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1. Lateral canthal suspension is an integral adjunct to lower blepharoplasty surgery. 2. These procedures include a canthoplasty where the lateral canthal tendon and/or temporal tarsus is modified and secured to the lateral orbital rim; or a canthopexy where the canthal tendon, and/or orbicularis muscle, is plicated to the lateral orbital rim. 3. Indications for canthal suspension include preexistent lower eyelid laxity, and prevention of lower eyelid malposition. 4. In aesthetic surgery less disruption of canthal architecture/integrity is best. 5. A thorough understanding of canthal and lower eyelid anatomy is essential to avoid surgical complications. 6. A careful preoperative evaluation of the eyelid position, tone, laxity, and globe/midface configuration (orbitofacial vector) are critical to attain appropriate outcomes. 7. Familiarization with both open (involves canthal incision) and closed (no canthal incision) canthal suspension techniques provides options for the aesthetic lower eyelid surgeon. 8. The risk of postblepharoplasty lower eyelid retraction, ectropion, and rounding of the canthal angle can be reduced with lateral canthal suspension. 9. The expectations and goals of lateral canthal suspension should be discussed with each patient before surgery. Patients unhappy with this form of surgery are often difficult to manage.

In order to incorporate the knowledge of two species of wild doves and compare the results of both, we assessed morphometrics (body weight, bill, tarsus, tail, wing, head and culmen length) and body condition index (using weigh, wing, tail and tarsus length) of Eurasian Collared-Dove Streptopelia decaocto and Mourning Dove Zenaida macroura (Aves: Columbidae) based on 40 specimens of each species collected during fall-winter 2013 and spring-summer 2014 in the municipality of Durango, Durango, Mexico. We found that body condition index was higher during fallwinter for both species. We also found size dimorphism. Males of Eurasian Collared-Dove were larger than females in head length (p = 0.002) and tail length (p = 0.05) but smaller in culmen length. Female Mourning Doves had a higher body condition index compared to males (p = 0.02) during both seasons. As expected, Eurasian Collared-Dove was larger in all measurements than Mourning Dove (p > 0.05) but tail length (p = 0.12).

Background The traditional technique for levator muscle resection includes a time-consuming dissection procedure that causes tissue trauma and swelling. The Putterman ptosis clamp has been popularly used in recent years for conjunctival mullerectomy. In this paper, we describe a modified surgical technique for ptosis treatment using the Putterman ptosis clamp. The modified technique improves the surgical results of levator muscle resection. Objectives We performed a retrospective case-series study to determine the outcomes and complications associated with the use of the Putterman ptosis clamp in levator muscle resection. Methods Adults aged ≥18 years with moderate-to-severe ptosis underwent the modified technique for levator muscle resection. We first performed dissection to expose the aponeurosis and tarsus. Then, we placed the Putterman ptosis clamp to measure redundant aponeurotic and septal tissues and to perform the resection. Following the adjustment of the eyelid fissure, we refixed the levator muscle to the tarsus with 4-0 vicryl stitches. Results Seventeen patients (34 eyes) were included in the study. Of the 34 eyes, 31 (91.2%) experienced the complete resolution of ptosis after the surgery. One patient (2 eyes, 5.9%) had mild bilateral dermatochalasis and received revision surgery 6 months postoperative. One patient (1 eye, 2.9%) lost the crease of the left eye and received revision surgeries 2 and 6 months after the first surgery. No residual ptosis or severe adverse events were noted in the patients. Conclusions Modified levator muscle resection using the Putterman ptosis clamp is an effective procedure for ptosis treatment. Level of Evidence 4

Made available in DSpace on 2018-12-11T17:15:32Z (GMT). No. of bitstreams: 0 Previous issue date: 2018-03-04 Purpose: To describe a new technique to treat congenital distichiasis. Methods: Case series of three distichiatic patients undergoing a novel surgical technique combining splitting of the lid margin with the distichiatic lashes, marginal tarsectomy in the affected area, and tarsoconjunctival graft obtained from the upper region of the tarsus. The graft was sutured at the exposed region of the marginal tarsectomy. Results: Good cosmesis was obtained in all cases and the lids margins healed completely with good surgical outcome and no lashes contacted the cornea postoperatively. Conclusions: The split lamellae with a composite tarsoconjunctival graft results in satisfactory functional and cosmetic outcomes. The upper tarsal region represents an ideal donor site. Oculoplastic Division King Khaled Eye Specialist Hospital Department of Ophthalmology Complejo Asistencial de Palencia Department of Ophthalmology King Saud University College of Medicine Department of Ophthalmology Faculdade de Medicina de Botucatu UNESP Department of Ophthalmology Faculdade de Medicina de Botucatu UNESP

Introduction Severe ptosis of more than 4 mm with poor levator function of less than 4 mm is treated via the frontalis muscle suspension technique using autogenous temporal fascia. Technical note The surgery was performed under general anaesthesia. The eyelid crease was incised and the tarsus exposed. An incision centered on the mid-pupillary level was then made just above the eyebrow with exposure of the frontalis muscle. The temporal fascia strip was sutured to the tarsus at three points. Every free end of the strip was then slid through the adjacent forehead subcutaneous tunnel to emerge together through the medial forehead incision. The eyelid crease was re-formed by suturing the skin with the graft. Discussion Frontalis suspension using autologous material is a harmless procedure, which does not alter the upper eyelid structures. It is an effective procedure in the long-term.

We describe the management of the congenital entropion with tarsal kink in a case of mobius syndrome. Mobius syndrome is extremely rare congenital neurological disorder results from the underdevelopment of the sixth and seventh cranial nerves which causes facial paralysis and inability to move the eyes from side to side. A congenital malformation of the tarsus known as tarsal kink was the associated eyelid anomaly which caused upperlid entropion. A two year old girl presented with both eyelids entropion of left eye which was corrected by upper lid tarsotomy, marginal rotation and levator suturing with tarsal plate and lower lid retractors were strengthened by their advancement to the tarsal plate.

We report a case of floppy eyelid syndrome (FES) treated with surgical approach at the PUC Campinas Hospital in 2019. This was a retrospective case report. A 42-year-old male patient diagnosed with FES. The patient elected for surgical repair due to severity of his symptoms. A lateral pentagonal upper eyelid resection was performed in the left eye, and eyelid tissue from the patient was examined using light microscopy and immunohistochemistry that revealed chronic conjunctival inflammation and papillary conjunctivitis. The pentagonal wedge resection is an effective treatment method that produces immediate relief of symptoms. In our case, no recurrence was observed up to 6-month follow-up.

The purpose of this paper is to report the outcome of retrotarsal tucking of Muller muscle-levator aponeurosis for the correction of borderline to moderate ptosis in conjunction with esthetic blepharoplasty in Asian eyelids and to explore the relationship between the extent of advancement and change in the eyelid position (MRD1). The medical records of 290 consecutive patients who underwent retrotarsal tucking of Muller muscle-levator aponeurosis from February 2005 to November 2011 were reviewed. Of those, 26 patients (51 eyelids) were statistically analyzed. The correction was performed through an external upper blepharoplasty approach. Once the orbital septum was opened, the Muller muscle-levator aponeurosis was advanced and tucked under the posterior surface of the tarsus by a single lifting suture. The average follow-up period was 20.6 months, with a range of 3–68 months. In 26 patients (51 eyelids), satisfactory results were recorded for 49 of 51 eyelids (96.1 %). The margin reflex distance-1 (MRD1) increased from 1.56 ± 0.70 mm preoperatively to 3.86 ± 0.94 mm postoperatively (p

A new species, Meloe (Meloe) kulabensis sp. n., is described from southwestern Tajikistan (Kulob, = Kulyab). The new species is characterized by rather slender legs with an almost straight middle tibia, comparatively long and narrow tarsi, the 1st segment of the hind tarsus almost 5 times as long as wide, a comparatively large transverse eye diameter (the distance between the eyes are 3 times the transverse eye diameter), a free (not merging) punctation, and a peculiar structure of the male genitalia. Similarly to Meloe ovalicollis Reitt., the new species bears a narrow brush of short and not dense hairs on the ventral surface of the 1st-4th segments of the fore tarsus. Meloe ovalicollis is recorded for the first time for Kazakhstan and Tajikistan.

The tarsus of the hispid beetle Basiprionota chinensis (Fabricius) (Coleoptera) is illustrated using scanning electron microscopy. It has five tarsomeres, the pretarsus is with a pair of ungues, with the tarsomeres exhibiting specialisation. The ungues, which articulate dorsally at the distal end, are broad basally (320–328μm long and 270–294μm wide), gradually narrowed to an acute apex over apical half, with their surface being rough dorsally and longitudinally grooved inwards ventrally. The first, second and third tarsomeres in their ventral surface have dense, adhesive setae, with each seta consisting of a shaft and a modified apex (terminal plate). These setae are either pointed, spatulate or discoidal depending on the shape of their tip; pointed ones are 38–54μm long, have acute, pronged and curved tips and located on the edge of tarsomeres I and II; spatulate ones are 46–53μm long, have pronged and curved terminal plates, but present only on tarsomere III and the edge of tarsomeres I and II; and the...

Rupture of the gastrocnemius muscle is occasionally found in neonatal foals associated with dystocia and assisted delivery. In this report, 3 cases of gastrocnemius muscle disruption in newborn Thoroughbred foals (6, 5 and 2 days old) are reported. In all cases, the foals were presented with inability to rise unassisted postpartum, a dropped tarsus and swelling in the caudal aspect of the thigh accompanied by a hematoma. Ultrasonography, radiography, computerized tomography (CT) and subsequent autopsy were performed to confirm the clinical and pathological features of these cases.

Purpose To evaluate the use of gold weight implantation in the upper eyelid in the treatment of upper eyelid retraction caused by thyroid ophthalmopathy as regards the cosmetic and functional results and the safety of the procedure. Patients and method This is a surgical intervention case series study. The study was carried out in Ophthalmology Department in El-Minya University Hospital between January 2013 and January 2014. The study was approved by the ethical committee board of El-Minya University. Test weights were applied to the skin of the upper eyelid using special adhesive tape in the sitting position to determine the suitable implantable weight. Three interrupted nonabsorbable sutures (5/0 Dacron) were used to secure the gold weight to the tarsus. The orbicularis was closed using interrupted 6/0 vicryl sutures. The skin was closed using interrupted 6/0 nylon sutures. Results As regards the postoperative results, by the end of the follow-up period, improvement of eyelid retraction was present in all cases. Normal upper eyelid margin position (covering 2 mm of the cornea) was attained in 10 eyelids (76.92%). Undercorrection was observed in 3 eyelids (23.07%). Two eyelids covered 1 mm of the cornea, and 1 eyelid rested at the upper limbus. All patients (100%) were satisfied as regards the cosmetic results, with the degree of satisfaction ranging between very good for 3 patients and excellent for 4 patients. One patient had bilateral brick-shaped appearance. Conclusions Gold weight implantation for treatment of thyroid-related upper eyelid retraction markedly improves the cosmetic appearance of the patient and, to a lesser extent, improves the manifestations of exposure with high patient satisfaction, and it is a relatively easy and safe procedure.

The mechanics of substrate adhesion has recently been intensively studied in insects but less is known about the sensorimotor control of substrate engagement. We characterized the responses and motor effects of tarsal campaniform sensilla in stick insects to understand how sensory signals of force could contribute to substrate grip. The tarsi consist of a chain of segments linked by highly flexible articulations. Morphological studies showed that one to four campaniform sensilla are located on the distal end of each segment. Activities of the receptors were recorded neurographically and sensilla were identified by stimulation and ablation of their cuticular caps. Responses were characterized to bending forces and axial loads, muscle contractions and to forces applied to the retractor apodeme (tendon). The tarsal sensilla effectively encoded both the rate and amplitude of loads and muscle forces, but only when movement was resisted. Mechanical stimulation of the receptors produced activation of motor neurons in the retractor unguis and tibial flexor muscles. These findings indicate that campaniform sensilla can provide information about the effectiveness of the leg muscles in generating substrate adherence. They can also produce positive force feedback that could contribute to the development of substrate grip and stabilization of the tarsal chain.

Summary Reasons for performing study Hindlimb proximal suspensory desmopathy is a common injury of sport horses but diagnosis can be difficult because diagnostic analgesia of the region lacks specificity. Perineural analgesia of the deep branch of the lateral plantar nerve (DBLPN) has been proposed as a more specific method of isolating pain of the proximal aspect of the suspensory ligament but the technique has not been evaluated in vivo. Objectives To determine the extent of diffusion of contrast medium and mepivacaine following DBLPN analgesia using a single-needle injection technique and to determine if there is inadvertent involvement of the tarsal sheath and/or tarsometatarsal (TMT) joint using this technique. Study design In vivo experimental study. Methods Perineural injection of the DBLPN was performed in 16 limbs with 3 ml of either mepivacaine hydrochloride or positive contrast medium. Contrast medium-injected limbs were radiographed 5, 15, and 30 min post injection and diffusion characteristics were described. In mepivacaine-injected limbs, synovial fluid from the TMT joint was obtained 10 and 20 min post injection and mepivacaine concentrations were analysed. Results At 5, 15 and 30 min post injection, the contrast medium extended, on average, 19.6, 20.6 and 21.0 mm proximal and 38.0, 43.5 and 51.9 mm distal to the injection site, respectively. Three of 8 (37.5%) limbs had evidence of contrast medium in the tarsal sheath. Two of 8 (25%) limbs had mepivacaine concentrations within the TMT joint sufficient to produce analgesia (>300 mg/l) at 10 min post injection. Conclusions Contrast medium diffused further in a distal direction than in a proximal direction. Analgesia of the DBLPN can result in inadvertent involvement of the tarsal sheath and/or TMT joint.

Objectives To describe the normal anatomy of the soft tissues of the canine tarsus as identified on computed tomography (CT) and magnetic resonance imaging (MRI) and to evaluate specific MRI sequences and planes for observing structures of diagnostic interest. Study Design Prospective descriptive study. Animals Canine cadavers (n = 3). Methods A frozen cadaver pelvic limb was used to trial multiple MRI sequences using a 1.5 T superconducting magnet and preferred sequences were selected. Radiographs of 6 canine cadaver pelvic limbs confirmed the tarsi were radiographically normal. A 16-slice CT scanner was used to obtain 1 mm contiguous slices through the tarsi. T1-weighted, proton density with fat suppression (PD FS) and T2-weighted MRI sequences were obtained in the sagittal plane, T1-weighted, and PD FS sequences in the dorsal plane and PD FS sequences in the transverse plane. The limbs were frozen for one month and sliced into 4–5 mm thick frozen sections. Anatomic sections were photographed and visually correlated to CT and MR images. Results Most soft tissue structures were easiest to identify on the transverse MRI sections with cross reference to either the sagittal or dorsal plane. Bony structures were easily identified on all CT, MR, and gross sections. Conclusions The anatomy of the canine tarsus can be readily identified on MR imaging.

During 25 field seasons between 1988 and 2012, Biodiversity Research Institute captured and uniquely color-banded 2,730 adult Common Loons (Gavia immer) on breeding territories in 11 States and seven Provinces throughout North America. Body mass was obtained from each individual; tarsus and bill measurements were obtained from more than half the birds banded. Clinal variation in body mass, tarsal width and bill length was observed. Body mass varied from 2,700 g to 7,600 g; loons from populations in the upper Great Lakes and central Canada were smallest, and size increased to the east and west. Examination of band return and satellite tracking data resulted in three migration distance groups: 20%) than associated females, and withinpair differences increased with decreasing migration distance (i.e., males from coastal States were proportionally larger than their ma...

Some new amber materials of Nemestrinidae from the mid-Cretaceous of Myanmar have been examined. Among them, two new species of Hirmoneura named, Hirmoneura burmanica sp. nov. and Hirmoneura mostovskii sp. nov. are described and illustrated based on two well-preserved specimens respectively. The new species H. burmanica sp. nov. is established based on R1 turned backwards and bm and discal cells broader than the fourth posterior cell. Grimaldi (2016) established Hirmoneura aff. richterae Mostovski and Delclos, 2000, but it can be identified as the new species Hirmoneura mostovskii sp. nov. based on its distinctly smaller body size and obviously longer second tarsomere of hind tarsus. Moreover, the venational variation of Hirmoneura caudiprima Grimaldi (2016) from Burmese amber was discussed here.

The aim of the study was to report the surgical outcome of mini-incisional correction method to treat involutional entropion.This is a retrospective interventional case series of 46 eyelids in 31 patients with involutional entropion and significant ocular irritation. In this technique, after turning the lower eyelid inside out, threads are introduced into it through the conjunctiva close to the inferior fornix. The lower lid retractor and tarsus are then connected using threads. These threads are applied at 3 locations of the lower eyelid and tightening them results in the eyelid being everted and the correction of entropion. Surgical success was defined as no contact between the eyelashes and the globe during forced closure of the eyelids. Surgical failure was defined as persistence of the eyelashes remaining in contact with the globe or cosmetic dissatisfaction.During the mean follow-up period of 22.1 months (range, 12-34 months), 43 of the eyelids (93.5%) were successfully corrected. Two patients (3 eyelids) experienced recurrence: 1 had involutional entropion combined with a cicatricial component, and the other had blepharospasm and apraxia of eyelid opening related to Parkinsonism. No postoperative complications such as overcorrection, suture-knot exposure, or ocular irritation were observed.Our mini-incisional entropion repair is based on reinforcement of the lower eyelid retractors using transconjunctival buried sutures. This technique is a quick, simple, and predictive for involutional entropion repair, and has a high success rate.

We report the case of a 15-month-old boy who presented with a mass lesion of the right upper eyelid that had been present since birth and had slowly enlarged over the last 3months. The lesion had minimal surrounding erythema simulating the appearance of a chalazion. Intraoperatively the lesion was noted to be firmly adherent to the underlying tarsus. The lesion was excised completely through an eyelid crease approach leaving the tarsus intact. The histopathology was consistent with dermoid cyst. To our knowledge, this is the third case of a tarsal dermoid cyst reported in the literature. Dermoid cyst should be included in the differential diagnosis of eyelid mass lesions, and particulary differentiated from a chalazion to avoid mismanagement that may lead to scarring, recurrence and inflammation. The excision of these lesions sparing the underlying tarsus can be possible.

Ultrasound imaging is not traditionally employed to evaluate eyelid lesions. Nevertheless, this technology permits the delineation of static and dynamic changes and could be useful in evaluating eyelid masses by providing additional information to clinicians for optimal surgical planning, especially in facilities where a computed tomography (CT) scan is not readily available. A 63-year-old woman presented in April 2014 with a painless mass in the right upper lid (RUL) associated with ptosis (Figure 1A) that had gradually developed during the previous 10 months. Retinopexy associated with vitrectomy with intraocular silicone oil filling was performed 15 months before to treat a retinal detachment in the right eye. Silicone oil was removed 8 months later. For the past 4 months, patient was under investigation for a breast nodule. Figure 1. (A) This 63-year-old woman presented with a painless mass in the right upper eyelid associated with upper lid ptosis that had gradually developed for 10 months. (B) Final aspect 1 year after excision of the mass and reinsertion of the levator aponeurosis to the tarsus. Marginal reflex distance (MRD-1) was −1 on the right and +3 on the left side. Levator function was 13 and 15 mm. Best corrected visual acuity was counting fingers 2 …

We describe a case of a 2-year-old mare that presented with a large firm swelling on the lateral aspect of the right tarsus. Diagnostic ultrasound demonstrated a fluid filled cavernous mass that was not clearly demarcated from the surrounding subcutaneous tissue. Contrast radiography with intralesional injection of contrast medium showed accumulation of the medium in the caverns of the mass and in the saphenous vein. Contrast enhanced computed tomography demonstrated 2 vascular meshes, one deep and one more superficially, closely associated with the mass. Surgical excision of the mass was performed and a vascular hamartoma was diagnosed based on histopathology. The horse showed no signs of recurrence 7 months after surgery.

The aim of this study is to describe the phenology of migration and biometrics of the turtle dove Streptopelia turtur in Greece, based on ringing studies on Antikythera Island. Spring passage takes place between early April and late May and autumn passage between early and late September. There is no significant difference in either wing length or tarsus length between adults and juveniles. Males have significantly greater wing length. There is no significant difference in tarsus length between the two sexes.

Summary Introduction Retraction of the lower eyelids has multiple etiologies. Its surgical treatment is a vertical elongation of the tarsus. This can be obtained by using a graft. We describe a sampling and grafting technique using palatal fibromucosa intratarsal graft. Technical note The procedure is performed in two steps under general anesthesia. The graft is harvested on the lateral sides of the palatine vault to avoid neurovascular bundles. This area corresponds to the maxillary fibromucosa according to Delaire's classification. The graft is then inserted in the lower eyelid tarsus. Discussion Many “spacers” are available to extend the posterior lamella vertically; the palatal fibromucosa graft may be used directly and is easy to harvest. It has a similar stiffness to that of the tarsus and there is no need to harvest periosteum. Sparing the periosteum allows for a better healing of the donor site and decreases postoperative pain. The lateral harvesting area, away from the anterior palatine artery, seems more accessible than the median area, especially in ogival palates.

SummaryObjective: Describe optimal corridors for mediolateral or lateromedial implant placement in the feline tarsus and base of the metatarsus.Methods: Computed tomographic images of 20 cadaveric tarsi were used to define optimal talocalcaneal, centroquartal, distal tarsal, and metatarsal corridors characterized by medial and lateral insertion points (IP), mean height, width, length and optimal dorsomedial-plantarolateral implantation angle (OIA).Results: Talocalcaneal level: The IP were at the head of the talus and plantar to the peroneal tubercle of the calcaneus and OIA was 22.7° ± 0.3. Centroquartal level: The IP were at the centre of the medial surface of the central tarsal bone and dorsoproximal to the tuberosity of the fourth tarsal bone and OIA was 5.9° ± 0.06. Distal tarsal level: The IP were at the centre of the medial surface of the tarsal bone II and dorsodistal to the tuberosity of the fourth tarsal bone and OIA was 5.4° ± 0.14. Metatarsal level: The IP were at the dorsomedial surface of the proximal end of the metatarsal bone II and at the dorsolateral surface of metatarsal bone V and OIA was 0.5° ± 0.06. Significant positive correlation was found between body weight and the length of each corridor.Clinical significance: Most of the corridors obtained in this study had a diameter between 1.5 mm and 2 mm with a length of 15 mm to 18 mm, which stresses the importance of their accurate placement.

The ultrastructural morphology of the tarsus of the adult beetle, Aspidomorpha dorsata (F.) (Coleoptera: Hispidae), is described for the first time, using scanning electron microscopy observations. The tarsus of A. dorsata consists of 5 tarsomeres and the distal pretarsus consists of a pair of ungues. The foretarsus and midtarsus are similar to each other whereas the hindtarsus exhibits specialization. The ungues, which articulate dorsally at the distal end of the tarsus, are broad basally (about 169 - 178 μm long and 126 - 133 μm wide), gradually taper into an acute apex over apical half, with the surface of the ungues being rough dorsally and longitudinally grooved innerly and ventrally. There are three small, parallel, accessory ungues (about 35 - 80 μm long) on the ungues. The surface of the accessory ungue is smooth. The ventral surface of the first, second and third tarsomeres is covered with dense adhesive setae. Each seta consists of two parts: a setal shaft and a modified apex (terminal ...

Lateral digital flexor tendonitis is a rarely reported cause of hind limb lameness in performance horses. The purpose of this retrospective study was to describe clinical and diagnostic imaging findings for a group of horses with lateral digital flexor tendinitis within the tarsal sheath. Equine cases with a diagnosis of lateral digital flexor tendonitis and magnetic resonance imaging (MRI) studies of the affected region were retrieved from North Carolina University’s medical record database. Recorded data for included horses were signalment; findings from history, physical examination, lameness examination, and all diagnostic imaging studies; treatment administered; and outcome. Four horses met inclusion criteria. Lameness was mild/moderate in severity and insidious in onset in all patients. Responses to flexion tests were variable. All horses showed positive improvement(70–90%) in lameness after tarsal sheath analgesia. Radiographic, scintigraphic, and ultrasonographic findings were inconclusive. For all horses, MRI characteristics included increased T2, PD, and STIR signal intensity within the lateral digital flexor tendon in the area of the tarsal sheath. Tarsal sheath effusion was slight in three horses, and mild/moderate in one horse. With medical treatment, two horses were sound at 6-month follow up, one horse was sound at 1-year followup, and one horse had a slight persistent lameness (grade 1/5) at 9-month followup. Findings supported the use of MRI for diagnosing lateral digital flexor tendonitis within the tarsal sheath in horses. Affected horses may have a good prognosis for return to athletic performance following appropriate medical treatment.

Purpose To examine the tarsal attachments of the levator aponeurosis. Design Experimental anatomic study. Participants Sixteen orbits from 12 fresh frozen white cadavers. Methods Eight specimens served as controls. In the remaining 8 specimens from 4 cadavers, the upper eyelid was everted. All specimens then were fixed in formalin. The age, sex, and laterality were recorded in both groups. The eyelid lamellae and tarsal attachments of the levator aponeurosis in particular were examined microscopically. Lamellar and nonlamellar ocular anatomic features and the relationships of the preaponeurotic and postaponeurotic spaces were measured. Main Outcome Measures Histologic findings of the extent and pattern of the tarsal attachments of the levator aponeurosis in relation to the tarsus and Muller's muscle and of the changes in the lamellae in eyelid eversion. Results The demographic and baseline anatomic characteristics of both the noneverted control and everted eyelid groups were similar. In comparing everted with noneverted controls, the preaponeurotic space was significantly shorter (6.22 and 10.61 mm, respectively; P = 0.003) and the preaponeurotic-to-postaponeurotic space ratio was halved (0.57 and 1.16, respectively; P = 0.005). Although the distance from the superior tarsal border to Whitnall's ligament increased significantly in everted versus noneverted eyes (14.65 and 11. 03 mm, respectively; P = 0.016), there was no significant difference in the length of postaponeurotic space in the 2 groups (11.07 and 9.69 mm, respectively; P = 0.370). The levator aponeurosis attached to the anterior tarsus in both groups. The proximal point of attachment was the superior border of the tarsal plate, adjacent to the insertion of Muller's muscle tendon. Conclusions The deeper aponeurotic fibers and Muller's muscle attach proximally at the superior tarsal border. Upon eyelid eversion, the 2 lamellae move as a unit and the postaponeurotic space remains stable. A proximal tarsal attachment suggests that blepharoptosis procedures that advance an involutional or disinserted levator aponeurosis onto to the superior tarsus approximate that aspect of native anatomic features. In addition, posterior surgical approaches that address Muller's muscle may involve resections in closer proximity to the aponeurosis than previously thought. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.

INTRODUCTION Pachydermoperiostosis or primary hypertrophic osteoarthropathy is a rare cause of ptosis. We report the case of a patient with pachydermoperiostosis and bilateral ptosis. The physiopathology and treatment of this ptosis are discussed. CASE REPORT A 49-year-old patient was referred to our department with ptosis. He had pachydermia of the face, hands and the feet, digital clubbing and periostosis. Examination of the eyelids showed that palpebral apertures were reduced to less than 4mm bilaterally and that eyelids were markedly thickened. All theses features were consistent with the diagnosis of pachydermoperiostosis. Other secondary conditions were ruled out. Ptosis correction was performed by palpebral skin and orbicularis resection as well as tarsectomy. The aesthetic outcome was satisfactory. DISCUSSION Pachydermoperiostosis is a rare inherited disease, characterized by pachydermia, digital clubbing and periotosis. Ptosis is the result of the palpebral hypertrophia. Excisions of skin, orbicularis muscle and tarsus often give good cosmetic outcomes. CONCLUSION Pachydermoperiostosis is a rare cause of ptosis, which development is attributed to eyelid thickening. Surgical management has satisfactory cosmetic outcome.

Summary Reasons for performing study Tarsal pain is a common cause of hindlimb lameness in horses. Diagnosis can usually be made with radiography and ultrasonography; however, in some cases, these techniques are inconclusive and additional imaging is necessary. No studies describing computed tomography (CT) features of different tarsal lesions in horses with tarsal lameness are reported. Objectives Our aims were as follows: 1) to characterise CT abnormalities in horses with tarsal lameness; 2) to compare CT findings with those from other imaging techniques; and 3) to assess whether CT can help to diagnose tarsal pathology. Study design Retrospective case series. Methods Computed tomography of the tarsus was performed on 15 horses (n = 17 joints) with tarsal lameness. The horses were divided into 3 groups depending on the reason for CT examination, as follows: 1) other imaging techniques were inconclusive; 2) evaluation of a fracture; or 3) other imaging techniques showed tarsal lesions, and CT was performed to assess whether additional lesions were present. Results Group 1 included 7 horses. Lesions detected with CT included subchondral cyst-like lesions (2 horses); an osteolytic lesion in the cochlea tibiae (one horse); degenerative changes of the distal tarsal joints (2 horses); osteolytic lesions tarsometatarsal joint (one horse); and sclerosis of the third tarsal bone with a lesion of the tarsometatarsal interosseous ligament (one horse). In this group, CT provided information on the character and extent of the lesion that was not available with other imaging techniques. Computed tomography revealed more information about the extent and complexity of the fracture than radiography in Group 2, whereas CT did not provide extra information in Group 3. Conclusions Focal lesions located between the tarsal bone surfaces are difficult or even impossible to detect with radiography and ultrasonography, but they can be detected and characterised with CT. Potential relevance Computed tomography of the tarsus should be considered when radiography and ultrasonography are inconclusive, or for further evaluation of tarsal fractures. The Summary is available in Chinese – see Supporting information.

The ultrastructure of the tarsus of adult Oides decempunctatus (Billberg) (Coleoptera: Chrysomelidae) was examined using scanning electron microscopy. Structurally the tarsus consists of 5 tarsomeres and a pair of bidentate ungues on the pretarsus. The ventral surfaces of the 1st, 2nd and 3rd tarsomere are covered with dense adhesive setae. Each seta consists of two parts: a setal shaft and a modified apex. Three types of setae, viz. tapered setae, spatulate setae and discoidal setae, are identified based on the shape of the setal tip. The tapered setae are located at the edge of the 1st tarsomeres and on the whole 2nd tarsomeres of the male forelegs and mesolegs and on the whole 1st and 2nd tarsomere of the female legs and male metalegs. They are about 40–60 µm long and 4 µm broad at base, taper from base to apex with a curved, acute and hook-like apex and have a density of approximately 1 seta/100 µm2. The spatulate setae are located at the edge of the 3rd tarsomeres of the male forelegs and me...

Summary This report describes the use of low-field standing magnetic resonance imaging (MRI) in the diagnosis and clinical decision making process in a 14-year-old Dutch Warmblood mare with a comminuted central tarsal bone fracture. Magnetic resonance imaging in the standing horse was preferred over computed tomography examination under general anaesthesia because the animal had sustained the injury during a poor recovery from a previous general anaesthetic episode. Magnetic resonance imaging examination identified a comminuted central tarsal bone fracture with a configuration that was not identifiable with radiography. Due to extensive comminution of this fracture, conservative management was pursued. Standing low-field MRI examination enabled safe examination of this animal and provided useful diagnostic information whilst facilitating the clinical decision making process.

The procedure can be used in cases of primary or secondary repair as an alternative to the Hughes or Tenzel type flaps. The graft is usually harvested from the contralateral upper eyelid. The free tarsal graft provides posterior lamellar replacement without a vascular supply. An anterior lamella replacement consisting of a vascularized flap is required to cover the graft.

PURPOSE To explore the clinical and histopathologic features and surgical outcome of intratarsal keratinous cyst (IKC). METHODS The clinical findings, histopathologic evaluations, and immunohistochemical studies in 15 cases of IKC were investigated, retrospectively. RESULTS Fifteen patients with an average age of 44.7 years had noninflamed eyelid cysts sized 1-6 mm in diameter. The cysts appeared as solid, whitish opalescent or yellow-white, mildly elevated lesions beneath the palpebral conjunctiva. The cysts embedded in the tarsus were completely excised with a portion of the adjacent tarsus by a surgical procedure through palpebral conjunctival approach. Histopathologic evaluations revealed stratified squamous epithelium linings and keratin contents, which were not identical to the common epidermal or epidermoid cysts. The results were negative for Alcian blue and periodic acid-Schiff staining and showed positive correlation to the immunoreaction for epithelial membrane antigen. No recurrence occurred in all patients who had their lesions removed completely. CONCLUSIONS Our study revealed the clinical and pathological characteristics of IKC, including the absence of inflammatory sign, lesion partially embedded in the tarsus and protruding beneath the conjunctiva with the intracystic keratinous contents, stratified squamous epithelium linings, string-like keratin contents from the histopathology sections, and strongly immunoreactivity to antibodies against epithelial membrane antigen. A complete excision of cysts with adjacent tarsectomy by transconjunctival approach was proved to be an effective treatment for prevention of recurrence.

The upper lid entropion is a rare eyelid malposition in which the external lid margin turns inward against the ocular surface. It may be classified as congenital (tarsal malformation, hypoplasia of tarsus, eyelid hyperlaxity) but is more commonly an acquired condition (traumatic, immunopathological, inflammation, involutional forms). Surgery is the treatment of choice for correction of upper lid entropion. Appropriate surgical techniques are available for the respective conditions. This article gives an overview of the most commonly used treatment strategies including non-surgical and surgical procedures. Transcutaneous and intermarginal access routes have proven to be safe methods for minimal or moderate upper lid entropion. Combined surgical procedures (e.g., rotation of tarsoconjunctiva, posterior lamellar graft, everting sutures and autologous cultivated oral mucosal epithelial transplantation and so on) should be applied as treatment strategies for severe upper lid entropion with cicatricial changes in the tarsoconjunctival layer, shortage of posterior lamella and severe ocular surface disease.

The Tenzel semicircular flap was first described by Dr. Richard Tenzel in 1975. The semicircular flap is useful for reconstruction of central lower eyelid defects. The Reverse Tenzel semicircular flap is performed for central upper eyelid defects. While canthotomy and cantholysis alone may be used to reconstruct defects comprising up to 25 %, the addition of the semicircular flap is useful to reconstruct defects as large as two-thirds of the eyelid with the caveat that tarsus is present on both sides of the surgical defect. The semicircular flap is rotated and advanced into the defect allowing for adequate wound closure. The procedure also requires reconstruction of the lateral canthus to restore the canthal angle and the blink dynamic. This is accomplished through fixation of the flap to the periosteum of the lateral orbital rim.

The Hughes tarsoconjunctival flap provides a means of reconstructing posterior lamellar defects of the lower eyelid. This lid sharing procedure allows reconstruction of lower eyelid margin defects encompassing as much as 90 % of the eyelid. The tarsoconjunctival flap entails advancing a flap of upper eyelid conjunctiva and tarsus down to the lower eyelid. The rectangular flap is sized according to the size of the defect. A portion of the upper lid tarsal plate and conjunctiva (approximately 4 mm in height) is left intact to maintain upper eyelid stability.

The Cutler Beard bridge flap procedure can be used to reconstruct upper eyelid defects up to 90 % in size. The bridge flap is a two stage lid sharing procedure. In the first stage, a full thickness pedicle is transposed from the lower eyelid to the upper eyelid. The second stage entails dividing the pedicle and trimming excess tissue as needed. Tissue transferred during the first stage includes skin, muscle, and conjunctiva. The tarsus is not transferred and as a result, the lid margin may be unstable and predisposed to entropion. This can be addressed by placement of a posterior lamellar graft. After completion of the first stage of surgery, the eyelids are completely shut. This is an important consideration when operating on a patient in which the operative eye is their better (or only) seeing eye.

A study was carried out on the tarsal bones of blue bull. The tarsus of blue bull consisted of five bones i.e., tibial tarsal (Astragalus), fibular tarsal (Oscalcis), fused central and fourth tarsal (Scaphocuboid), first tarsal (Cunciformparvum) and second and third tarsal fused (Cuseiform magnum).The average height and breadth of tibial tarsal was 6.81±0.01 cm and 3.84±0.01 cm, respectively. The fibular tarsal was the longest, elongated bone of the tarsus and flattened from side to side with an average height and breadth 12.00±0.01 cm and 3.72±0.01 cm, respectively. The central and the fourth tarsalswere fused together to form a large single bone. The average height and breadth for central and fourth fused tarsal was 2.54±0.01 cm and 5.11±0.01 cm, respectively. The first tarsal was a quadrilateral piece of bone placed at the postero-internal part of the tarsus. The length and maximum breadth of first tarsal was 2.14±0.01 cm and 3.32±0.01 cm, respectively. The second and third fused tarsal was a small plate of bone having length and breadth of second and third fused tarsal 1.68±0.01 cm and 3.34±0.01 cm, respectively.

Background The purpose of this study was to evaluate the results of tarsoaponeurectomy in patients with unsuccessful results after repetitive surgery or who developed post-traumatic blepharoptosis. Methods The files of 107 patients (136 eyes) on whom surgery was performed between January 2010 and December 2014 due to blepharoptosis were scanned retrospectively. Among these patients, the files and operational notes of eight patients who underwent surgery through the method of tarsoaponeurectomy were examined in detail. The epidemiological data, indication for surgery, previous ptosis and/or eyelid surgeries and trauma histories, preoperative and postoperative measurement data (palpebral space (PS), margin reflex distance (MRD1, MRD2), levator muscle function (LMF)) of the patients were recorded. The follow-up time of the patients was 7 to 34 months with an average of 16 months. Results A total of eight patients consisting of three females and five males were included in the study. The age range was 19 to 63 years with an average of 39 ± 16.2 years. Four patients had traumatic ptosis history whereas four patients had previous multiple levator procedure surgery history. Those patients with a history of ptosis had undergone surgery with levator procedure at least two times. Additionally, one patient had upper eyelid entropion, one had anophthalmic socket syndrome, and one had exposure keratopathy and traumatic dilated pupil. Seven patients had ptosis in the left eye whereas one patient had ptosis in the right eye. All patients were given a tarsoaponeurectomy as the basic surgical procedure while the patient with entropion was given a tarsal fracture and ear cartilage grafting as additional surgery. Two patients with vertical notching were also given a vertical blepharotomy through which a strip of tarsus was removed. Conclusions Tarsoaponeurectomy is an alternative method for oculoplastic surgeons used to deal with patients on whom sufficient and desired results have not been achieved despite repetitive surgery and in post-traumatic cases where levator muscle and aponeurosis cannot be dissociated peroperatively.

A 61-year-old woman presented with a slow-growing mass on the right upper eyelid. The hard, fixed, and nontender mass was apparent on the right upper eyelid. It was immobile, and it seemed to be adhered to the tarsus. Total excision of the mass was performed. A histopathological examination revealed a solid mass with fibrous and myxoid areas with scattered spindle- to stellate-shaped cells in a fibromyxoid matrix. The immunochemistry examination stained positively for CD34 and CD99. Based on these findings, the lesion was diagnosed as a tarsal fibromyxoma. Although rare, a fibromyxoma originating from the tarsus should be considered in the differential diagnosis of solid tarsal lesions.

Formalin preserved ocular-associated anterior adnexa tissues from five necropsied Asian elephants (Elephas maximus) were dissected with attention to the palpebrae, conjunctiva, nictitating membranes, nasolacrimal ducts, and periocular glandular tissues. Gross and histologic examination revealed that lacrimal and tarsal glands were not present. Evidence of the lacrimal drainage apparatus, including lacrimal punctae or any remnant of lacrimal sacs, was also absent. In contrast, well-developed sebaceous glands associated with accessory hairs along the palpebrae were exceptionally abundant. Mixed-secreting accessory lacrimal glands were noted in the deep stroma posterior to the tarsus of both palpebrae and the gland of the nictitating membrane. Apparently, the Asian elephant has developed a novel tear system in the absence of lacrimal and tarsal (meibomian) glands. Clinical examinations and bacterial cultures of the visible periocular tissues were performed on eight living adult Asian elephants to confirm the postmortem anatomic findings and provide guidance to the clinician during examination of the elephant conjunctiva.

Management of retraction of the upper lid during the congestive phase of thyroid eye disease is usually limited to conservative treatment. We evaluated the efficacy of subconjunctival injection of triamcinolone for the treatment of the upper lid retraction associated with thyroid eye disease.Thirty patients (43 eyes, 11 men and 19 women) with the upper lid retraction associated with thyroid eye disease were evaluated between May 2009 and September 2010. A dose of 0.5 mL of triamcinolone acetonide (40 mg/mL) was injected into the subconjunctival space at the upper margin of the tarsus. If the upper lid retraction had not improved or was still severe 2 weeks after the initial injection, then triamcinolone was injected repeatedly at 2-week intervals. Photographs were taken before the injection and at the follow-up visit, and lid parameters including marginal reflex distance 1, interpalpebral fissure height, total palpebral fissure area, the upper nasal palpebral fissure area, and the upper temporal palpebral fissure area were measured. Changes in the lid parameters after the injection were evaluated.The mean number of injections per patient was 2.67, and the mean (SD) follow-up period was 260.97 (91.10) days. All lid parameters improved significantly after the triamcinolone injection (all P's < 0.05). Nineteen of 22 patients in the congestive phase responded to the triamcinolone injection; however, 6 of 8 patients in the fibrotic phase did not respond to the triamcinolone injection. Complications associated with the triamcinolone injection included an increased intraocular pressure (2 patients) and a mild ptosis (1 patient).The subconjunctival triamcinolone injection is a simple and effective treatment option for the upper lid retraction associated with thyroid eye disease, and this treatment is more effective for the patients in the congestive phase.

The objective of this study is to describe the normal histological appearance of the dorsoproximal aspect of the sagittal ridge of the third metacarpal/metatarsal bone in young Warmblood horses, and to compare it to the different radiographic variations (irregular, indentation, lucency, notch) described at this level. A total of 25 metacarpo/metatarsophalangeal joints of 12 Warmblood horses were used. Five samples of each radiographically described group were selected for histological processing. Each category was compared with the normal control group. Each group showed a bone cortex, covered by hyaline cartilage and longitudinally aligned collagen fibres covered by loosely organized connective tissue proximally. The normal and irregular group showed a smooth bone cortex. In the indentation and lucency group, a depression in the cortex was detected. The notch group presented an expansion of the cortex. The collagen fibres and connective tissue were located in the depression in the indentation group whereas the location varied in the lucency and notch group. The radiologic detected differences are translated into detectable histological differences. Further research is warranted to determine whether these variations are developmental or congenital and to evaluate their potential influence on the joint function during hyperextension.

The ontogeny of morphological traits in three members of the oribatid mite family Galumnidae – Acrogalumna longipluma (Berlese, 1904), Allogalumna alamellae (Jacot, 1935) and Galumna alata (Hermann, 1804) – is described and illustrated for the first time and compared with the literature. The juveniles of all species have macrosclerites, microsclerites and a humeral organ, but particular species differ in body size, the length of c-series setae, pattern of integument in anterior part of gastronotum and shape of solenidion ω1 on tarsus I. Their larvae additionally differ by the shape of setae in and dp, presence of transverse furrow on the gastronotum and the length of prodorsal seta in, whereas the nymphs differ by the size of circumgenital macrosclerite and presence of adanal macrosclerite. The adults of these species differ mainly by the presence of lamellar ridge L on the prodorsum and location of seta le, shape of porose area Aa, presence of median pore mp on the notogaster and shape of sensillus. The ...

Postnatal growth of nestling great cormorants Phalacrocorax carbo sinensis was studied at two northeastern Mediterranean wetlands, the Lakes Kerkini and Mikri Prespa, northern Greece. A method for constructing growth curves from only two visits to bird colonies was used. Logistic growth parameters re-calculated from the logarithmic equation fitted well to the actual growth data of initial-final measurements of body mass, bill length, bill + head length, and tarsus length. Growth rates (K) did not significantly differ between colonies for all variables: body mass (0.205 and 0.206 day−1 at Lakes Kerkini and Mikri Prespa respectively), bill length (0.131 and 0.147 day−1), bill + head length (0.109 and 0.121 day−1) and tarsus length (0.201 and 0.215 day−1). Asymptotic values (A) did not significantly differ between colonies for body mass (2126.7 g and 2128.95 g) and bill length (70.57 and 68.83 mm) but did so for bill + head (147.89 and 151.51 mm) and tarsus length (75.42 and 71.31 mm). The inflectio...

The biological attachment device on the tarsal appendage of the earwig, Timomenus komarovi (Insecta: Dermaptera: Forficulidae) was investigated using field emission scanning electron microscopy to reveal the fine structural characteristics of its biological attachment devices to move on smooth and rough surfaces. They attach to rough substrates using their pretarsal claws; however, attachment to smooth surfaces is achieved by means of two groups of hairy tarsal pads. This biological attachment device consists of fine hairy setae with various contact sizes. Three different groups of tenent setae were distinguished depending on the cuticular substructure of the endplates. Two groups of setae commonly had flattened surfaces, and they were covered with either spoon-shaped or spatula-shaped endplates, respectively. While the flattened tip setae were distributed at the central region, the pointed tip setae were characteristically found along the marginal region. There were no obvious gender-specific differences between fibrillar adhesive pads in this insect mainly because the forceps-like pincers are used during copulation to grasp the partner.

The morphology of the juvenile stages of the mite Birsteinius clavatus (Oribatida, Liacaridae) is described and illustrated. The body and legs possess a granular cerotegument. The nymphs possess exuviae (this fact is mentioned for Liacaridae for the first time). Sensilla are well developed, possessing elongate spindle-shaped hairs, with noticeable swelling and flagellate tip. Interlamellar setae are long, setiform in larva, and small thornshaped in nymphs. Gastronotic setae are long, barbed, possessing flagellate tips. Setal formulae of the body (larva to tritonymph) are the following: genital (0-1-2-4), aggenital (0-0-1-1), anal (0-0-0-2), adanal (0-0-3-3), gastronotic (11-12-12-12) and epimeral setae (3-1-2, 3-1-2-1, 3-1-2-2, 3-1-3-3). Palpal tarsus possesses 8 setae and a single solenidion; the solenidion is not fused with any seta. Femora I and IV possess very long seta. Juvenile stages of B. clavatus combine morphological features of Liacarus (Liacaridae) and Gustavia (Gustaviidae). Norton’s hypothesis (1983) on phylogenetic relations in Gustavioidea is discussed.

Morphology of the first instar nymph of Leucaspis loewi Colvée (Hemiptera: Coccinea: Diaspididae) The first instar nymph of Leucaspis loewi Colvée is redescribed and illustrated. The sex has not been determined. It has 5-segmented antennae, one trilocular disc pore associated with the anterior spiracle, one pair of well-developed lobes, and fimbriate plates on all abdominal segments. Tibia and tarsus are not fused - they are separated from each other by a septum. A campaniform sensillum is always present at the bases of the tarsi. Dorsal submedian setae are present on each abdominal segment 1-7.

Although the growth of pheasants is an important issue, there are few publications providing information on body weight and morphometrics of pheasants at different ages. The aim of this study was to investigate body weight, tarsus length, wing length and wingspan in farmed pheasants aged 3-16 weeks. The study was carried out on 50 pheasants (31 females and 19 males). All one-day old birds were marked and kept until the 16th week of life. In the 3rd 8 h 12th and 16th weeks of life all pheasants were weighted and tarsus length, wing length and wingspan were measured. Male chicks appeared to be significantly heavier than females (P< or = 0.01) already in the third week of life. Also their wings were longer and their wingspan attained higher values (P < or = 0.05). Absolute gains of the majority of traits also differed between sexes (being larger in males) in all studied periods. Values of body weight, tarsus length and wingspan noted in the third week of life were significantly correlated with all later measurements. Thus body weight and some biometrical traits of pheasant chicks measured already at the 3rd week of life could be applied as predictors of future body weight and size.