Frontalis Muscle Flap Suspension for the Correction of Congenital Blepharoptosis in Early Age Children

Abstract

BackgroundWe aimed to report our successful use of frontalis muscle flap suspension for the correction of congenital blepharoptosis in early age children.MethodsThis retrospective study included 61 early age children (41 boys, 20 girls) with an average age of 6 years (range, 3–10 years) with congenital blepharoptosis who received surgery during the period from March 2007 to January 2011. There were 39 cases of unilateral blepharoptosis and 22 cases of bilateral blepharoptosis, thus a total of 83 eyes were affected. If patient had bilateral blepharoptosis, both eyes were operated on in the same surgery. Patients were followed for 3 months to 5 years. The procedure was performed without complications in all cases.ResultsThe postoperative healing grade was good in 81 eyes (97.6%); the correction of blepharoptosis was satisfactory, the double eyelid folds were natural and aesthetic, the eyelid position and the curvature were ideal, and the eyes were bilaterally symmetrical. The postoperative healing grade was fair in 2 eyes (2.4%); blepharoptosis was improved compared with that before surgery. At discharge, lagophthalmos was noted in 10 eyes of which 4 cases resolved by the last follow-up. The remaining 6 cases were mild. Eleven eyes received reoperation for residual ptosis after the first surgery. The curvature of the palpebral margin was not natural in 4 eyes. These unnatural curvature possibly was caused by an excessively low lateral fixation point or postoperative avulsion.ConclusionFrontalis muscle flap suspension under general anesthesia for the correction of congenital blepharoptosis in early age children can achieve good surgical results.

Surgical treatment of post-traumatic changes of eyelids, orbit and periorbital region

“…(19). In recent years, there have been publications about the use of a frontal muscle flap, with its own blood supply and innervation, which is directly connected to the eyelid and provides its opening without the need of implants or autologous transplants (21,22). In our case of traumatic paralytic ptosis, we used a combined technique of maximum levator resection and modified front suspension with frontal muscle flaps and fascia.…”

Functional centre of the upper eyelid: the optimal point for eyelid lifting in ptosis surgery

“…Hou et al 11 suggested that the height of the lateral fixation point should be higher than that of the midpoint to obtain a natural curvature in frontalis muscle flap suspension surgery for the correction of congenital ptosis. The concept of the functional eyelid centre could explain why the fixation point would be better placed slightly laterally in these studies.…”

Eyelids, Eyelashes, and Eyebrows

“…Congenital blepharoptosis is most frequently associated with an idiopathic dystrophy of the levator palpebrae superioris muscle (Hou et al 2013;Hoyt and Taylor 2013;Kanski and Bowling 2013). Other theories propose absent muscle development due to a failure of neuronal migration as the cause behind the ptosis (McMullan and Tyers 2001).…”