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Les kystes dermoïdes sont des dérivés embryologiques des tissus mous. Ils résultent d'une inclusion ectodermique aberrante dans le mésoderme au cours du développement embryonnaire précoce. Ces kystes ont une progression lente, et sont fréquents en pédiatrie. Quatre-vingts pour cent d'entre eux siègent au niveau de la tête, et la plupart se situent à la suture fronto-zygomatique, au niveau de la queue du sourcil. Cliniquement, ils sont superficiels ou profonds. Le diagnostic est fortement suspecté cliniquement, parfois renforcé grâce aux examens complémentaires, et posé une fois l'analyse histologique réalisée. L'exérèse chirurgicale par voie ouverte sans rupture du kyste est le gold standard. Dermoid cysts are embryological derivatives from soft tissues. They result from an ectodermic inclusion in the mesoderm, during the early embryonic development. These cysts have a slow development and are mostly encountered in the pediatric population. Eighty percent of them are located in the head and neck area, and most of them are on the frontozygomatic suture. They are superficial or deep on clinical examination. The diagnosis is mostly easy, sometimes with the help of radiological examination. The confirmation is histological. Surgical removed by an open approach, without cyst rupture is the gold standard treatment. [ABSTRACT FROM AUTHOR]

Studies on the muscular-deep fascial system which connects the upper eyelid, brow, and glabella, are lacking. This study aimed to explore the fine anatomy of the muscular-deep fascial system in the region between the eyebrow and the superior orbital margin. We included eight formalin–phenol-embalmed cadavers (16 sides of specimens), and categorized them into anatomical dissections and histological sections. Five cadavers (10 sides) were dissected for gross anatomical observation, whereas all soft tissues of the other three cadavers (6 sides) were dissected for tissue sectioning and histological analysis. Three tissue blocks and 16 strips in each block were trimmed, numbered, and sliced into these specimens. Hematoxylin–Eosin and Masson's Trichrome staining were performed. In the region between the eyebrow and the superior orbital margin, the frontalis was covered by the orbicularis oculi. Fibers of the frontalis muscle penetrated into the orbicularis oculi muscle bundles, and crosslinked around the eyebrow level. Both the frontalis and the orbicularis oculi were attached to the thickened multilayered deep fascia in this region, which could be regarded as the muscular-deep fascial system. The muscular-deep fascial system connects the frontalis deep fascia and deep forehead compartments down to the orbicularis-supporting ligament. The precise anatomy of the muscular-deep fascial system in the region between the eyebrow and the superior orbital margin may provide a valuable reference for soft-tissue fixation and suspension in facial surgery. [ABSTRACT FROM AUTHOR]

Background: Purely suprasellar and some complex intra-suprasellar Rathke cleft cysts (RCCs) are commonly treated via extended endonasal endoscopic approach or traditional transcranial approach. The feasibility of the trans-eyebrow supraorbital keyhole approach (TSKA) for RCCs was evaluated in this retrospective study. Methods: A cohort of 16 patients (11 females and 5 males) with RCC was surgically treated via TSKA between January 2013 and November 2021. The medical data and follow-up results were analyzed. Results: Eight patients had a purely suprasellar RCC, and 8 patients had an intra-suprasellar RCC with most of pituitary gland occupying the sellar floor. The mean maximal size of the cysts was 15.4 (range 7–29) mm. Postoperatively, complete cyst drainage was achieved in 15 (93.7%) patients. Preoperative headache, visual dysfunction, and hypopituitarism improved in 12 (100.0%), 3 (75.0%) and 3 (75.0%) patients, respectively, and hyperprolactinemia normalized in all patients. Except 2 (12.5%) cases of transient diabetes insipidus (TDI), no other complications were observed. During the mean follow-up period of 41.0 (range 4–102) months, 1 (6.3%) radiological recurrence was found. Conclusions: For the treatment of purely suprasellar and some intra-suprasellar RCCs with most of the pituitary occupying the sellar floor, the endoscopic TSKA has the advantage of the minimal invasiveness, excellent visualization of the intrasellar compartment, no additional damage to the underlying pituitary gland, and no risk of CSF leakage. TDI or DI is relative commonly found in treatment of these RCCs. During surgery, care should be taken to avoid damage to the surrounding structures, including the pituitary stalk. [ABSTRACT FROM AUTHOR]

Tessier number 10 cleft is one of the rarest facial clefts. Surgical treatment of this type of cleft is challenging due to the complexity of periorbital and temporal soft tissue deformities. A 23-year-old male patient presented with typical facial deformities of Tessier number 10 cleft. The surgical procedure involved using a free anterolateral thigh flap to reconstruct the eye socket, while the superficial temporal artery pedicle scalp flap was used to reconstruct the eyebrow deformity. The patient had no complications and 16 months after surgery, the patient had good aesthetic results. A hair-bearing scalp flap with a pedicle of the frontal branch of the superficial temporal artery combined with an anterolateral thigh-free flap can effectively resolve most soft tissue deformities of Tessier number 10 cleft and reconstruct the orbital socket in a single surgery. At the same time, it augments the soft tissue of the frontotemporal area and provides good aesthetic results. [ABSTRACT FROM AUTHOR]

Objective: To review the efficacy and safety of PS neodymium-doped yttrium aluminum garnet (Nd:YAG) laser for the removal of cosmetic tattoos of the eyebrows. Method: This was a retrospective review from January 2022 to August 2023 of patients who underwent cosmetic tattoo removal of the eyebrows with PS Nd:YAG laser. Results: A total of 24 patients were included in the review. 70% of patients were rated as “very much improved” (75-100% of the tattoo removed) and 30% of patients were rated “much improved” (50-75% of the tattoo removed). 1064-nm was the 1st wavelength used in all the cases. The average number of sessions required to obtain satisfactory results was 3. Four patients experienced unexpected change in their primary color of the eyebrow tattoos after the 1st treatment, which was successfully treated with 532-nm wavelength. None of the patients experienced dyspigmentation, scarring, or damage/bleaching of hairs of the eyebrows. Conclusion: PS Nd:YAG garnet laser is an effective and safe treatment for the removal of cosmetic tattoos of the eyebrows. [ABSTRACT FROM AUTHOR]

Objectives: The present analyses report integrated results from BRAVE-AA1 (NCT03570749) and BRAVE-AA2 (NCT03899259) on the clinical benefits of baricitinib treatment on the basis of the amount of scalp hair regrowth through 52 weeks of treatment. Methods: This post hoc analysis was conducted with data from patients who were treated continuously for 52 weeks with baricitinib 4 mg or 2 mg. Clinical outcomes were assessed using the Severity of Alopecia Tool (SALT) and Clinician-Reported Outcome (ClinRO) for Eyebrow (EB) and Eyelash (EL) hair. Secondary measures included the Hospital Anxiety and Depression Scale and Skindex-16 adapted for alopecia areata. At week 52, patients were classified into three subgroups: SALT ≤ 20 response, intermediate response (achieved a 30% improvement from baseline (SALT30) without a SALT score ≤ 20), or nonresponse (never achieved SALT30). The criterion of SALT30 approximates a minimal clinical meaningful response to therapy. Results: At week 52, with baricitinib 4 mg treatment, the greatest (70%) improvement in EB and EL was observed in responders, but approximately 50% of patients with intermediate response and 20% of nonresponders experienced complete/nearly complete EB and EL regrowth. Improvement in emotional distress was directionally related to improvements in scalp hair regrowth, while impact on quality of life was proportionately greater for the responder subgroup. Conclusions: Clinically meaningful regrowth in eyebrow and eyelash hair can occur in the absence of complete scalp hair regrowth after treatment with baricitinib. Emotional distress and quality of life improvement is most associated with obtaining a clinical meaningful improvement in scalp hair. Trial Registration Number: BRAVE-AA1, ClinicalTrials.gov number, NCT03570749, start date, 24 September 2018; BRAVE-AA2, ClinicalTrials.gov number, NCT03899259, start date, 8 July 2019. [ABSTRACT FROM AUTHOR]

Background Supraorbital eyebrow craniotomy is a minimally invasive alternative to a frontotemporal craniotomy and is often used for tumor and vascular pathologies. The purpose of this study was to investigate how patient cosmetic outcomes are affected by technique variations of this approach. Methods PubMed, Embase, and Scopus databases were systematically searched, and results were reported according to PRISMA guidelines. For the meta-analysis portion, the DerSimonian–Laird random effects model was used, and the primary end points were patient satisfaction and percentage of permanent cosmetic complications. Results A total of 2,629 manuscripts were identified. Of those, 124 studies (8,241 surgical cases) met the inclusion criteria. Overall, 93.04 ± 11.93% of patients reported favorable cosmetic outcome following supraorbital craniotomy, and mean number of cases with permanent cosmetic complications was 6.62 ± 12.53%. We found that vascular cases are associated with more favorable cosmetic outcomes than tumor cases (p = 0.0001). Addition of orbital osteotomy or use of a drain is associated with adverse cosmetic outcomes (p = 0.001 and p = 0.0001, respectively). The location of incision, size of craniotomy, utilization of an endoscope, method of cranial reconstruction, skin closure, use of antibiotics, and addition of pressure dressing did not significantly impact cosmetic outcomes (p > 0.05 for all). Conclusions Supraorbital craniotomy is a minimally invasive technique associated with generally high favorable cosmetic outcomes. While certain techniques used in supraorbital keyhole approach do not pose significant cosmetic risks, utilization of an orbital osteotomy and the addition of a drain correlate with unfavorable cosmetic outcomes. [ABSTRACT FROM AUTHOR]

Post herpetic itch (PHI) is a less commonly reported sequela of herpes zoster. It can begin upon the resolution of the lesions or several weeks later. PHI is neuropathic in nature and is said to be caused by neural injury in the form of demyelination of itch-transmitting nerve fibers in the skin. The majority of PHI resolves over weeks to months with symptomatic treatment. We report a case of PHI resulting in frictional alopecia of eyebrows and scalp due to frequent rubbing of the skin and hairs secondary to bothersome neuropathic itch. [ABSTRACT FROM AUTHOR]

Drooping of the upper eyelid and eyebrow (ptosis) is common among people and cause the patients dissatisfaction. Various methods have been developed to treatment of the upper eyelid and eyebrow ptosis. However, the current methods focus on surgery to improve the disorder. But patients are worried about the risks of the procedure, and seeking for a non‐invasive alternative method. Therefore, non‐invasive methods with consistent efficient improvement are needed, especially for middle‐aged patients. This study was conducted of 9 patients who underwent the upper eyelid and eyebrow ptosis. Endolift laser method was used to treat the patients' upper eyelid and eyebrow ptosis. The biometric assessment was used to evaluate the efficiency of the technique. Also the results were evaluated by 3 board‐certified dermatologists (blind). Additionally, patients' satisfaction was evaluated at the end of the treatment. The biometric results showed that Endolift laser can increase the thickness, density, and elasticity of the skin in the eyelid area. The patient's satisfaction results showed excellent improvement in the 90% of patients. The results by the dermatologist displayed improvement in about 90% of patient. Endolift laser has been proved efficient and consistent for upper eyelid and eyebrow ptosis rejuvenation and treatment. [ABSTRACT FROM AUTHOR]

Leukotrichia is one of the difficulties of vitiligo treatment. Hair follicle transplantation is an efficient method to treat vitiligo‐associated leukotrichia. A trichiasis electrolyzer, commonly used for treating trichiasis, can be used to damage and remove the depigmented hair follicles. To evaluate the efficacy of the electrolysis of depigmented hair using a trichiasis electrolyzer combined with single hair follicle transplantation for the treatment of vitiligo‐associated leukotrichia. A total of 15 patients with stable vitiligo‐associated eyebrow and eyelash leukotrichia were enrolled from Department of Dermatology, Hangzhou Third People's Hospital between January 2020 and January 2021. All patients were treated using a trichiasis electrolyzer combined with single hair follicle transplantation. The patients were followed up at the first week, the first month, the third month, and the sixth month after surgery. The texture and growth state of the transplanted hair were observed, and the number of surviving transplanted follicles and regenerating depigmented follicles were recorded. The transplanted hair grew as expected with natural shape. No local infection or obvious scar was observed. Most of the depigmented hair in the lesion area re‐pigmented and only a few depigmented hairs regenerated. The average survival rate of the transplanted hair follicles was 71.6%, and the average regeneration rate of the depigmented hair was 11.6%. The electrolysis of depigmented hair using a trichiasis electrolyzer combined with single hair follicle transplantation was an effective and safe method to treat vitiligo‐associated leukotrichia. [ABSTRACT FROM AUTHOR]

Supraorbital eyebrow keyhole craniotomy is a minimally invasive alternative to a frontotemporal craniotomy and is often used for tumor resection and aneurysm clipping. The purpose of this study is to provide a contemporary review on the outcomes related to this approach and to determine whether they vary with the type of pathology and the addition of an endoscope. PubMed, Embase, and Scopus databases were systematically searched, and results were reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. For the meta-analysis portion, the DerSimonian–Laird random effects model was used. A total of 2629 manuscripts were identified. of those, 124 studies (8241 surgical cases) met the inclusion criteria. Mean total complication rate was 26.7 ± 25.7% and the mean approach-related mortality rate was 1.3 ± 2.8%. Technical success, defined as gross total tumor resection or complete aneurysm clipping, was achieved in 83.6 ± 21.5% of the cases. Vascular pathologies were associated with greater technical success, lower total complications, and longer length of hospital stay compared with tumor cases (P < 0.05 for all). For vascular cases, addition of the endoscope yielded lower technical success (P = 0.001) and lower complication rate (P = 0.041). The use of the endoscope for tumor pathologies did not affect technical success, complications, mortality, length of hospital stay, operative time, or reoperation rate (P > 0.05). The supraorbital craniotomy via an eyebrow incision is a feasible minimally invasive approach with an overall high technical success rate for both vascular and tumor pathologies. [ABSTRACT FROM AUTHOR]

The goal of this case series analysis is to demonstrate that peri-orbital small to medium-sized skin defects can be treated by a direct closure associated with a M-Y plasty. By crossing the orbital eyelid, this technique allows to avoid large undermining and longer scars that are usually associated with the use of local flaps in this region. Twenty patients were operated on between May 2018 and November 2019, for the removal of periorbital skin tumors. Eleven were at high risk of developing delayed healing, post-operative hematoma, or showed a very thin skin, poorly prone to tolerate a large undermining. Defect size was between 1.5 to 13 cm2. All the defects underwent a direct closure with a M-Y plasty. Eighteen patients healed without any complication. Two had a delayed healing at the Y junction. No hematoma, abscess, cutaneous necrosis, or unaesthetic deformity were recorded. The majority of our patients had significant comorbidities, so that a flap reconstruction was considered too aggressive. We here demonstrate that through a direct closure associated with a plasty, they could all benefit from a oncological excision, with a safe reconstruction and very few complications. [ABSTRACT FROM AUTHOR]

A 70-year-old man presented to the emergency department with pain and swelling in his right periorbital region after a fall. Physical examination revealed ecchymosis and tenderness in the area, but no apparent fractures were seen on a plain radiograph. However, a crescent-shaped radiolucency known as the black eyebrow sign was present, indicating a suspicion of occult orbital wall fracture. Computed tomography confirmed the diagnosis of nondisplaced fractures at the medial and inferior orbital wall. The patient was treated conservatively and followed up at the outpatient department. [Extracted from the article]

This article discusses a case of an 85-year-old woman who was diagnosed with hypothyroidism. The patient presented with difficulty getting out of bed, edema in the limbs, and loss of the outer third of her eyebrows. The article highlights that eyebrow loss, also known as the Queen Anne sign, is an uncommon manifestation of hypothyroidism. The authors emphasize the importance of considering hypothyroidism as a differential diagnosis for patients with eyebrow loss, as untreated hypothyroidism can lead to severe complications. [Extracted from the article]

Eyebrow restoration can be best done with individual single hair follicles grafts harvested by FUE. Understanding the male and female eyebrow allows us to plan an aesthetic reconstruction, requiring 70 to 120 grafts. Selection of donor hair, angle of placement, alignment and direction within the rows influences the results, as does scarring and perfusion of the skin. Details of planning, technique, anesthesia and postoperative care, as well as drawbacks of older methods, are discussed in the article. [ABSTRACT FROM AUTHOR]

Object: Resection of lesions located within the third ventricle presents a surgical challenge. Several approaches have been developed in an attempt to obtain maximal resection, while minimizing brain retraction. In this work, we assess the surgical exposure and maneuverability of the endoscopic supraorbital translaminar approach (ESTA), a potential alternative to fenestrate the lamina terminalis and approach the third ventricle by using the endoscope through a keyhole supraorbital-eyebrow craniotomy. Methods: Five cadaveric heads were used to assess the corridor depth, area of exposure, and viewing angles offered by the ESTA. One additional utilized specimen provided a stepwise dissection of the approach. Results: The ESTA was successfully performed in all specimens. Depth of the surgical corridor from the craniotomy to the ipsilateral internal carotid artery (ICA), lamina terminalis, and contralateral carotid were 70.7 ± 2.9 mm, 73.2 ± 2.9 mm, and 78.9 ± 4.1 mm, respectively. Viewing angle referenced to the ipsilateral ICA was 6.5 ± 4.2°, while the viewing angle for the lamina terminalis was 25.8 ± 4.3°. The surgical exposure provided by the ESTA was 1655 ± 255 mm2. Conclusions: The ESTA provides a wide surgical view of the lamina terminalis and may be potentially used to approach lesions located in the anterior third of the third ventricle. As a pure endoscopic approach, the ESTA requires minimal brain retraction, while affords good visualization of targeted lesions around the lamina terminalis. The ESTA uses an anterolateral approach and so provides a short and straightforward approach to these structures. [ABSTRACT FROM AUTHOR]

Background: The classical eyebrow supraorbital keyhole craniotomy has limited working volume due to the thick incurving of the frontal bone necessitating generous drilling of the frontal base. However, the basal variant with sectioning of the orbital rim results in increased periorbital edema.Objective: We describe a novel orbital rim sparing single-piece fronto-orbital keyhole approach, probably the first such report with a comparative review of relevant literature.Methods: Following eyebrow incision, bidirectional drilling with a ball tip behind the fronto-zygomatic suture exposes the periorbita and frontal dura, with orbital roof in-between. The craniotomy is fashioned with an angled fronto-orbital cut parallel to and sparing the orbital rim with dura-guard over the periorbita, a frontal cut over the dura, and an optional cut along the lateral orbital roof from within the burr hole. A comparative review of this technique with traditional methods is also carried out.Results: Compared to the classical supraorbital keyhole, this minimally invasive approach yields a wider basal exposure with greater working volume for intracranial and orbital lesions. Compared to the basal variant of keyhole fronto-orbital approach, this technique results in the least disturbance to periorbita's attachment with the orbital margin, maintenance of orbital contour, better cosmesis with use of simple tools and self-fitting flap.Conclusion: The orbital rim sparing single-piece fronto-orbital keyhole craniotomy is an easy and novel minimally invasive approach with greater working volume without the disadvantages of sectioning the orbital rim. [ABSTRACT FROM AUTHOR]

Eyebrows have a critical functional and aesthetic role on the face. Alopecia on the eyebrows has multiple origins, including scars formed after deep burns on the head and neck region. Reconstruction of the eyebrows represents a challenge for plastic surgeons due to their particular anatomical structure and variations inside of genders. Follicular Unit Transplantation (FUT) is believed to be the gold standard for the treatment of all sorts of alopecia, including that located on the eyebrows. However, FUT is technically demanding and requires skills, extensive anatomical knowledge, and equipment. In settings where FUT is still not feasible, flaps such as the superficial temporal artery island scalp flap remain reliable options. A 32-year-old male patient presented at the National Burn and Plastic Surgery Center, Casablanca (Morocco), with right eyebrow alopecia caused by fire burn on the face. We reconstructed the alopecia using a superficial temporal artery island scalp flap. The result was excellent. The patient and the physician were both very satisfied, and the patient stated that he was more comfortable with his social relationships. Among the current procedures used for the reconstruction of eyebrow alopecia, the superficial temporal artery island flap remains a versatile solution, especially after burn injuries in male patients. [ABSTRACT FROM AUTHOR]

Objectives  Cranioorbital lesions present a great challenge for neurosurgeons and ophthalmologists. There is no consensus on the choice of surgical approach. The aims of this study were to investigate 49 cases of cranioorbital lesions and evaluate surgical approaches and outcomes. Patients and Methods  A retrospective study was done on 49 patients (51 operations) from 2009 to 2018. Information about the lesion was used to decide whether the supraorbital eyebrow approach (SEA) or pterional approach (PA) was performed. Results  Twenty-eight patients had surgical resection using SEA, 21 patients received PA, each group included one case of recurrence, who underwent reoperation via the same approach. SEA provided better cosmetic satisfaction, and a shorter incision than PA (p  < 0.05). There was no significant difference in total resection rates, visual outcomes, recovery of ptosis, and other new surgical-related complications between SEA group and PA group (p  > 0.05). Forty-nine cases of proptosis (94.1%, 49/51) were improved. Thirty-three patients (33/37, 89.2%) who underwent follow-up for longer than 12 weeks had a modified Rankin Scale (mRS) score ≤ 3. Conclusion  Surgery is the preferred treatment for cranioorbital lesions, but total resection is difficult. SEA may be a more minimally invasive option for some more limited lesions superior to optic nerve. PA may be more reasonable for the lesion with obvious hyperostosis and more extensive lesions. [ABSTRACT FROM AUTHOR]

Side effects of tattoos can occur due to unexpected body responses. Concerns about the side effects of tattoos are growing concomitantly with the increasing number of tattooed individuals. We report a rare case of basal cell carcinoma (BCC) on a tattooed eyebrow. A 48-year-old woman with no family history or occupational risk of skin cancer had her eyebrows tattooed 6 years prior, and she noticed a black mass on her right eyebrow 1 year before presentation. Staged excision was planned due to the patient's reluctance regarding the possibility of a wide scar. After the first surgical procedure, a histopathological examination confirmed BCC. Wide excision and primary closure were performed for remnant BCC, and no recurrence was observed. The mechanism of skin neoplasms involving tattoos has not been clearly identified. Unapproved tattoo inks contain carcinogenic substances, and previous case reports indicate that skin neoplasms may differ depending on the tattoo color. Therefore, the carcinogenic effects of these unknown components of tattoo ink might cause skin neoplasms. Accurate component analysis and systematic management of tattoo ink is necessary, and medical practitioners must also pay attention to this possibility because it is easy to overlook tattoos as a causal factor contributing to cancer. [ABSTRACT FROM AUTHOR]

Lesions arising at the ventral thalamopeduncular junction are difficult to resect. In addition to being relatively inaccessible, these lesions are located in one of the most sensitive areas of the brain. A critical question is whether new approaches could be developed to allow surgeons to adequately resect these lesions with reasonable outcomes. In the present report, we describe our approach to resect lesions in this region of the brain using an eyebrow craniotomy approach with a trajectory through the supracarotid triangle. Through retrospective data collection, we present a small series of patients who had undergone an eyebrow, supracarotid triangle approach to resect lesions located at the thalamopeduncular junction. We describe our surgical technique and report patient outcomes using this approach. Three patients had undergone an eyebrow, supracarotid approach for resection of a lesion arising at the ventral thalamopeduncular junction. Two patients had presented with a cavernoma and one with a pilocytic astrocytoma. Complete resection of all 3 lesions was achieved during surgery without any intraoperative complications. No patient developed permanent contralateral weakness despite entering the peduncle during surgery. One patient developed permanent paresthesia in his left hand. Lesions arising at the ventral thalamopeduncular junction can be adequately resected with reasonable outcomes using an eyebrow, supracarotid triangle approach. This operative technique establishes another potential operative corridor by which neurosurgeons can resect lesions arising within this relatively inaccessible part of the brain. [ABSTRACT FROM AUTHOR]

Background: Clinical outcomes of eyebrow restoration with single‐follicular‐unit hair transplantation largely depend on the surgeon's anatomic knowledge, experience, and technical skills. Aims: To evaluate the effect of the reconstruction with single follicular unit transplantation on eyebrow loss and provide technical tips. Patients and Methods: A total of 352 patients with eyebrow loss were recruited. A template of the restoration region was modeled or specifically designed. The scalp strips from the back occipital or retro‐auricular regions were harvested for single follicular unit hair. The follicles were transplanted by punching recipient area with 21‐G syringe needle. Patients were followed up every 2 months for 4 years after surgery. Results: Out of 352, 320 (91%) patients had their transplanted hair grow well with satisfactory direction and appearance. Seventeen patients (5%) experienced encryption transplantation of a sparse hair for the first 6 months but felt satisfied afterward. Twelve (3%) patients did a simple make‐up on the transplanted hair because there was an obvious difference between the transplanted hair and the natural one. Three (1%) patients with burned injury suffered of mild folliculitis and cured by 75% alcohol inunction. All patients had no obvious scar at the donor sites. Conclusion: Single follicular transplantation for eyebrow loss resulted in natural restorations with excellent satisfaction. The technique is simple, safe, and effective. The usage of syringe needle, microscope slide forceps, and a magnifier could implant the hair in a right angle, desired direction and depth, and increase the survival rate. [ABSTRACT FROM AUTHOR]

Transcranial approaches to the orbit provide familiar and flexible approaches with wide access to the majority of the orbit, only limited in the inferomedial orbit. A pterional craniotomy is the predominant approach but can be expanded with an orbital or zygomatic osteotomy for even wider access. Minimally invasive approaches, such as the lateral supraorbital or "eyebrow" supraorbital approach, are options for selected pathologies and minimize morbidity related to the approach. [ABSTRACT FROM AUTHOR]

Background Infrabrow blepharoplasty has become a common surgical method used to rejuvenate aged upper eyelids in Asians. In this paper, we describe the parallel excision method for infrabrow blepharoplasty as a useful alternative to the conventional elliptical excision method. The authors' experience over a 3-year period is presented and reviewed. Methods A retrospective review of parallel excision infrabrow blepharoplasty cases at our hospital between 2014 and 2017 was performed. Three oculoplastic surgeons compared preoperative and postoperative photographs using the Strasser grading system. Results From the medical records of 123 patients, a total of 93 patients with moderate-tosevere bilateral dermatochalasis were selected as subjects. The exclusion criterion was levator function less than 8 mm. The total mean follow-up period was 2 years (range, 0.5-3.5 years). The mean skin excision height and width were 9.75 mm (range, 5-16 mm) and 58.51 mm (range, 42-75 mm), respectively. All patients who underwent surgery recovered without major complications, and all patients had high levels of satisfaction and improvements in their visual field. In the Strasser evaluation performed by the oculoplastic surgeons, most patients were found to have excellent results. Conclusions The parallel excision method for infrabrow blepharoplasty is a safe and effective technique that yields more natural- and youthful-looking eyelids than the conventional elliptical excision method. In our method, more effective manipulation of the orbicularis oculi muscle led to a reduction in frontalis compensation, resolution of sunken eyelids, and correction of lateral hooding. [ABSTRACT FROM AUTHOR]

Background: Previous studies have proven the efficacy and safety of 0.01% and 0.03% bimatoprost for the treatment of eyebrow hypotrichosis; however, there is no comparison study between both concentrations. Aims: To compare the efficacy and safety between 0.01% and 0.03% bimatoprost for the treatment of eyebrow hypotrichosis. Patients/Methods: This prospective, randomized, double‐blind, split‐face clinical study was conducted in 30 patients with eyebrow hypotrichosis. Each side of eyebrow of individual patients was randomly assigned for 0.01% and 0.03% bimatoprost, applied on each eyebrow once daily. Eyebrow density, diameter, the Global Eyebrow Assessment scale, 7‐point rating scale, and patient satisfaction were evaluated. Side effects were also recorded. Results: Both 0.01% and 0.03% bimatoprost significantly improved eyebrow density and diameter (P <.05), although there were no statistically significant differences in changes in eyebrow density and diameter from baseline between both concentrations (P =.96 and.84, respectively). Additionally, patients significantly preferred 0.03% bimatoprost in terms of clinical improvement and satisfaction (P =.04 and.003, respectively). Conclusions: Both 0.01% and 0.03% bimatoprost are effective and safe for the treatment of eyebrow hypotrichosis. Bimatoprost 0.03% is superior to its 0.01% counterpart, albeit without statistical significance. [ABSTRACT FROM AUTHOR]

Osteomas are benign, slow-growing osteogenic lesions frequently found in the craniomaxillofacial region. They can be classified as peripheral, central, or extraskeletal. Reactive mechanisms to trauma or infection, as well as muscle traction, are thought to play a major role in the development of peripheral osteomas. In the present report, a 41-year-old woman presented with a slowgrowing, painless mass on her left eyebrow. She had suffered trauma 15 years prior. In the computed tomography scan, a 2.5 × 2 × 0.7-cm radio-opaque tumor was detected just medial to the left supraorbital foramen, and a peripheral osteoma was clinically diagnosed. An elective operation under general anesthesia was planned. Following a suprabrow incision, subcutaneous and intramuscular dissection was performed. In the surgical plane deep to the corrugator muscles and superficial to periosteum, a branch of the supratrochlear nerve was encountered and preserved using a vessel loop. The osteoma beneath the periosteum was extracted in multiple fragments using a chisel and mallet to minimize trauma to the nerve. Contour and facial symmetry were corrected. To use a suprabrow incision, the surgeon must understand neighboring anatomical structures, including the course of the supratrochlear and supraorbital neurovascular bundles. When these structures are located adjacent to tumor lesions, careful surgical maneuvers should be performed to preserve them. [ABSTRACT FROM AUTHOR]

Background and Aim: Heavy metals such as lead and cadmium are toxic and carcinogenic compounds that are absorbed through the skin. Therefore, the aim of this study was to determine the amount of lead and cadmium heavy metals in bulk branded cosmetic bags (mascara and tattoo) distributed in Birjand. Materials and Methods: In this descriptive-analytical study, by referring to the Birjand cosmetics and health center union and by using a simple random sampling method, the 12 centers are selected and by referring to them, 63 samples of mascara and eyebrow tattoos were selected. Due to the limited number of eyebrow cosmetics brands, all existing brands were sampled. The lead and cadmium levels of the samples were determined using acid digestion and atomic absorption. Data were analyzed using statistical tests of Kruskal-Wallis and Mann-Whitney. Results: The mean lead concentration in mascara and tattoos was 51.8-227.4 μg / g and 37.5 ± 313.6 mg / g, respectively, and in all samples, the concentration of cadmium was zero. There was a significant difference among the different tattoo samples in terms of concentration of lead (P<0.05), but there was no significant difference between mascara samples (P=0.761). Conclusion: Due to unauthorizedly, the concentration of lead heavy metal in conventional cosmetic products and also no significant difference among famous brands, sufficient awareness of the risk of large amounts of such substances is necessary. [ABSTRACT FROM AUTHOR]

We describe a patient who presented with erythematous papules and hair loss solely limited to the eyebrows. Clinicians should be aware of this presentation of leukemia cutis and consider this diagnosis in a patient with a history of CLL. [ABSTRACT FROM AUTHOR]

Dermatochalasis is a skin excess in the upper eyelid whichmay be associated with either an aesthetic and functional defect, blocking the peripheral vision. Upper blepharoplasty is the gold standard procedure for correction of dermatochalasis and to restore youthful contours to the periorbita. It is one of the most commonly performed procedures in aesthetic plastic surgery; however, there is still a lack of consensus about this procedure. The excess skin is sometimes removed alone or in conjunction with a strip of orbicularis oculi muscle. The rationale for bothmuscle and skin resection or skin alone preserving the muscle is uncertain. Some authors have studied the aging influence in brow position, and a few studies pointed out the influence of the upper blepharoplasty on brow height. The true effects, regarding the position of the eyebrow, of both techniques, with or without resection of the preseptal orbicularis oculi muscle, are unclear. The authors present a review of the literature to find the rationale for resecting or preserving the orbicularis oculi muscle in upper eyelid blepharoplasty and its relation to eyebrow position. [ABSTRACT FROM AUTHOR]

Rejuvenation of the upper face is a key component of overall facial rejuvenation. The upper face is probably the most important purveyor of our sense of well-being and our primary transmittal of nonverbal social interaction. There are many aspects to the aging changes in the area. Central to these concerns is the level and shape of the eyebrow. Ptosis of the lateral brow begins at a relatively young age and tends to worsen over time. This article describes an adaptation of modifiable techniques to address focal issues of the lateral eyebrow. [ABSTRACT FROM AUTHOR]

Basal cell carcinoma (BCC) is the most common malignant neoplasm in humans and its incidence has been increasing in recent decades. Despite the low mortality rates and the rare occurrence of metastases, the tumor may present local invasive behavior and relapses after treatment, causing important morbidity. Exposure to ultraviolet radiation represents the main environmental risk factor associated with its genesis, and is therefore a preventable factor. The present study aims to report the case of a patient diagnosed with basal cell carcinoma of the infiltrative type on the eyebrow, who underwent surgery to remove the lesion using the technique of bilateral flap reconstruction. This procedure was followed by the student authors of the study, who deepened the subject and carried out an extensive review related to it. The difficulty of reconstructing the affected site was also explored, which represents a challenge to the surgeon, both because of the low number of corrective options and the region aesthetically crucial to the patient. It was concluded that in addition to an early diagnosis, it is essential that appropriate treatment be implemented, and afterwards, a rigorous outpatient follow-up should be performed. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to determine if ocular dominance plays a role in predicting compensatory eyebrow elevation in cases of ptosis. Methods: This retrospective observational cohort study screened all individuals presenting to two tertiary oculoplastics practices with complaints of ptosis for entry. Primary position photographs were obtained. Ocular dominance was assessed via a modified Porta test. Ptosis was defined in bilateral cases as marginal reflex distance of <2.5 mm in both eyes and in unilateral cases as either an MRD1 < 2.5 mm or MRD1 of >1 mm lower on one side. Asymmetry in brow height was defined as a difference of >1 mm. Chi square and t-tests were performed. Results: Sixty-eight patients from the both tertiary practices met inclusion criteria (37 male, 31 female). Concordance between the higher brow and the dominant side was 50.0% (n = 22, p > 0.05). Mean brow height on the dominant side (15.5 mm) was not statistically different than brow height on the non-dominant side (15.3 mm, p > 0.05). The concordance between the higher brow and the lower MRD1 eyelid was not significant (45.5%, n = 20, p > 0.05). The difference in mean brow height between the lower and higher MRD1 eyes was not significantly different (−0.11 mm; p > 0.05). This also held true when restricted to unilateral cases (0.28; p > 0.05). Conclusions: Although asymmetric brow elevation can be noted in patients with ptosis, ocular dominance does not appear to be concordant with this asymmetry. Additionally, brow height does not appear to be concordant with MRD1 in cases of ptosis. [ABSTRACT FROM AUTHOR]

Objective: To review current management strategies for olfactory groove meningioma (OGM)s and the recent literature comparing endoscopic endonasal (EEA) with traditional transcranial (TCA) approaches. Methods: A PubMed search of the recent literature (2011-2016) was performed to examine outcomes following EEA and TCA for OGM. The extent of resection, visual outcome, postoperative complications and recurrence rates were analyzed using percentages and proportions, the Fischer exact test and the Student's t-test using Graphpad PRISM 7.0Aa (San Diego, CA) software. Results: There were 444 patients in the TCA group with a mean diameter of 4.61 (±1.17) cm and 101 patients in the EEA group with a mean diameter of 3.55 (± 0.58) cm ( p = 0.0589). GTR was achieved in 90.9% (404/444) in the TCA group and 70.2% (71/101) in the EEA group ( p < 0.0001). Of the patients with preoperative visual disturbances, 80.7% (21/26) of patients in the EEA cohort had an improvement in vision compared to 12.83%(29/226) in the TCA group ( p < 0.0001). Olfaction was lost in 61% of TCA and in 100% of EEA patients. CSF leaks and meningitis occurred in 25.7% and 4.95% of EEA patients and 6.3% and 1.12% of TCA patients, respectively ( p < 0.0001; p = 0.023). Conclusions: Our updated literature review demonstrates that despite more experience with endoscopic resection and skull base reconstruction, the literature still supports TCA over EEA with respect to the extent of resection and complications. EEA may be an option in selected cases where visual improvement is the main goal of surgery and postoperative anosmia is acceptable to the patient or in medium-sized tumors with existing preoperative anosmia. Nevertheless, based on our results, it seems more prudent at this time to use TCA for the majority of OGMs. [ABSTRACT FROM AUTHOR]

This is a systematic review of eyebrow reconstruction options, using the PubMed database, as well as dermatology and plastic surgery texts. Eyebrow reconstruction options in various clinical scenarios (small, large, medial, lateral, and total defects) are presented. The goals of eyebrow reconstruction are to provide structural, functional, and aesthetic restoration. A good understanding of various eyebrow reconstruction techniques is essential for plastic, dermatologic, and oculoplastic surgeons. [ABSTRACT FROM AUTHOR]

Résumé La région temporale, aux limites imprécises chez le sujet jeune s’individualise lors du vieillissement avec l’apparition d’un creusement de la fosse temporale, la visibilité des rebords osseux temporal, orbitaire et zygomatique qui la bordent, la chute de la partie latérale du sourcil et l’apparition des rides de la patte d’oie. Cette région encadre le regard et, à ce titre, doit être prise en considération lors de l’examen clinique au même titre que les étages facial et cervical. Les techniques visant à son rajeunissement sont nombreuses nuancées et graduelles. Tant que la ptose sourcilière n’est pas manifeste et la distance cils-sourcil non altérée, les techniques volumatrices et la toxine botulique peuvent répondre efficacement et harmonieusement à la demande des patients. Ensuite, les techniques chirurgicales de liftings temporal et sus-sourcilier doivent être envisagées et couplées aux techniques de lipostructure de plus en plus pratiquées. Il est à noter que dans un nombre croissant des cas, la demande de rajeunissement temporal précède celle du rajeunissement cervicofacial. Ceci souligne l’importance que revêt cette région tant dans le cadre de la prévention ou au moins du ralentissement du processus que dans la cure des stigmates du vieillissement. Summary The temporal region has imprecise limits in the young patient. During the aging process, it becomes individualized with the appearance of a temporal fossa, the temporal, orbital and zygomatic bone margins, the ptosis of the lateral part of the brow and the appearance of the wrinkles of the crow's foot. As this area frame the look, it should be taken into consideration during the clinical examination as well as the facial and cervical stages. The rejuvenation techniques are numerous, nuanced and gradual. As long as the eyebrow ptosis is not evident and the distance of the eyebrows unaltered, the volumizing techniques and the botulinum toxin can respond effectively and harmoniously to the patients’ demand. Then the surgical techniques of temporal and brow liftings must be considered and coupled with the techniques of lipostructure that are more and more practiced. It should be noted that the demand for temporal rejuvenation is increasing and precedes the demand of cervicofacial rejuvenation. This underlines the importance of this region both in terms of preventing or at least slowing down the process than in terms of curing the stigma of aging. [ABSTRACT FROM AUTHOR]

Résumé L’examen clinique est la première étape de toute démarche thérapeutique médicale ou chirurgicale. Sa qualité est essentielle afin d’adapter le traitement à la demande du patient. Dans le cadre du rajeunissement facial, l’interrogatoire et la compréhension des motivations, photos anciennes à l’appui, participent à l’évaluation. La connaissance de l’anatomie et du processus de vieillissement facial facilite l’analyse. Il s’agit non seulement de déterminer le degré de ptôse tissulaire, mais aussi d’évaluer les variations volumétriques. Enfin, les tensions musculaires et la qualité cutanée participent à la genèse de rides distinctes. Ces modifications complexes aboutissent à un aspect fatigué ou triste, voire âgé. Les demandes des patients, souvent limitées à une seule région, ne doivent pas dispenser d’une analyse globale. Le rôle du praticien est aussi de faire prendre conscience au patient, avec tact, de l’incidence des autres régions sur l’impression générale. L’objectif sera d’obtenir un résultat harmonieux, naturel qui signe l’excellence du savoir-faire médicochirurgical. L’examen clinique doit, en outre, permettre de repérer les difficultés techniques. Enfin, un bilan photographique, voire vidéo, fixe l’analyse et permet de disposer d’éléments objectifs pour affiner le traitement, aider à sa compréhension et évaluer le résultat. Le temps passé à examiner et expliquer permet de statuer avec le patient sur les choix thérapeutiques et d’en préciser leurs limites. Il permettra ainsi d’accroître la satisfaction du patient qui doit s’approprier le résultat. Cet effort d’analyse est dès lors un acte opératoire, tout aussi important que la technique elle-même. Apporter un résultat « sur mesure », indispensable lorsqu’il s’agit de l’image de la personne, constitue enfin la garantie du plaisir à toujours vouloir améliorer notre pratique. Summary The first step to determine a medical or surgical intervention is the clinical exam. The clinical exam is the paramount step to provide a treatment plan that can be modified and individualized accounting the patient preferences. During the consultation for facial rejuvenation, attention should be paid to understand the patient's motivation and expectations. A thorough understanding of the anatomy and the natural history of ageing will facilitate the analysis of the face. Not only the degree of ptosis but also the degree of volume loss will need to be assessed, as well as the influence of the facial muscles, the skin quality, and the different causes of rythids. The comprehensive age-related anatomical changes are often perceived and described as tiredness or sadness. Patients very commonly only point out a single anatomical region. During the consultation, the surgeon should provide the patient with the information of the comprehensive interplay of the different anatomical regions and their individual ageing process. Obtaining a harmonious, natural appearing outcome is the result of excellent surgical skills and applied knowledge. The clinical exam should also find out traps and technical difficulties. Although standardized photographs allow a static evaluation of one's result, video may deliver additional information about the postoperative result, and may contribute to the understanding of the technique used. Spending the additional time by performing a thorough facial analysis and preoperative planning is well-invested time. Having a good understanding of the possible surgical improvements and limitations will be beneficial for both, the patient and the surgeon. Managing the expectations of the patient and careful preoperative planning will increase patient's satisfaction. At the same time, the surgeon will able to critically assess his/her own result and taking pleasure improving their own technique. [ABSTRACT FROM AUTHOR]

The eyebrow region is very important for facial movements, symmetry and overall face aesthetic appearance of the face. Partial eyebrow defects after tumor excision can be repaired using several surgical techniques which are often complicated and clinically inapplicable. The aim of the study is to establish a simplified surgical method for the treatment of partial eyebrow defects using the rest of the eyebrow by the double random V-Y flaps. During the period from January 2009 to January 2016, a total of 12 patients (3 males, 9 females) with partial eyebrow defects were treated with eyebrow flap reconstruction. Patient's age ranged from 48 to 82 years. These defects were caused by tumor excision. Defects were up to half the eyebrow width, localized in the middle three quarters of the eyebrow. The minimum area of the defect was 0.8 cm and the maximum area was 2.5 cm. The patients were treated with double random V-Y advancement flaps. All the patients were followed postoperatively for at least a year. Clinical effects of eyebrow reconstruction were evaluated using a designed scoring system. All the 24 flaps survived without significant complications and all reconstructed eyebrows were continuous, symmetrical and with good integrity. After an average of 3.28 years of follow-up, the patients did not have infection, tumor recurrence, nor scarring. Based on our experience with 12 patients who underwent eyebrow reconstruction, we may recommend double V-Y advancement flaps as a model for the treatment of patients with partial eyebrow defects. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to identify the different factors that an oculoplastic surgeon should consider while practicing cosmetic or reconstructive eyebrow surgery in order to have the final patient’s satisfaction. Subjects and methods: In an observational case series study, five photographs were taken from each of 60 females to show ideal eyebrow positioning with fingers. Eyebrow landmarks, including tarsal plate show (TPS) and eyebrow height, were measured in the ideal position. Brow apex position and brow apex angle were evaluated in the desired position of eyebrow. Results: The mean desired apex angle of eyebrow was measured as 135±9 mm. In all, 48.33% of our subjects preferred a wider brow angle, 28.33% a narrower one, and 23.33% a brow angle without any change. The location of brow peak was transferred to the lateral canthus in the desired position. The ideal brow peak in the lateral canthus and between lateral canthus and lateral limbus was assigned to 33.3% and 66.6% of cases, respectively. The desired eyebrow apex angle in two age groups of our subjects (>40 years and ≤40 years) was not statistically different. Conclusion: Landmarks of the eyebrow and its desired position are somehow different between different studies, which may be explained by the variation in race, gender, culture, and age. As there is not any uniform rule in planning of cosmetic surgeries of eyebrow, oculoplastic surgeons should consider the difference in culture, race, age, and desire of the patients and have their surgical plans for every individual patient distinctively. [ABSTRACT FROM AUTHOR]

Background This study evaluated dynamic changes in eyebrow position related to aging. Methods Female participants were recruited and separated into two groups aged 20-30 years (the younger group, n=20; mean age, 24.8 years) and 50-70 years (the older group, n=20; mean age, 55.8 years). Photogrammetry was used to determine the eyebrow position at the medial canthus (MC), lateral limbus, lateral canthus, and lateral end point (EP) for 6 actions: smooth opening (the reference action) and closing of the eye, forward gaze, maximum opening and closing of the eye, and maximum frown. Videos were also recorded. Results No differences in eyebrow position were detected at the MC when opening or closing the eyes smoothly, gazing straight ahead, or closing the eyes maximally. For all 6 actions, the position of the lateral EP in the older group was significantly lower than in the younger group (P=0.003), and the smallest degree of vertical movement at this point was found in both age groups (P<0.001). Vertical movement at the 4 landmarks of the eyebrows decreased with aging. Conclusions Eyebrow position was unchanged at the MC with aging, except at maximal eye opening and maximal frown. No differences in eyebrow position were observed between the younger and older groups when eyes were maximally closed, except at the EP. It is important to focus on correction of the lateral EP for periorbital rejuvenation. [ABSTRACT FROM AUTHOR]

Sarcoidosis is a granulomatous disease that can involve multiple organs including the lungs, eyes, nerves, and skin. Cosmetic tattooing can be a predisposing factor for sarcoidosis, and its incidence is likely to increase along with its popularity. A 47-year-old woman with symptoms of fever and polyarthritis along with erythema nodosum lesions on the legs, swollen eyebrows, and a history of multiple eyebrow tattooing was referred to our center. Since the signs and symptoms were positive for Löfgren's syndrome triad including erythema nodosum, bilateral hilar lymphadenopathy, and polyarthritis, a diagnosis of acute sarcoidosis was made, and treatment was started accordingly. The patient was unresponsive to routine therapeutic agents used for sarcoidosis; however, she successfully responded to adalimumab. Our case indicates that systemic sarcoidosis could develop as a reaction to cosmetic tattooing, which might be refractory to conventional therapeutic agents including corticosteroids and non-biologic disease-modifying antirheumatic drugs, while tumor necrosis factor antagonists such as adalimumab, could lead to disease remission. [ABSTRACT FROM AUTHOR]

This article evaluates the effect of upper eyelid blepharoplasty on eyelid margin position and brow height. This study is a retrospective analysis of patients who underwent upper eyelid blepharoplasty without concurrent blepharoptosis repair or brow surgery. The medical records of the participants were retrospectively reviewed and an established image analysis software was used to quantify the upper margin reflex distance (MRD1) as well as brow height using high quality standardized clinical photographs. A total of 19 patients (38 eyelids and brows) met the inclusion criteria. The mean preoperative MRD1 was 2.8 mm, and the mean post-operative MRD1 was 3.5 mm, revealing an increase of MRD1 from upper blepharoplasty alone of 0.7 mm (p = 0.0001). The mean preoperative brow position was 17.5 mm above the pupil, and the mean post-operative position was 17.4 mm, for an average change of position of -0.2 mm (p = 0.39) following upper eyelid blepharoplasty. Upper eyelid blepharoplasty without ptosis surgery results in a statistically significant increase in MRD1. Brow position does not demonstrate a statistically significant change in patients who undergo upper eyelid blepharoplasty for simple dermatochalasis. [ABSTRACT FROM AUTHOR]

Background: The eyebrow region presents challenges for filling: the skin is thick, the three-dimensional anatomy is complex and there is a predisposition towards fat atrophy and skeletonization with aging. Hyaluronic acid gel fillers are well known for their use in the periorbital region. We report our long-term experience with eyebrow filling over a period of five years. Methods: Twenty cases of periorbital eyebrow filling with hyaluronic acid gel fillers were followed up over a period of five years. The eyebrow filling was customized based on the patient's anatomical features in a three-dimensional plane. Standardized photographs before and after the procedure in standard lighting conditions were evaluated. Results: Hyaluronic acid gel fillers were tolerated well in the eyebrow region. There were no cases with blue-gray dyschromia or prolonged edema as is the case with lower eyelid injections. The eyebrow gained volume and looked fuller immediately after the injection. There were three cases with excessive eyebrow puffiness noted on a long-term follow-up which may be the accumulated filler weighing the eyebrow. No other adverse events were noted. Conclusion: The eyebrow anatomy is a complex three-dimensional structure. Deflation in the eyebrow area along with the superior sulcus occurs with aging. Filling the eyebrow with hyaluronic acid gel fillers is a useful tool in the armamentarium of the cosmetic facial surgeon and can be used in isolation in select patients or as an adjunct to surgical rehabilitation. We believe the fillers last longer and are well tolerated in the eyebrow region due to the complex anatomy specific to this region. [ABSTRACT FROM AUTHOR]

The main objective of this study is to recognize facial emotional expression effectively in human–computer interaction. A surface electromyography (sEMG) based eyebrow emotional expression recognition method is proposed. Using a specially designed headband, we conducted an experiment in which we recorded the sEMG signals from the frontalis and corrugator supercilii muscles of six participants who were instructed to pose the facial expressions of anger, fear, sadness, surprise and disgust. Subsequently, six features of the sEMG time domain were extracted and used as input vectors to an emotion recognition model based on an Elman neural network (ENN). The performance of this model was compared to another recognition model based on a Back Propagation neural network (BPNN). The average recognition rate for the five emotions achieved by the ENN-based model was 97.12% in the training and 96.12% in the test set, which was slightly superior to the performance of the BPNN-based model. [ABSTRACT FROM AUTHOR]

Background: Descent of the lateral aspect of the brow is one of the earliest signs of aging. The purpose of this study was to describe an open surgical technique for lateral brow lifts, with the goal of achieving reliable, predictable, and long-lasting results. Methods: An incision was made behind and parallel to the temporal hairline, and then extended deeper through the temporoparietal fascia to the level of the deep temporal fascia. Dissection was continued anteriorly on the surface of the deep temporal fascia and subperiosteally beyond the temporal crest, to the level of the superolateral orbital rim. Fixation of the lateral brow and tightening of the orbicularis oculi muscle was achieved with the placement of sutures that secured the tissue directly to the galea aponeurotica on the lateral aspect of the incision. An additional fixation was made between the temporoparietal fascia and the deep temporal fascia, as well as between the temporoparietal fascia and the galea aponeurotica. The excess skin in the temporal area was excised and the incision was closed. Results: A total of 519 patients were included in the study. Satisfactory lateral brow elevation was obtained in most of the patients (94.41%). The following complications were observed: total relapse (n=8), partial relapse (n=21), neurapraxia of the frontal branch of the facial nerve (n=5), and limited alopecia in the temporal incision (n=9). Conclusions: We consider this approach to be a safe and effective procedure, with long-lasting results. [ABSTRACT FROM AUTHOR]

Ablative surgery for skin cancer of the face can often leave patients with significant deformities. These disfigurements can include loss of hair in conspicuous areas such as the eyebrows, leaving the patients with unsightly facial asymmetry. Eyebrow transplantation serves to address this issue; however, it has often been discouraged in patients who are destined to receive radiotherapy to the cutaneous area in question. This is due to the anagen effluvium effect of radiation therapy on hair follicles. We present a case in which the transplanted eyebrow hair follicles survived the deleterious effects of radiotherapy, leaving the patient with a symmetrical and aesthetically satisfactory eyebrow appearance. [ABSTRACT FROM AUTHOR]

We investigated whether the position of the eyebrows influences the perceived shape of the eyes by employing psychophysical measurements. Experiment 1 used arched and straight eyebrows at five different inclinations as stimuli and measured the perceived inclination of the eyes. The results demonstrated that the eyes are perceived to be somewhat inclined in the same direction as the eyebrows. Experiment 2 measured the perceived eye size by manipulating the distance between the eyes and the eyebrows and the curvature of the eyebrows across three levels. The results showed that the lower eyebrows (ie closer to eyes) made the eyes appear larger and the higher eyebrows made the eyes appear smaller, while eyebrow curvature had no effect on perceived eye size. Experiment 3 examined the role of the eye–eyebrow distance in the eye inclination illusion shown in experiment 1. The eye inclination illusion was unaffected by the eye–eyebrow distance, suggesting that the eye inclination illusion and the eye size illusion may involve different kinds of assimilation. These illusions are discussed in terms of face perception and possible practical applications. [ABSTRACT FROM AUTHOR]

Introduction Craniopharyngiomas are known for an irregular growth pattern and extension into the retrochiasmatic space with adherence to adjacent structures. We describe the use of the transciliary supraorbital approach (eyebrow approach) for resection of craniopharyngiomas with retrochiasmatic extension. Methods Our clinical database was reviewed to identify operative cases of craniopharyngiomas between July 1998 and January 2011. Only patients who had retrochiasmatic extension and underwent an eyebrow approach were included in this analysis. Endoscopy was used to aid surgical resection at the discretion of the surgeon. Six patients were identified (three from a retrospective review and three during the course of prospective follow-up evaluation). Results The group included three men and three women (mean age: 41.2 years; range: 28-57 years). All patients had visual and hormonal deficits at presentation. Complete resection was achieved in four patients. Endoscopic assistance was used in three patients. Opening of the frontal sinus occurred in two cases during surgery; an additional surgical procedure was required for repair of a cerebrospinal fluid leak in one of these cases. The duration of clinical follow-up ranged from 18 to 97 months. All patients had excellent cosmetic results, visual improvement to a serviceable level, and a Karnofsky performance scale score ⩾80. Conclusions The eyebrow approach is safe for resection of craniopharyngiomas with retrochiasmatic extension. This approach offers a reasonable surgical corridor for resection of the retrochiasmatic tumor component and can be enhanced using endoscopic assistance. [ABSTRACT FROM AUTHOR]

Introduction: In evaluation for blepharoplasty, patients often desire improved cosmesis and/or correction of visual field deficits. However, patients are usually unaware of eyelid or brow asymmetry. Furthermore, the prevalence of eyelid and brow asymmetry is infrequently reported in the medical literature. Purpose: To determine the prevalence of brow and eyelid asymmetry in patients evaluated for upper lid blepharoplasty. Methods: One hundred consecutive patients evaluated for upper lid blepharoplasty were included in the study. Standard pre-operative photographs were taken of all patients using consistent background and photographic equipment. Two of the authors (KM & AM) independently recorded the margin pupil (MPD), central eyebrow (CED), nasal eyebrow (NED) and temporal eyebrow (TED) distances. To test the inter-observer reliability, the senior author (SMT) recorded the same measurements for 10% of randomly selected patients. We calculated 95% confidence intervals to compare symmetry between the right and left sides. Results: One hundred patients (94 female, mean age 57.7) were included in the study. The average MPD, CED, NED and TED distances were 0.55 mm (95% CI 0.45-0.65), 1.77 mm (95% CI 1.47-2.07), 1.34 mm (95% CI 1.14-1.54), and 1.78 mm (95% CI 1.50-2.06), respectively. Ninety-three percent of patients had at least one asymmetric measurement of greater than 1 mm. Seventy-five percent of patients studied had at least one measurement greater than 2 mm while 37 percent had at least one greater than 3 mm. Conclusion: Brow and eyelid asymmetry is common in patients being evaluated for upper lid blepharoplasty. The facial plastic surgeon should identify and document facial asymmetry pre-operatively, and discuss it with prospective blepharoplasty patients. This will improve informed consent and patient expectations. [ABSTRACT FROM AUTHOR]

High-quality periocular images have sufficient variability between people that they can be used for automated recognition. However, there are no standards for training people to compare periocular images in a forensic context. Potential methods for training people to compare eyebrow images are investigated in this article. Pairs of images were presented to volunteers who decided whether the images showed the same person or different people. A control group with minimal instruction and no training responded with 87.6% accuracy. A second group viewed 100 training pairs before the test and achieved 94.2% accuracy. A third group rated specific features in the images and had 0.1% improvement over the second group. Experimental results show that actively comparing at least thirty training images and receiving immediate feedback improves trainees' performance six to seven percent. If a quantitative quality score is needed, a linear combination of similarity ratings on different features may be used. [ABSTRACT FROM AUTHOR]

Partial loss of the eyebrows can be the result of epilation, scars, and inflammatory diseases. Facial hair and eyebrows play a major role in our mimetic expression and interaction. Therefore, facial hair restoration of the eyebrows can improve the appearance and psychological well-being of patients. We report the use of partial longitudinal follicular unit transplantation (PLFUT) to restore eyebrows. A total of 10 patients (age between 18 and 59 years; mean, 39 years) have been treated with PLFUT to restore the eyebrows. The grafts were harvested from the occipital area of the scalp. Suitable grafts were impregnated with a preservative solution and implanted into the eyebrows areas. Hair growth in the donor area as well as the eyebrows was observed before treatment and at intervals of 1 week, 3 months, and 1 year after treatment. Evaluation of the donor area reveals no visible scars with almost all hair follicles in the donor site reproducing hairs after 1 year. All treated patients were satisfied or very satisfied with their cosmetic results. PLFUT is a reliable, patient friendly method suitable for hair restoration of eyebrows in healthy persons as well as in burn scar tissue. [ABSTRACT FROM AUTHOR]