7 PTOSIS: LEVATOR MUSCLE SURGERY AND FRONTALIS SUSPENSION

2001 ◽  
Keyword(s):  
Levator Muscle ◽  
Frontalis Suspension

scholarly journals The analysis of complications due to the erroneous strategy of the surgical treatment of the upper lid ptosis

2016 ◽  
Vol 11 (2) ◽  
pp. 89-92 ◽  
Author(s):  
I. A Filatova ◽  
S. A Shemetov
Keyword(s):  
Surgical Treatment ◽  
Surgical Intervention ◽  
Levator Muscle ◽  
Clinical Group ◽  
Upper Eyelid ◽  
Incorrect Choice ◽  
Tarsal Plate ◽  
Short Period ◽  
Frontalis Suspension ◽  
Upper Lid

Objective. The purpose of the present study was to analyze the complications developing as a result of the application of the incorrect strategy of the surgical treatment of the upper lid ptosis. Material and methods. The analysis of the clinical material covers the period of 10 years. A total of 275 patients presenting with the upper lid ptosis underwent the surgical intervention. A separate clinical group consisting of 89 patients (32.4%) was distinguished, each having been previously operated from 1 to 4 times (m = 1.8) either without effect, with a poor effect, or suffering various complications. The age of the patients varied from 3 to 63 (mean 14.7 ± 5.3) years. The children (n = 61) accounted for 68.5% of the total number of the patients. All the patients underwent the surgical treatment consisting of the revision and cutting of the scar, the excision of inadequate “frontalis suspensions”, resection of the levator muscle, and frontalis sling suspension of the upper eyelid to a brow with the use of the mersilen mesh. Results. The analysis of the available clinical materials has demonstrated the following mistakes in the choice of the strategy of the surgical treatment of the upper lid ptosis: (1) Inadequate frontalis sling suspensions in 72.5% of the cases were performed. Nevertheless, the surgery of the suspension type was carried out in 38.3% of the cases of the mild and moderately severe ptosis when the levator function remained intact and sufficient. (2) In the majority of the patients, the technical errors resulting in inadequate “frontalis suspensions” took place, with the suspensions being either mistakenly fixed to the soft tissues of the upper eyelid or rigidly attached to the periosteum of the upper edge of the orbit rather than to the upper tarsal plate. Moreover, 21.4% of the patients presented with the cicatrices at the internal surface of the upper eyelids following frontalis suspension even though the surgical intervention envisaged neither the opening of the conjunctiva nor the resection of the tarsal plate. (3) The inadequate choice of a material for frontalis suspension (strings, rigid tapes, fishing line, and elastics). (4) The large number of repeated surgical interventions during a short period of time. In all the cases, the surgical treatment caused the improvement of the patients’ conditions as appeared from the reduction of the degree of ptosis, the better expression of the crease of the upper eye lid, and lagophthalmia of 1-3 mm. In addition, the mobility of the upper eyelids increased upon the resection of the levator muscle (m = 3.9 mm). In the presence of complications of the previous operations for the resection of the levator, its function also increased (m = 2.3 mm). Conclusion. The majority of the complications have been caused by the incorrect choice of the method for the surgical treatment of the upper lid ptosis which suggests the necessity of the differential approach to the diagnostics and surgical treatment of this pathological condition taking into consideration its cause and severity. Of primary importance is the choice of the treatment by the pathogenetically substantiated method.

scholarly journals Results of Frontalis Suspension Surgery in Eyes with Poor Levator Muscle Function

2015 ◽  
Vol 53 (1) ◽  
pp. 36-40
Author(s):  
Onur Yaya ◽  
Nedime Demir Deveci ◽  
Ayşe Feyza Önder
Keyword(s):  
Muscle Function ◽  
Levator Muscle ◽  
Frontalis Suspension

scholarly journals Predicting the Success Rate of Levator Resection Surgery Using Whitnall Ligament Position

2021 ◽  
Vol 5 (2) ◽  
Keyword(s):  
Success Rate ◽  
Abnormal Development ◽  
Levator Muscle ◽  
Surgical Approaches ◽  
Clinical Feature ◽  
Eyelid Margin ◽  
Upper Eyelid ◽  
Determining Factors ◽  
Levator Resection ◽  
Frontalis Suspension

Ptosis is defined as lower positioning of the upper eyelid margin which normally is placed 1.5 mm below the superior corneal limbus [1]. Ptosis can be accounted as the 3rd most common eyelid disorders following chalazion and entropion [2]. It may result in amblyopia, visual field defect, cosmetic and psychological problems. Generally, ptosis is subdivided to congenital and acquired cases [3]. Abnormal development of levator muscle or innervation abnormalities is responsible for congenital cases of ptosis. On the other side, trauma, several neurologic disease, and defective levator aponeurosis can lead to acquired ptosis [4]. Levator function, clinical feature, and concomitant eyelid or face abnormalities are the determining factors for choosing appropriate surgical plan [5]. Common surgical approaches include frontalis suspension technique and levator muscle procedures (levator advancement and levator resection) in which frontalis suspension is performed in cases with poor levator function and the latter one is suitable for patients with preserved levator function [4]. Levator resection outcomes are not absolutely predictable. Multiple factors such as ptosis severity, levator function, and age of patient have been discussed as predictive factors for surgical success rate.

Factors Affecting Eyelid Crease Formation Before and After Silicone Frontalis Suspension for Adult-Onset Myogenic Ptosis

2015 ◽  
Vol 31 (3) ◽  
pp. 227-232 ◽  
Author(s):  
Richard C. Allen ◽  
Esther S. Hong ◽  
M. Bridget Zimmerman ◽  
Leslie A. Morrison ◽  
Jeffrey A. Nerad ◽  
...  
Keyword(s):  
Adult Onset ◽  
Factors Affecting ◽  
Before And After ◽  
Frontalis Suspension

A Modified Technique Combining Excision of the Levator Muscle and Tarsus for Blepharoptosis in Asians: A 6-Year Experience with 116 Cases

2011 ◽  
Vol 36 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Fei Liu ◽  
Feng Yang ◽  
Xu-Song Luo ◽  
Jia-Sheng Dong ◽  
Bianca Chin ◽  
...  
Keyword(s):  
Levator Muscle ◽  
Modified Technique
Sign in / Sign up

Export Citation Format

Share Document