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To evaluate the outcomes of endonasal dacryocystorhinostomy (EN-DCR) surgery in patients with sarcoidosis.Retrospective chart review of all patients with sarcoidosis undergoing EN-DCR in 6 practices from 1999-2011.We included 18 procedures in 14 patients (8 female, 6 male) who underwent EN-DCR for acquired NLDO secondary to sarcoidosis. The mean age was 53.7 (range 38-82). The presenting symptom in all cases was epiphora. Eight patients (57%) complained of having additional nasal congestion. Surgery was performed using endoscopic powered-type DCR with flaps in 12/18 (67%) and non-endoscopic mechanical EN-DCR in 6/18 (33%). In 15 (83%) cases the lacrimal sac and nasal mucosa appeared abnormally yellowish, crusty, oedematous and friable. Five patients were treated with pre-operative oral steroid and overall 8 patients had oral prednisolone post operatively, 30-60 mg tapered within 10 days-8 weeks. One patient had difficulties in tapering down the oral steroids at 6 months of follow-up. All patients were free of epiphora and patent to syringing, with nasal endoscopy revealing free flow of fluorescein through the ostium at a mean follow-up of 11.3 months (median follow-up 9 months).All 18 cases of acquired nasolacrimal duct obstruction secondary to sarcoidosis were treated successfully with EN-DCR. An abnormal appearance of the nasal mucosa is an important sign. Nasal congestion is a frequent sign. A successful outcome may not depend on intensive long-term therapy with local or systemic steroids. Mechanical or powered EN-DCR for nasolacrimal duct obstruction secondary to sarcoidosis achieves encouraging medium-term outcomes.

As the surgeon learns to address the aging changes of the forehead, brows, eyelids and cheeks, the natural progression is to understand aging of the lower one-third of the face and aging of the neck. An understanding of surface anatomy, a review of the underlying anatomical changes of aging and an overview of the palette of procedures applicable to the aging of the neck are presented to introduce the surgeon to this important part of the aging face.

Metastatic mucinous adenocarcinoma in the orbit is extremely rare. We review the literature and report a case of metastatic mucinous adenocarcinoma of the orbit in a 37-year-old male with primary pancreatic adenocarcinoma.

There has been a bewildering increase in the number and types of lasers available to the modern surgeon for the treatment of a variety of lesions. Pigmented and vascular lesions lend themselves to laser therapy and are common presentations in the cosmetic practice. While many different lasers may be effective for the treatment of these lesions, each has its own advantages and disadvantages. A detailed understanding of the specific properties and the applicability of the different lasers is vital if one is to successfully incorporate these lasers into one's practice. In this article, we discuss the different types of lasers available for the treatment of these lesions, discuss the specific indications and limitations and present our experience with the krypton laser.

Modern cosmetic surgery of the periorbital area has reached new levels of sophistication. Effective execution of advanced surgical procedures demands artistic intuition and a thorough understanding of anatomy. This article discusses the basic and applied anatomy of the upper and middle thirds of the face. Particular emphasis is placed on recent advances in our understanding of facial anatomy and their surgical applications.

(1989). Equipment and Methods: Clinical photography: a method of accurate documentation. Journal of Audiovisual Media in Medicine: Vol. 12, No. 4, pp. 154-156.