Immanuel Kant noted this approach would not be suitable for understanding complex systems such as an organism. He said there would never be a " Newton of the blade of grass " : because the blade of grass is more than the sum of its parts, complete knowledge of the parts list will not necessarily be predictive of the behavior of the whole. Fortunately, we don't have to resort to a vitalistic exp...

BACKGROUND The eyelid and canthal areas are common locations for cutaneous tumors. The medial canthus includes, among many other apparatuses, the canthal tendon and lacrimal canaliculi, and its characteristic thin and supple skin is hard to mimic and restore using tissue from other regions. Accordingly, reconstruction of the canthal area can prove challenging for surgeons. Although various meth...

OBJECTIVES To describe the split orbicularis myomucosal flap and to review our center's experience with this technique for large defects of the lower lip. METHODS All patients presenting to the senior author (Y.D.) for lower lip reconstruction using this flap were reviewed in a retrospective fashion. RESULTS A total of 14 patients with a minimum follow-up of 6 months (mean, 3.4 years; range...

We have reviewed the surgical management of essential blepharospasm over the last 15 years, comparing the results from facial nerve avulsion with those from orbicularis muscle stripping. After facial nerve avulsion 50% of patients remained free of troublesome spasm for 15 months after surgery, but only 25% remained so for more than two years. Following orbicularis oculi myectomy 50% of patients...

BACKGROUND Static reconstruction surgery that tightens the tension of the inferior tarsus, thereby raising the lax lower eyelid, is a common treatment for paralytic ectropion of the lower eyelid. We present one such operative procedure, in which an orbicularis oculi muscle flap was used. METHODS The surgical technique involves partial resection of the tarsus and the skin, as well as a superio...

BACKGROUND To determine if fine-motor eye exercises can be used for treatment of unilateral, idiopathic cranial nerve VII paresis to improve rate of recovery. METHODS In this prospective, randomized controlled trial, eligible patients were randomized to perform fine-motor eye exercises (n=18) or to do no exercise (n=9) for a period of four weeks. Orbicularis oculi muscle strength was measured...

PURPOSE To determine the effect of hyperthyroidism on both myofiber number and myosin heavy-chain isoform composition within the palpebral orbicularis oculi muscle in rabbits. METHODS Four New Zealand White rabbits were made hyperthyroid by injection of 3,3,3'-triiodothyroinine intraperitoneally every other day for 1 month. Four rabbits were used as control animals. After 1 month the rabbits ...

OBJECTIVE To evaluate changes in lower eyelid position using digital image analysis in patients who have undergone an orbicularis suspension flap combined with blepharoplasty. METHODS A total of 68 patients (136 eyes) underwent a lower eyelid orbicularis oculi suspension flap combined with blepharoplasty. Digital image analysis was used to standardize each patient's preoperative and postopera...