Proprioceptive Phenomenon With Involutional Ptosis

Segal, Kira L.; Lelli, Gary Joseph; Djougarian, Alina; Rosenberg, Caroline; McCullough, April J.; Lisman, Richard D.

doi:10.1097/iop.0000000000000438

Cited by 22 publications

(10 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Ipsilateral frontalis muscle activation in anophthalmic patients with ptosis is an interesting phenomenon that demonstrates the presence of non-visual stimuli in frontalis recruitment, showing that a sensory trigger - and not a visual stimulus - might be responsible for frontalis recruitment in these patients. 81 , 82 Histologic studies have confirmed the presence of Golgi tendon organs, muscle spindles, and myotendinous cylinders within the levator muscle, 83 and neural structures have been demonstrated in Müller’s muscle fibers. 84 These nerve terminals may be implicated in proprioception, and the pathway for frontalis contraction might originate in proprioceptive fibers in the Müller’s muscle through the trigeminal ganglion.…”

Section: Ptosis In Anophthalmic Patientsmentioning

confidence: 88%

“… 84 These nerve terminals may be implicated in proprioception, and the pathway for frontalis contraction might originate in proprioceptive fibers in the Müller’s muscle through the trigeminal ganglion. 82 The eyelid, in close contact with the prosthesis, may provide an alternative pathway to stimulate ipsilateral frontalis recruitment. 83–85 …”

Section: Ptosis In Anophthalmic Patientsmentioning

confidence: 99%

See 1 more Smart Citation

Anophthalmic Socket Syndrome: Prevalence, Impact and Management Strategies

Quaranta‐Leoni¹,

Fiorino²,

Quaranta‐Leoni³

et al. 2021

OPTH

View full text Add to dashboard Cite

Anophthalmic socket syndrome determines functional deficits and facial deformities, and may lead to poor psychological outcomes. This review aims to comprehensively evaluate the features of the syndrome, based on literature review and authors’ clinical and surgical experience. An electronic database (PubMed,MEDLINE and Google Scholar) search of all articles written in English and non-English language with abstract translated to English on anophthalmic socket syndrome was performed. Data reviewed included demographics, presentations, investigations, management, complications and outcomes. Different types of orbital implants were evaluated; the management of implant exposure was examined; different orbital volume enhancement procedures such as secondary implantation, subperiosteal implants and the use of fillers in anophthalmic patients were described; the problems related to socket contraction were outlined; the treatment options for chronic anophthalmic socket pain and phantom eye syndrome were assessed; the most recent advances in the management of congenital anophthalmia were described. Current clinical evidence does not support a specific orbital implant; late exposure of porous implants may be due to pegging, which currently is seldom used; filler absorption in the orbit appears to be faster than in the dermis, and repeated treatments could be a potential source of inflammation; socket contraction results in significant functional and psychological disability, and management is challenging. Patients affected by anophthalmic socket pain and phantom eye syndrome need specific counseling. It is auspicable to use a standardized protocol to treat children affected by clinical congenital anophthalmia; dermis fat graft is a suitable option in these patients as it helps continued socket expansion. Dermis fat graft can also address the volume deficit in case of explantation of exposed implants and in contracted sockets in both children and adults. Appropriate clinical care is essential, as adequate prosthesis wearing improves the quality of life of anophthalmic patients.

show abstract

Section: Ptosis In Anophthalmic Patientsmentioning

confidence: 88%

Section: Ptosis In Anophthalmic Patientsmentioning

confidence: 99%

Anophthalmic Socket Syndrome: Prevalence, Impact and Management Strategies

Quaranta‐Leoni¹,

Fiorino²,

Quaranta‐Leoni³

et al. 2021

OPTH

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…Segal et al attributed this response to possible proprioceptive fibers in Mueller muscle, as the authors were able to stimulate brow elevation by inducing ptosis with an external upper eyelid weight in anophthalmic patients. 7 In a similar project, Beaulieu et al caused ipsilateral brow elevation by placement of an upper eyelid weight in sighted patients. 9 In the current study population, preoperative ipsilateral eyebrow elevation was common in patients undergoing enucleation, with many having bilateral symmetrically elevated brows.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5] We, like others, have observed that anophthalmic patients can exhibit ipsilateral brow elevation, raising the question as to whether proprioceptive mechanisms may be mediating frontalis muscle stimulation. 6,7 The primary aim of this study was to determine the incidence of eyebrow elevation both before and after enucleation. The study also investigated other clinical features including eyelid position, levator function, and superior sulcus deformity to identify any association of these findings with eyebrow position in anophthalmic patients.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Eyebrow Position Before and After Enucleation

Custer

Maamari

Huecker

et al. 2022

Ophthalmic Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

Purpose: The presence of eyebrow elevation in anophthalmic patients has been used as evidence to support a proprioceptive stimulus for frontalis innervation. In this study, we examined the frequency of brow elevation before and after enucleation and reviewed additional clinical findings to determine if any were associated with eyebrow position. Methods: A retrospective study was performed on 134 anophthalmic patients. Demographics, measurements, and photographs were reviewed. Reference photographs were used to subjectively grade brow position and sulcus depth. Results: Preoperative eyebrow elevation was present in 56.2% of patients without blepharospasm from a painful eye, of who 62% had chronic visual loss. Ipsilateral ptosis (p = 0.008), deep superior sulcus (p < 0.001), and right-sided pathology (p = 0.045) were more common in patients with brow elevation. Symmetrically elevated brows were more frequent before right than left enucleation (p = 0.05). Brow position remained stable after 61.9% of procedures. While often mild, postoperative brow elevation was seen in 31.0% of patients without preoperative elevation. Deepening of the superior sulcus was more common in patients with new relative brow elevation (p = 0.031). Anophthalmic ptosis and right-left surgical side were not associated with new postoperative brow elevation. Conclusions: Eyebrow elevation was often present prior to enucleation and associated with an increased occurrence of ptosis, superior sulcus deepening, and right-sided pathology. Intact vision was not needed to maintain an elevated brow. Superior sulcus deepening, but not ptosis, was more common in patients developing new postoperative brow elevation. The findings support both proprioceptive and compensatory mechanisms for eyebrow elevation.

show abstract

Involutional Ptosis

Çetinkaya,

Quaranta Leoni

2024

Oculoplastic, Lacrimal and Orbital Surgery

View full text Add to dashboard Cite

Proprioceptive Phenomenon With Involutional Ptosis

Cited by 22 publications

References 13 publications

Anophthalmic Socket Syndrome: Prevalence, Impact and Management Strategies

Anophthalmic Socket Syndrome: Prevalence, Impact and Management Strategies

Eyebrow Position Before and After Enucleation

Involutional Ptosis

Contact Info

Product

Resources

About