Stellate rhytidectomy: superior entropion repair in a dog with excessive facial skin

Abnormalities in eyelid position and function can lead to chronic irritation of cornea and conjunctiva. Corneal ulceration, vascularization and pigmentation are common consequences. Loss of vision, or loss of the globe may be the end result. The combination of ptosis and entropion of the upper eyelid is commonly seen in breeds with abundant forehead skin folds. Treatment options include surgical reduction of skin folds, suspending the brows, enforced secondary granulation of the upper eyelid, or a combination of procedures. Lid-shortening procedures reduce corneal exposure, improve functional blinking and reduce likelihood of traumatic proptosis. Although a lateral canthoplasty is technically easier to perform, a medial canthoplasty is the preferred method of eyelid shortening. An involuted lateral canthus with entropion is seen in certain dog breeds with a broad skull base and redundant facial skin. Surgical correction is by either applying traction to the lateral canthus, or by resection of the lateral canthal ligament. A combination of entropion, ectropion and macroblepharon may result in the presence of diamond shaped eyelids. Surgical correction involves the combination of several procedures. Upper eyelid agenesis is a congenital absence of part of the upper eyelid in cats. Treatment options include a skin-orbicularis flap from the lower eyelid with a conjunctival pedical graft, the transposition of the lower eyelid to the upper eyelid, cross lid flap and subdermal plexus flap, and subdermal collagen injection. Several techniques for reconstruction of upper and lower eyelid defects are described.

Section: Ptosis/entropionmentioning

confidence: 99%

“…Stellate rhytidectomy is a procedure in which excessive skin folds are removed to reduce the downward forces placed on the upper eyelid by these folds. 5 The dog is anesthetized and placed in sternal recumbency. The skin on the top of the head is lifted and the area of skin to be removed is outlined using a sterile pen.…”

Section: Ptosis/entropionmentioning

confidence: 99%

Adnexal surgery in dogs and cats

Woerdt

2004

“…This case warranted a novel approach to address the specific anatomic abnormality. As previously reported, the weight and shape of excessive facial folds in the Shar Pei make that breed a good candidate for stellate rhytidectomy 7 . Similarly, midline rhytidectomy has been successful in the English Cocker Spaniel 8 .…”

Section: Discussionmentioning

confidence: 64%

“…For noncomplicated cases, the most common surgical procedure is the local removal of eyelid skin with the Hotz‐Celsus procedure, 9 with or without lateral canthoplasty 10 . However, failure to concurrently address ptosis or brow droop has been associated with treatment failure 5,7,8 . When standard techniques of entropion repair fail or are likely to inadequately address brow droop, then additional techniques are warranted.…”

Section: Discussionmentioning

confidence: 99%

Coronal rhytidectomy in conjunction with deep plane walking sutures, modified Hotz‐Celsus and lateral canthoplasty procedure in a dog with excessive brow droop

McCallum¹,

Welser²

2004

This case report describes a unique technique of rhytidectomy in a Bloodhound to repair excessive brow folding and droop complicating underlying entropion. This case posed specific challenges due to the loose fascial plane connective tissue. A large circular area of coronal skin was excised, followed by placement of deep plane walking fixation sutures for cosmetic realignment and to alleviate brow droop. In addition, a modified Hotz-Celsus procedure and lateral canthoplasty were performed to address the primary entropion. The coronal rhytidectomy was considered a successful approach to repair excessive brow droop in this Bloodhound.

“…Surgical correction is the only definitive treatment, and several techniques have been described, such as Hotz–Celsus, lateral canthal closure, medial canthal Y to V‐plasty, stellate rhytidectomy, and the Stades method . In each case, the surgeon has to select the most appropriate corrective surgical technique to restore normal eyelid conformation and resolve ocular pain and corneal changes.…”

Section: Introductionmentioning

confidence: 99%

NonsuturedHotz–Celsus technique performed byCO₂laser in two dogs and two cats

Serrano

Rodríguez

2013

It is described a new version of modified Hotz-Celsus technique performed in four patients, two cats and two dogs. The surgery was carried out using CO(2) laser in order to avoid bleeding and decrease the anesthetic time. Besides, the wound created was not sutured and it healed by secondary intention without any complication. As a conclusion, this modification is a successful alternative to treat entropion in a safe and fast way.