- Klinik für Augenheilkunde, Universitätsklinikum Lübeck.
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Sakamoto T, Imauchi Y, Ishio K, Sugasawa M, Kagaya F. Cheek Mucocele Occurring Long after Parotid Duct Transplantation for Xerophthalmia. Ann Otol Rhinol Laryngol 2003; 112:912-4. [PMID: 14587985 DOI: 10.1177/000348940311201015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Takashi Sakamoto
- Department of Otorhinolaryngology, University of Tokyo, Tokyo, Japan
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Zhu Z, Yu G, Mao C, Cai Z, Zou L, Lu L, Peng X, Zhang L, Li N. [Treatment of xerophthalmia by transplantation of autologous vascularized submandibular gland]. Zhonghua Yi Xue Za Zhi 2002; 82:244-6. [PMID: 11953171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
OBJECTIVE To investigate the feasibility of treatment of xerophthalmia by transplantation of autologous vascularized submandibular gland (SMG). METHODS The SMGs of 19 patients with severe keratoconjunctivitis were transferred to their temporal region by microsurgery. The arteries and veins of the SMGs were anastomosed to the super-temporal arteries and veins, the SMG ducts were implanted into the conjunctival fornix of the eye. The saliva secreted by the SMG was used as the substitute of tear. RESULTS The transplantation succeeded in 14 patients and failed in 4. Follow up lastred for 3 months to 2 years. The symptom of corneal xerosis disappeared, the symptoms of photophobia and anemophobia were alleviated, and artificial tear substitutes were not used any more. Epiphora appeared in 4 cases and disappeared after partial resection of the transplanted gland. Atresia of orifice occurred in one case and was cured by reconstruction of the duct. CONCLUSION Transplantation of autologous vascularized SMG is effective in treating severe keratoconjunctivitis sicca.
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Jia G, Wang Y, Lu L, Wang X, Li Z. [Reconstructive lacrimal gland with free submandibular gland transfer for management of xerophthalmia]. Zhonghua Yan Ke Za Zhi 1998; 34:388-90. [PMID: 11877235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
OBJECTIVE In order to seek more efficient surgical method to treat total xerophthalmia. METHOD Microvascular submandibular gland transfer was used to reconstruct lacrimal gland for management of the dry eye. 5 cases (6 eyes) with total xerophthalmia were operated with this method. RESULTS All the patients were followed up for 1 - 30 months. The results were satisfactory, the submandibular salivary gland relieved the dryness and improved visual acuities with negligible side effect. CONCLUSION Microvascular submandibular gland transfer is potentially the best surgical solution to total xerophthalmia.
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Affiliation(s)
- G Jia
- Department of Ophthalmology, The First Affiliated Hospital, China Medical University, Shenyang 110001
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Abstract
PURPOSE To report a case of bilateral corneal ulcers and perforations resulting from hypovitaminosis A in an alcoholic patient. METHODS A 38-year-old cachetic man presented with bilateral corneal ulcerations and severe visual loss. He was hospitalized, developed bilateral corneal perforations, and was treated with bilateral corneal transplants. RESULTS Serum vitamin A level was 0.01 microg/dL (normal, 0.30-0.75). The electroretinogram was consistent with vitamin A deficiency. His clinical status improved after vitamin A replacement. CONCLUSIONS Although rare in developed countries, the ophthalmologist must consider avitaminosis A in the differential diagnosis of corneal ulcerations in cachetic, alcoholic, or chronically ill patients. Early diagnosis and treatment can prevent unwanted outcomes.
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Affiliation(s)
- M S Macsai
- Department of Ophthalmology, West Virginia University School of Medicine, Morgantown 26506, USA
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Patel BC, Patipa M, Anderson RL, McLeish W. Management of postblepharoplasty lower eyelid retraction with hard palate grafts and lateral tarsal strip. Plast Reconstr Surg 1997; 99:1251-60. [PMID: 9105351 DOI: 10.1097/00006534-199704001-00007] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Lower eyelid malposition is the most common long-term complication following transcutaneous lower eyelid blepharoplasty. The malposition may include rounding of the lateral canthal angle, lower eyelid retraction with inferior scleral show, or frank ectropion. The result is cosmetically unacceptable and may be associated with tearing, irritation, and other exposure keratitis symptoms. Multiple factors, including lower eyelid laxity, shortage of skin, and scarring of the middle lamella, may be responsible for this malposition. A systematic examination of the lower eyelid, as presented, helps to assess the degree to which each of these factors is responsible for the malposition. Patients with the most severe degree of lower eyelid malposition generally have middle lamella scarring. If this abnormality is not addressed, lower eyelid procedures aimed at correcting the malposition are doomed to failure. In the presence of significant middle lamella scarring, a spacer is required to provide vertical height and stiffness to support the lower eyelid following release of the cicatrix. A systematic approach aimed at addressing the underlying abnormalities was developed. In patients with significant middle lamella scarring, hard palate mucosa grafts were used as spacers in 29 eyelids (17 patients). A lateral canthotomy and transconjunctival incision allow access to the scarring in the lower eyelid retractors and septum. After careful release of all cicatrix, a hard palate mucosa graft is inserted between the lower border of the tarsal plate and the recessed conjunctiva, lower eyelid retractors, and septum. Horizontal lower eyelid laxity, when present, is corrected by performing a lateral tarsal strip. Most patients do not have a true deficiency of the anterior lamella (skin and orbicularis oculi muscle). When a moderate amount of anterior lamella deficiency is present with significant scarring of the middle lamella, the technique we describe allows correction of the lower eyelid malposition without a skin graft. After a follow-up interval of 6 to 30 months (mean 14 months), excellent results were obtained in all eyelids. Complications included corneal abrasions in two eyes before routine use of bandage cornea contact lenses at the end of surgery and a secondary bleed from the roof of the mouth in one patient. Palate mucosa closely resembles tarsus and provides excellent vertical support to the eyelid. It is stiff enough to maintain eyelid contour without causing a cosmetically unacceptable bump. Tissue can be obtained with ease. The technique, as described, addresses the underlying causes of lower eyelid malposition and gives excellent functional and cosmetic results.
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Affiliation(s)
- B C Patel
- Division of Ophthalmic Plastic, Reconstructive and Orbital Surgery, Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
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Abstract
Occlusion of the lacrimal canaliculi improves the objective signs and subjective symptoms of dry eye. In this review, methods of occlusion are classified as surgical, thermal and tamponade. Surgical methods include dacryocystectomy, canalicular ligature, canalicular offset, canalicular excision, transfer of the punctum to dry dock, punctal tarsorrhaphy and punctal patch. Thermal methods include cautery, diathermy and laser burn. Tamponade methods use absorbable inserts of hydroxypropyl cellulose, gelatin, collagen and catgut, and nonabsorbable inserts of silicone (punctum plugs, canalicular plugs), polyethylene, cyanoacrylate, and others. The characteristics of all these methods are analyzed.
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Affiliation(s)
- J Murube
- Hospital Ramón y Cajal, Universidad de Alcalá, Madrid, Spain
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Zhang H, Zhou Z, Chen Z, Zhao C. [Management of the dry eye with parotid duct transplantation: a summary on 40 cases]. Yan Ke Xue Bao 1995; 11:67-9. [PMID: 9208654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE As today the effect of parotid duct transplantation is clinically regarded as uncertainty, and there is still absent of effective managenent of the dry eye, this paper tries to clarify its value, and see if it can be used clinically. METHODS Forty dry eyes were operated with a follow up of 3 weeks to more than 6 years in the past 42 years. The pre- and postoperative changes of tear flow and vision, and the cause of dry eye, operative method, length of parotid duct and complications of bilateral operation were briefly summarized. RESULTS Of these 40 operated eyes postoperatively, 82.5% had tearing, but no tearing occurred in 27.5%. Finally: vision increased in 72.5% with out any decrease. There was no difference in the results whether the procedure done extraorally or intraorally. The parotid duct being shorter was only seen in 7.5%, which were satisfactorily managed by tube making with oral mucosa. Four cases operated binocularly and silmutaneously, only 1 occurred aveolar abscess with complaining dry mouth, but cured 1 week later. After operation, profusive tearing occurred in 25 dry eyes caused by trachoma during eating and 96% usually, but tearing stopped finally in 3 eyes (2, due to infection). Four dry eyes with ocular pemphigoid failed. Among 9 dry eyes resulted from Stevens-Johnson syndrome, 6 had little tearing postoperatively, 2 of which attained a nearly normal results. One of the two dry eyes resulted from alkali eye burn failed and the other, occurred tearing but only followed-up for 1 month, the result was uncertain. CONCLUSION As the technique of the parotid duct transplantation is simple and easy with no much complications, and for treating the dry eye, there is up to now still absent of effective management, therefore, the parotid duct transplantation should be considered to be indicated in dry eyes esp, caused by Stevens-Johnson syndrome. Though its success rate is lower than that of traucomatous ones, the satisfactory result of nearly normal postoperative tearing may be got. In ocular pemphigoid, however, it is contraindicated.
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Affiliation(s)
- H Zhang
- Center of Dacryology, Second Affiliated Hospital, 1st Military Medical University, Guangzhou, China
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Affiliation(s)
- M May
- Facial Paralysis and Sinus Surgery Center, Shadyside Hospital, Pittsburgh, PA 15232
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Lasudry J. Experimental approach to surgical treatment of lacrimal insufficiency by microvascular submandibular salivary gland autotransplantation. Bull Soc Belge Ophtalmol 1992; 245:45-51. [PMID: 1344746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
When compared to the parotid duct transposition, the microvascular submandibular salivary gland autotransplantation presents the advantage of providing a more viscous tear substitute, and a basal flow rate unaffected by meals. If future attempts to re-innervate the graft are successful, this procedure could be promising in restoring an acceptable lacrimal function in severe xerophthalmia.
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Affiliation(s)
- J Lasudry
- Hôpital Universitaire Saint-Pierre, Bruxelles
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19
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Kumar PA, Hickey MJ, Gurusinghe CJ, O'Brien BM. Long term results of submandibular gland transfer for the management of xerophthalmia. Br J Plast Surg 1991; 44:506-8. [PMID: 1954514 DOI: 10.1016/0007-1226(91)90006-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Free submandibular gland transfer is potentially the best surgical solution to total xerophthalmia. Experimentally, gland function has only previously been followed for 2 months. This study was designed to investigate the long term effects of free transfer on gland function. Simultaneous creation of experimental xerophthalmia and free microvascular transfer of the submandibular gland to the orbit was completed in 10 rabbits. Two died before the end of the experimental period and the study was based on the remaining eight. Six months after transfer, five of the eight transferred glands were histologically normal and contained healthy neurones and nerve terminals. In these animals, tear secretion in the transfer eye was significantly greater than that of the control eye at 2 (p less than 0.05) and 6 months (p less than 0.02) after transfer. In the transfer eye, tear secretion was also found to have significantly increased from preoperative levels at 2 (p less than 0.05) and 6 months (p less than 0.01). The observed innervation of the transferred glands may play a role in maintaining secretion in the long term.
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Affiliation(s)
- P A Kumar
- Microsurgery Research Centre, St Vincent's Hospital Melbourne, Victoria, Australia
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Macleod A, Kumar PA, Hertess I, Newing R. Microvascular submandibular gland transfer; an alternative approach for total xerophthalmia. Br J Plast Surg 1990; 43:437-9. [PMID: 2393769 DOI: 10.1016/0007-1226(90)90009-o] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A case of total xerophthalmia is reported in which microvascular transfer of the submandibular gland relieved the dryness with negligible side-effects.
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Affiliation(s)
- A Macleod
- Microsurgery Research Centre, St Vincent's Hospital, Melbourne, Australia
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Kumar PA, Macleod AM, O'Brien BM, Hickey MJ, Knight KR. Microvascular submandibular gland transfer for the management of xerophthalmia; an experimental study. Br J Plast Surg 1990; 43:431-6. [PMID: 1697488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Free submandibular salivary gland transfer was investigated as a method of treatment for xerophthalmia. Xerophthalmia was created in rabbits by surgical removal of the lacrimal gland and the incidence of corneal ulceration was seen to correlate with the decrease in tear secretion. Microvascular transfer of the submandibular salivary gland to drain saliva into the conjunctival fornix prevented the development of corneal ulceration in 63% of the cases.
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Affiliation(s)
- P A Kumar
- Microsurgery Research Centre, St Vincent's Hospital, Melbourne, Australia
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22
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Bernard JA, Fayet B, Pouliquen Y. [New models of the punctum plug and inserter]. Bull Soc Ophtalmol Fr 1989; 89:1131-2. [PMID: 2620394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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23
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Abstract
We performed punctal occlusion by thermal cautery on 23 patients (45 sides, 90 puncta). One punctum on the right side was randomly assigned to deep cauterization of the punctum and vertical canaliculus, and the other punctum assigned to cauterization of the punctum only. The two treatments were assigned to the opposite puncta on the left side. One month after cauterization, the puncta that received deep cauterization were significantly more likely to have remained closed than those that received superficial cauterization (P less than .01). Survival analysis over a period of follow-up that exceeded one year after surgery, using time to examination because of a reopened punctum as the endpoint, indicated a long-term advantageous effect of deep over superficial cauterization.
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Affiliation(s)
- M E Knapp
- Department of Ophthalmology, University of Michigan, W. K. Kellogg Eye Center, Ann Arbor 48105
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24
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Affiliation(s)
- A M Nasr
- Division of Oculoplastic Surgery, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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25
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Gola R, Gambarelli-Mouillac N, Ourgaud M, Berard PV. [Epiphora after transposition of Stenon's duct. Therapeutic solution]. Bull Soc Ophtalmol Fr 1980; 80:935-8. [PMID: 7449013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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26
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Radian AB, Radian AL, Liviu A. [Transplantation of the lacrimal gland, a new operation in ocular xerosis]. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Ser Oftalmol 1979; 23:203-6. [PMID: 531288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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27
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Abstract
Xerophthalmia, or dry eye, is an old human affliction. Among the many causes are trachoma, surgical or traumatic destruction of the lacrimal gland, and paralysis of the greater superficial petrosal nerve after Bell's palsy or from the presence or removal of an intracranial posterior fossa tumor. The technique of parotid duct transfer is a well established effective means to rehabilitate the dry eye. A method of parotid duct transfer is described.
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28
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Jones DB. Prospects in the management of tear-deficiency states. Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol 1977; 83:693-700. [PMID: 898490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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29
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Patten JT, Cavanagh HD, Pavan-Langston D. Penetrating keratoplasty in acute herpetic corneal performations. Ann Ophthalmol 1976; 8:287-94. [PMID: 773241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Central corneal perforations have traditionally been managed by conjunctival flaps, tissue adhesives, soft contact lenses, corneal patches and other conservative measures for the immediate preservation of the eye. An alternative method of treatment is immediate penetrating keratoplasty. We present the result of immediate keratoplasty for 25 eyes referred with acute central corneal perforations, 20 of herpetic origin and 5 with a chemical burn or dry eye syndrome. In all cases, the eye was successfully preserved. Twelve of 20 grafts (60%) for herpetic perforation went on to eventual clear grafts as opposed to 1 of 5 grafts (20%) in the dry eye or chemically burned patients. Significant complications encountered included cataract formation, secondary glaucoma and persistent epithelial defects; however, these should not preclude eventual restoration of good visual acuity. Penetrating keratoplasty in acutely inflamed and perforated eyes used to lead to angle closure and secondary glaucoma in a considerable number of cases, sometimes progressing to total disaster. We have shown that if enough corticosteroids are given immediately postoperatively, the risk for angle closure is not significant.
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30
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Kurbanaeva ES, Kudoiarov GK. [Morphological aspects of xerophthalmia after transplantation of Stensen's duct into the conjuctival cavity]. Vestn Oftalmol 1975:43-6. [PMID: 1146054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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31
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32
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Kurbanaeva FS. [Late results of Stensen's duct transplantation]. Vestn Oftalmol 1973; 5:44-6. [PMID: 4780043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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33
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Srivastva KN, Singh M, Bhardwaj PC, Pathak LR. Stenson duct "implantation" in xerophthalmia--a surgical technique. Two case studies. Eye Ear Nose Throat Mon 1970; 49:522-6. [PMID: 5524412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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34
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Goddé C, Bonnin P, Varret D. [A case of Filatov-Chevaljev operation]. Ann Otolaryngol Chir Cervicofac 1970; 87:356-9. [PMID: 5424461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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35
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36
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Jébéjian R. [The surgical treatment of xerosis. (Technical remarks on 2 cases treated surgically with the Filatow-Chevalyev method)]. Ann Ocul (Paris) 1969; 202:477-89. [PMID: 5370654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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37
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38
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Gyenes V, Grósz I. [Transposition of the parotid duct in xerophthalmia. Sialodochoconjunctivostomy]. Orv Hetil 1969; 110:660-2. [PMID: 5767734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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39
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Bennett JE. The management of total xerophthalmia. Trans Am Ophthalmol Soc 1968; 66:503-29. [PMID: 5720849 PMCID: PMC1310312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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40
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Strampelli B. [Technical improvements in osteo-odonto-keratoprothesis]. Ann Ottalmol Clin Ocul 1966; 92:155-78. [PMID: 5959660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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41
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PAUFIQUE PL, FREIDEL C, DUMAS P, CHARLEUX J. [Parotid salivary derivations in xerophthalmia]. Ann Chir Plast 1961; 6:235-42. [PMID: 14484459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
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43
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FARINA R, ATTADIA ER, de CARVALHO C, BAROUDI R. [Xerophthalmia. Surgical treatment by transplant of the parotid duct]. Rev Paul Med 1961; 58:227-34. [PMID: 13698191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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44
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ASHLEY FL, SCHWARTZ AN, STRAATSMA BR, FORD JC. Transplantation of the parotid duct for xerophthalmia. Am Surg 1959; 25:815-8. [PMID: 13794750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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45
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VASILEV I. [Surgical therapy of parenchymatous xerosis]. Khirurgiia (Mosk) 1959; 12:405-9. [PMID: 13841436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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46
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STRAMPELLI B. [Results after 10 years in a case of implantation of Steno's duct into the conjunctival sac in xerophthalmia; presentation of clinical case]. Boll Ocul 1958; 37:89-100. [PMID: 13560675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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47
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BENNETT JE, BAILEY AL. Surgical treatment of total xerophthalmia; transplantation of the parotid duct to the inferior cul-de-sac with report of a case. AMA Arch Ophthalmol 1957; 58:372-4. [PMID: 13457527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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48
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BENNETT JE, BAILEY AL. A surgical approach to total xerophthalmia; transplantation of the parotid duct to the inferior cul-de-sac. AMA Arch Ophthalmol 1957; 58:367-71. [PMID: 13457526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
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49
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LAO YS. Transplantation of parotid duct into the conjunctival sac for the treatment of xerophthalmia with report of a case. Chin Med J 1955; 73:223-9. [PMID: 13250661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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