<p>Eyebrow Elevation as a Prognostic Factor for Success of Frontalis Suspension in Severe Congenital Ptosis</p>

Abstract

The study aims at evaluating eyebrow elevation as a prognostic factor for frontalis sling procedure success in patients suffering from severe congenital ptosis with poor levator function. Patients and Methods: This is a retrospective study that included 66 eyelids of 57 patients selected from a surgical log database between January 2016 and June 2019. All of them underwent frontalis suspension surgery for treating severe congenital myogenic ptosis with poor levator function. Based on the absence or presence of brow elevation, patients were divided into two groups: 1 and 2, respectively. The latter was further subdivided into subgroup A with unilateral brow elevation and subgroup B with bilateral brow elevation. All included cases completed 6 months of follow-up after surgery. Postoperative functional outcomes in the form of margin reflex distance (MRD1) and palpebral aperture (PA) were recorded and correlated to preoperative brow elevation status. Results: Both principal groups showed improvement of MRD1 and PA compared to the preoperative values. There was no statistically significant difference between both groups for the tested parameters in the 1st postoperative week. By the 6th postoperative month, MRD1 and PA showed statistically significant higher values in group 2 compared to group 1 (p<0.001). However, the difference between subgroups A and B was statistically insignificant for the same parameters. Conclusion: Eyebrow elevation is significantly associated with the success of frontalis suspension procedure. Hence, brow position evaluation should be included in the preoperative assessment of patients undergoing frontalis suspension for congenital ptosis.

Development and validation of a convolutional neural network to identify blepharoptosis

“…This underscores the relevance of adhering to Hering's Law of equal innervation, positing symmetrical innervation of ocular and eyelid muscles. In scenarios involving marked ptosis in one eye, the principle of equal innervation necessitates the elevation of the contralateral eyelid 21 . Should the ptotic eyelid be elevated, the opposing eyelid is inclined to descend due to the reciprocal relationship in stimulus response.…”

Factors Affecting the Outcome of Frontalis Sling Surgery in Patients with Severe Blepharoptosis

“…This was a retrospective analytical study using logistic regression to evaluate the impact of each of the considered factors on the results of frontalis sling surgery, using the Statistical Package for the Social Sciences (IBM, SPSS statistics) software, version 22. This study included 120 patients with severe cases of ptosis with margin to reflex distance 1 ≤1; 12 , 13 the levator function (LF) was in the poor (≤4 mm) 14 or fair (5–7 mm) 14 range. In cases of severe ptosis and poor LF (≤4 mm), a frontalis sling or suspension surgery was performed.…”

Avaakchitiyam adhyaya of bhela indriya sthana - an explorative study

“…The frontalis muscle elevates the forehead and eyebrows. 34 Acquired brow ptosis (Bhruvau Namantyau Va Drushyate) can occur due to various causes such as senile, traumatic (intra cranial, intra temporal and extra temporal facial nerve damage), myogenic (myasthenia gravis, myotonic dystrophy, and oculopharyngeal muscular dystrophy), infectious (Ramsay Hunt syndrome, herpes, lyme disease, tertiary syphilis, HIV, polio and West Nile virus), spasm induced (blepharospasm and facial dystonia) and neoplastic (basal or squamous cell carcinoma and acoustic neuroma) (Jeevet Tryaham Rogi). 35 Bell's palsy is facial nerve paralysis (with eyebrow asymmetry?)…”