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Correction of congenital severe ptosis by suspension of a frontal muscle flap overlapped with an inferiorly based orbital septum flap.

Abstract：

BACKGROUND:This report introduces a new method for correction of congenital severe upper eyelid ptosis. METHODS:The poor levator-function upper eyelid ptosis of 22 patients was corrected using suspension of the frontal muscle flap overlapped with an inferiorly based orbital septum flap as a motor unit, which substituted for the function of the levator muscle. The frontal muscle flap and orbital septum flap were formed in the frontal part and upper eyelid, respectively. Two flaps were overlapped and sutured to suspend the upper eyelid and to correct the congenital severe upper eyelid ptosis. This technique avoids the need for the linking structure necessary with the standard frontalis sling approach and improves the direction of pull to mimic that of a normal levator more closely than that of frontalis muscle advancement. RESULTS:The follow-up period ranged from 6 to 20 months (mean, 12 months). A total of 4 patients had bilateral surgery, whereas 18 patients underwent unilateral surgery (26 eyelids). In 22 cases (26 eyes), congenital severe upper eyelid ptosis was treated using suspension of the frontal muscle flap overlapped with an inferiorly based orbital septum flap. After the operation, 17 cases (19 eyes) were followed up and analyzed retrospectively. The average follow-up period was about 12 months (range, 6-20 months). The 17 corrected eyes had a symmetric redundant fold of preseptal skin according to the marginal reflex distance-1 (MRD-1) measurement used to judge efficacy. Two eyes in this series required reoperation for undercorrection. Complications such as ectropion and corneal exposure were avoided. CONCLUSION:Use of a frontalis muscle lap overlapped with an inferior based orbital septum flap to manage severe congenital upper eyelid ptosis is a useful procedure that results in substantial cosmetic and functional improvement with few complications.

journal_name

Aesthetic Plast Surg

journal_title

Aesthetic plastic surgery

authors

Pan Y,Zhang H,Yang L,Song B,Xiao B,Yi C,Han Y

doi

10.1007/s00266-008-9125-y

subject

Has Abstract

pub_date

2008-07-01 00:00:00

pages

604-12; discussion 613

issue

eissn

0364-216X

issn

1432-5241

journal_volume

pub_type

杂志文章

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Correction of congenital severe ptosis by suspension of a frontal muscle flap overlapped with an inferiorly based orbital septum flap.