Results of surgical procedures for the correction of foot-drop and of lagophthalmus due to leprosy

Weber, Martin; Soest, A. Van; Neff, G; Chiang, T J; Pfau, Richard

doi:10.5935/0305-7518.19920030

Cited by 2 publications

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“…Weber et ai. 6 reported 64 % of eyes with full closure after TMT. In our series 60% of eyes at discharge and 77% of eyes at final fo llow-up achieved fu ll closure.…”

Section: · 1 (3)mentioning

confidence: 99%

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Temporalis muscle transfer in the correction of lagophthalmos due to leprosy

Soares¹,

Chew²

1997

Leprosy Review

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SummaryIn the correction oflagophthalmos due to leprosy neuritis temporalis muscle transfer (TMT) is used to provide a motor to assist in lid closure. This study of TMT in 51 eyes was carried out to assess the effectiveness of TMT in achieving lid closure and corneal protection. The average lid gap preoperatively on light closure was 7·3 mm which was reduced to 3·2 mm on final follow-up. The average lid gap pre-operatively on tight closure was 5· 3 mm which was reduced to 0-4 mm at final follow-up. It is possible to train patients with partial or total anesthesia of the cornea in a visual THINK-BLINK reflex. The common complications encountered were ectropion in 6 eyes (12% ) and ptosis in 3 eyes (6%).Lagophthalmos due to paralysis of the orbicularis oculi muscle is found in approxi mately 5% of newly diagnosed leprosy patients. 5 , 7 This is a result of leprosy neuritis affecting the zygomatic and temporal branches of the facial nerve. Lagophthalmos can lead to exposure keratitis, corneal ulceration, and blindness, especially when there is coexisting corneal anaesthesia.The main goals of the temporalis muscle transfer (TMT) are to enable the patient to attain closure of the eye, and to prevent loss of vision. This study assesses the degree to which the TMT achieves these goals. MethodsFifty-one TMT operations in 35 patients (27 male and 8 fe male) were fo llowed up. The operations were performed between 1963 and 1995 (29 since 1992). Sixteen patients had bilateral TMT's, 3 operations were redone due to failure.Data was collected prospectively on patients operated after I January 1994. This consisted of pre-operative, discharge, and fo llow-up measurements of lid gaps (in mm) on light closure (as in sleep) and tight closure (full voluntary musculature), frequency of blinking (blinks/min during spontaneous conversation), voluntary muscle strength of 38 0305-7518/97/068038 +05 $0 1 .00 © Lepra

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“…Weber et ai. 6 reported 64 % of eyes with full closure after TMT. In our series 60% of eyes at discharge and 77% of eyes at final fo llow-up achieved fu ll closure.…”

Section: · 1 (3)mentioning

confidence: 99%

“…10·0 (20) 14·7 (6) sleep the eye is protected. Some surgeons use TMT only for those patients with sensitive corneas and use tarsorrhaphy for those with anaesthetic corneas.…”

Section: · 1 (3)mentioning

confidence: 99%

Temporalis muscle transfer in the correction of lagophthalmos due to leprosy

Soares¹,

Chew²

1997

Leprosy Review

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“…The procedure adopted was the transfer of the tendon of the tibialis posterior muscle to the extensor tendons of the toes in the fo ot so as to ensure active dorsiflexion of the fo ot. [1][2][3] …”

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Surgical reconstruction of leprotic foot-drop

Bari¹,

Islam²,

Haque³

1996

Leprosy Review

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Summary We have operated on 25 patients for correction of foot-drop due to leprosy from March 1992 to July 1994. The method used was circumtibial transfer of the tibialis posterior to the tendons of extensor hellucis longus and the extensor digitorum longus in the fo ot together with lengthening of the Achilles tendon. The results were satisfactory in 20 of these cases as judged by adequate restoration of heel-toe gait and of active dorsiflexion. The follow-up period ranged from 6 months to 2 years. Inadequate post-operative physiotherapy was the reason for unsatisfactory results in five cases.It is well recognized that correction of fo ot-drop deformity in leprosy is essential to ensure normal walking and to prevent plantar ulcerations. This paper describes the procedure adopted and the results of surgical correction of fo ot-drop due to leprosy in 25 patients at the Leprosy Control Institute and Hospital, Mohakhali, Dhaka in Bangladesh. The procedure adopted was the transfer of the tendon of the tibialis posterior muscle to the extensor tendons of the toes in the fo ot so as to ensure active dorsiflexion of the fo ot. 1-3 Material and methodsIn the Institute between March 1992 and July 1994 we saw 34 patients with fo ot-drop due to leprosy. Nine of these were treated conservatively and 25 were treated surgically. Of these 25 patients 20 were male and 5 female. Their ages ranged fr om 12 to 45 years. Contracture of the Achilles tendon was present in all cases. The fo llow-up period was 6 months to 2 years.

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Results of surgical procedures for the correction of foot-drop and of lagophthalmus due to leprosy

Cited by 2 publications

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Temporalis muscle transfer in the correction of lagophthalmos due to leprosy

Temporalis muscle transfer in the correction of lagophthalmos due to leprosy

Surgical reconstruction of leprotic foot-drop

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