Objective To observe the cl inical outcome of treating blepharophimosis-ptosis-epicanthus inversus syndrom (BPES) by means of primary and complex recection of levator palpebrae superioris musculus. Methods From May 2001 to May 2007, 12 patients with BPES were treated, including 6 males and 6 females aged 4-15 years old (average 7 years old).All patiens marked signs of BPES— typical ptosis of the upper eyel ids, epicanthus inversus, palpebral fissure, and increased distance between inner canthus.The eye fissure width was (2.8 ± 1.8) mm, the eye fissure length was (19.8 ± 4.7) mm, and the inner canthic diameter was (41.6 ± 6.5) mm.The muscular strength of levator palpebrae superioris was deficient in 4 cases, the muscular strength of levator palpebrae superioris was (2.0 ± 0.6) mm in 8 cases.All patients were associated with visual function congenital defects of varying degrees.The surgical technique included shortening of the internal canthal l igaments, recection of the tarsus and levator muscle, and skin plasty. Results All the incisions healed by first intension.Twelve patients were followed up for 12-48 months (average 30 months).Amel ioration of ptosis and epicanthus was achieved.At 18 months after operation, the eye fissure width of 10 petients was (9.0 ± 2.1) mm, the eye fissure length was (26.5 ± 3.5) mm, and inner canthic diameter was (30.2 ± 2.7) mm, the muscular strength of levator palpebrae superioris increased to (5.6 ± 1.9) mm, showing significant difference when compared with preoperation (P lt; 0.05). Conclusion The primary and complex recection of levator palpebrae superioris musculus can provide relating good cosmetic and functional results for the correction of BPES. Patients with BPES should receive surgery as early as possible.
ObjectiveTo investigate the psychological states and their influencing factors in parents of congenital defect neonates admitted to Intensive Care Unit (ICU). MethodsThe self-designed general information questionnaire was used to collect the demographic data, and self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the states of anxiety and depression of the parents of congenital defect neonates admitted to ICU between June 1 and November 29, 2013. ResultsA total of 152 parents were included in this investigation. The average score of SAS was 39.45±8.53. The average score of SDS was 43.28±10.76. Univariate analysis found that parents with lower educational level, poorer family income, positive family history and countryside residence might have higher score of SAS, while parents with Han nationality, poorer family income and family history would have higher score of SDS. Multivariate analysis discovered that living condition and family history were related to anxiety status. However, depression state was influenced by nationality, family income and family history. ConclusionA considerable number of parents of congenital defect neonates admitted to ICU have anxiety or depression. And nationality, family income, family history and living condition are the major risk factors.
ObjectiveTo investigate the diagnosis and treatment of thumb polydactyly with symphalangism in children.MethodsSeven cases of thumb polydactyly with symphalangism were treated between January 2013 and May 2017. There were 5 males and 2 females, aged from 10 months to 11 years, with an average age of 3.1 years. The thumb-polydactyly was diagnosed with MRI and it was seen that the base of radial multi-finger and the proximal phalangeal joint were connected by cartilage. All patients were treated with resection, lateral collateral ligament reconstruction, bone osteotomy and internal fixation.ResultsThe operation was successfully completed, and there was no early complications such as infection and flap necrosis. All patients were followed up 6-23 months (mean, 14.1 months). At last follow-up, there was no deformity finger, scar contracture, and other complications. The extension of the interphalangeal joint was no limited, and the flexion range of the interphalangeal joint was 20-75° (mean, 56.7°). The appearance and function of the thumb was rated as excellent in 3 cases and good in 4 cases by Japanese Society for Surgery of the Hand (JSSH) scoring, with the excellent and good rate of 100%.ConclusionThe thumb polydactyly with symphalangism in children can be combined with clinical manifestations, X-ray film, and MRI examination to diagnose, and can obtain satisfactory results through the reconstruction of lateral collateral ligament, bone osteotomy, and internal fixation.