Upper lid orbicularis oculi muscle strip and sequential brow suspension with autologous fascia lata is beneficial for selected patients with essential blepharospasm

Patil, Basavaraj; Foss, Alexander

doi:10.1038/eye.2008.314

Cited by 7 publications

(8 citation statements)

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“…One main approach in the treatment of essential blepharospasm is to reduce muscle mass in the cranial portion of the orbicularis oculi muscle, often together with parts of the procerus and the corrugator supercilii muscles [ 7 ]. These procedures can be combined with suspension operations [ 8 ]. They are considerably more invasive than suspension operations alone, as performed in our own and other institutions [ 3 – 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Many patients increase vertical traction by contracting the frontalis muscle to widen the opening of the palpebral fissure. Since BoNT treatment alone will not provide any significant improvement of the eye opening, a number of more or less invasive surgical procedures have been introduced [ 3 – 5 , 7 , 8 ]. In our patients with this condition we perform frontalis suspension surgery (“sling operation”) based on the technique of Roggenkämper and Nüssgens [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Frontalis suspension surgery to treat patients with essential blepharospasm and apraxia of eyelid opening-technique and results

et al. 2014

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IntroductionWe describe the results of 15 patients suffering from essential blepharospasm with apraxia of eyelid opening who underwent frontalis suspension surgery.Material and methodsPatients with apraxia of eyelid opening and unresponsive to botulinum toxin injections were studied. Bilateral frontalis suspension surgery was performed (sling operation) using polytetrafluoroethylene (Gore-Tex®) sutures. The patients reported the degree of improvement using a subjective rating scale to evaluate the benefit of the operation at two times after surgery (0-10 days and 180-360 days).ResultsThe patients reported a high degree of subjective improvement. In the early postoperative period (0-10 days) the mean degree of subjective improvement was 74.6% (standard deviation (SD) 26.4%). At 180-360 days after surgery the mean improvement was 70.0% (SD 26.7%). Small hematomas of the upper lid occurred postoperatively in all patients. Other complications were suture extrusions (9.1%), suture granulomas (6.1%), lacrimation (5.0%) and local infections (7.5%). Postoperatively, all patients needed additional botulinum toxin injections for optimal outcome.ConclusionFrontalis suspension surgery is a minimally invasive and effective treatment option for apraxia of eyelid opening in patients with essential blepharospasm unresponsive to botulinum toxin injections alone.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Frontalis suspension surgery to treat patients with essential blepharospasm and apraxia of eyelid opening-technique and results

et al. 2014

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“…In recent years, various forms of myectomy or frontal suspension have been reported on [Nicoletti et al 2009;Patil and Foss, 2009]. Retrospective studies report marked improvement or resolution of BSP and increased effect of BoNT with myectomy or single frontal suspension, with long-term benefit [Chapman et al 1999;Grivet et al 2005;Wabbels and Roggenkamper, 2007;Georgescu et al 2008].…”

Section: Myectomymentioning

confidence: 99%

Current and future medical treatment in primary dystonia

Delnooz

Warrenburg

2012

Ther Adv Neurol Disord

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Dystonia is a hyperkinetic movement disorder, characterized by involuntary and sustained contractions of opposing muscles causing twisting movements and abnormal postures. It is often a disabling disorder that has a significant impact on physical and psychosocial wellbeing. The medical therapeutic armamentarium used in practice is quite extensive, but for many of these interventions formal proof of efficacy is lacking. Exceptions are the use of botulinum toxin in patients with cervical dystonia, some forms of cranial dystonia (in particular, blepharospasm) and writer's cramp; deep brain stimulation of the pallidum in generalized and segmental dystonia; and high-dose trihexyphenidyl in young patients with segmental and generalized dystonia. In order to move this field forward, we not only need better trials that examine the effect of current treatment interventions, but also a further understanding of the pathophysiology of dystonia as a first step to design and test new therapies that are targeted at the underlying biologic and neurophysiologic mechanisms. http://tan.sagepub.com dystonia are given intramuscularly, often under electromyography (EMG) guidance, and need to be repeated every 3-6 months. Contraindications for the use of BoNT include history of neuromuscular disease, e.g. myasthenia gravis, LambertEaton syndrome or motor neuron disease, and a history of hypersensitivity to BoNT, albumin or saline. BoNT injections are also contraindicated in combination with aminoglycoside, penicillamine, quinine and calcium-channel blockers as the effect of these drugs may be potentiated. As teratogenicity of BoNT is still unknown, it is advised not to use BoNT during pregnancy and lactation. Keywords Cervical dystoniaBoNT injections are the first-line therapy for cervical dystonia (CD). Meta-analysis of several double-blind, placebo-controlled trials have demonstrated a beneficial effect of the BoNT type A (BoNT-A) versus placebo on multiple domains, such as dystonia severity, pain and the patient's and physician's subjective judgement. Adverse events are usually transient and mild. The most relevant side effects, of increasing frequency with higher doses and therefore dose-limiting, are neck weakness, dysphagia, dry mouth/sore throat and voice changes/hoarseness. Others are doseindependent and include pain at the site of injection, malaise, upper respiratory infection and headache [Costa et al. 2005b].BoNT also has proven long-term safety and efficacy. Several large case series have shown treatment efficacy up to 10 years, without longterm adverse effects [Blackie and Lees, 1990;Haussermann et al. 2004]. The occurrence of a secondary nonresponse, likely due to antibodies to BoNT or other components, was rare (1-2%) [Kessler et al. 1999;Haussermann et al. 2004;Brin et al. 2008]. Also primary nonresponse is seen, but reports documenting its occurrence are sparse [Truong et al. 2005]. A comparison of efficacy and safety between two preparations of BoNT-A, (onabotulinumtoxinA [Botox ® ] and rimabotulinumtoxin...

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“…Alguns pacientes podem apresentar também contrações involuntárias de outros grupos musculares, caracterizando a síndrome de Meige, síndrome de Brueghel ou distonia orofacial idiopática (3) . Na prática oftalmológica, as distonias faciais mais frequentemente observadas são o blefaroespasmo essencial benigno (BEB) e o espasmo hemifacial (EHF) (4) . As modalidades de tratamento dessas alterações consistem em medicações via oral, intervenções cirúrgicas, aplicação local de toxina botulínica e outros métodos complementares, como psicoterapia (4)(5)(6) .…”

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“…Na prática oftalmológica, as distonias faciais mais frequentemente observadas são o blefaroespasmo essencial benigno (BEB) e o espasmo hemifacial (EHF) (4) . As modalidades de tratamento dessas alterações consistem em medicações via oral, intervenções cirúrgicas, aplicação local de toxina botulínica e outros métodos complementares, como psicoterapia (4)(5)(6) . Dentre tais modalidades, a mais consagrada é a aplicação periocular de toxina botulínica tipo A (7) .…”

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Avaliação da fenda palpebral após aplicação de toxina botulínica tipo A em pacientes com distonias faciais

Cunial

Fonseca

Rehder

2012

Rev. bras.oftalmol.

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Upper lid orbicularis oculi muscle strip and sequential brow suspension with autologous fascia lata is beneficial for selected patients with essential blepharospasm

Cited by 7 publications

References 8 publications

Frontalis suspension surgery to treat patients with essential blepharospasm and apraxia of eyelid opening-technique and results

Frontalis suspension surgery to treat patients with essential blepharospasm and apraxia of eyelid opening-technique and results

Current and future medical treatment in primary dystonia

Avaliação da fenda palpebral após aplicação de toxina botulínica tipo A em pacientes com distonias faciais

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