The Function-Preserving Frontalis Orbicularis Oculi Muscle Flap for the Correction of Severe Blepharoptosis With Poor Levator Function

Huang, Shu-Hung; Lee, Chia-Chen; Lai, Hsin-Ti; Takahashi, Hidenobu; Wang, Yu-Chi; Lai, Chung-Sheng

doi:10.1093/asj/sjaa429

Cited by 10 publications

(13 citation statements)

References 33 publications

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“…In 2021 Huang et al 17 described the function preserving frontalis orbicularis oculi muscle flap for treatment of severe blepharoptosis with poor levator function. This refinement stresses on sub-muscular dissection from the lower portion of the OOM, thereby leaving most of it in situ without disturbing its integrity and function.…”

Section: Discussionmentioning

confidence: 99%

“…This refinement stresses on sub-muscular dissection from the lower portion of the OOM, thereby leaving most of it in situ without disturbing its integrity and function. 17 …”

Section: Discussionmentioning

confidence: 99%

“…This refinement stresses on sub-muscular dissection from the lower portion of the OOM, thereby leaving most of it in situ without disturbing its integrity and function. 17 The three most common sequelae that must be discussed preoperatively include under-correction, overcorrection, and asymmetry. Apart from routine minor ptosis correction during esthetic blepharoplasty, it is always advisable to educate the patient about such issues and the possibility of requiring a small revisionary surgical step.…”

Section: Abdulrauf • Frontalis Suspension In Muscular Dystrophymentioning

confidence: 99%

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Frontalis Suspension in Muscular Dystrophy: 16-years Follow-up

Abdulrauf¹

2022

Plastic and Reconstructive Surgery - Global Open

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Summary Acquired eyelid ptosis in adults, with complete loss of levator palpebrae superiosis function, can be a challenging problem to diagnose and treat. A 48-year-old woman with chronic bilateral severe blepharoptosis of 10 years duration is presented, whose neurological investigations excluded myasthenia gravis. The patient was preliminarily diagnosed with chronic progressive external ophthalmoplegia. The levator excursion was negligible, and a frontalis suspension procedure was considered using a conventional autogenous fascia lata graft. An optimal outcome was achieved with over 16-years follow-up. Although the patient was healthy otherwise upon first presentation, 10 years later, she developed other neurologic manifestations, including dysphagia and oral dryness. The fact that blepharoptosis did not recur over the years in this case differentiates an oculo-pharyngeal type of muscular dystrophy in this patient from other types and from the more frequent condition of chronic progressive external ophthalmoplegia.

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Section: Discussionmentioning

confidence: 99%

“…This refinement stresses on sub-muscular dissection from the lower portion of the OOM, thereby leaving most of it in situ without disturbing its integrity and function. 17 …”

Section: Discussionmentioning

confidence: 99%

Section: Abdulrauf • Frontalis Suspension In Muscular Dystrophymentioning

confidence: 99%

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Frontalis Suspension in Muscular Dystrophy: 16-years Follow-up

Abdulrauf¹

2022

Plastic and Reconstructive Surgery - Global Open

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“…Traditional frontalis suspension is mostly sutured with mousse thread, which may cause self-rejection as a foreign body, and cause swelling of the eyelid, exposure keratitis, and incomplete closure of the eyelid, which affects the postoperative effect ( 25 ). In the present results, the incidences of exclusion reaction, upper eyelid inversion trichiasis, exposure keratitis and incomplete eyelid closure in the control group were higher than those in the observation group, which may be related to the above reasons.…”

Section: Discussionmentioning

confidence: 99%

Application of e-PTFE Frontalis Suspension in the Treatment of Congenital Ptosis in Children

Zhang

Liu

et al. 2022

Front. Surg.

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PurposeAnalysis of the value of expanded polytetrafluoroethylene (e-PTFE) frontalis suspension applied to children with congenital ptosis.MethodsEighty clinical cases of children with congenital ptosis from October 2019 to October 2021 were randomly selected from our hospital. All children were divided into the observation group (n = 44) treated with e-PTFE frontalis suspension and the control group (n = 36) treated with frontalis flap suspension according to the treatment procedure. Comparison of eyelid condition [palpebral fissure height, margin reflex distance (MRD), eyelid closure time], ocular surface status [corneal fluorescein staining (CFS) score, tear film breakup time (TBUT), surgical eye lacrimal river height (LRH), sehirmer test I (STI)], frontal muscle strength of affected side, cosmetic results and complications in both groups at 1, 6 and 12 months postoperative follow-up.ResultsAt 1, 6 and 12 months after surgery, there was no significant difference in terms of palpebral fissure height and MRD between both groups (p > 0.05); After surgery, the eyelid closure time was shorter in the observation group than in the control group (p < 0.05). At 1, 6 and 12 months after surgery, the CFS scores were lower in the observation group than in the control group (p < 0.05); At 6 and 12 months after surgery, the TBUT was longer and the surgical eye LRH was higher in the observation group than in the control group (p < 0.05); At 1, 6, and 12 months after surgery, there was no significant difference in STI between both groups (p < 0.05). At 1, 6 and 12 months after surgery, the frontal muscle strength of affected side was higher in the observation group than in the control group (p < 0.05). At 1, 6, and 12 months after surgery, there was no significant difference in cosmetic results between both groups (p > 0.05). The overall complication rate in the observation group (6.82%) was lower than that in the control group (25.00%) (p < 0.05).ConclusionThe surgical and cosmetic results of e-PTFE frontalis suspension and frontalis flap suspension applied to congenital ptosis are comparable, but the former has the advantage of faster postoperative recovery, better ocular surface status, less frontali muscle strength damage and fewer complications.

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“…The FOOM flap has demonstrated both contractility and elasticity, properties not possessed by a frontalis sling. This operation also spares the need of a second surgical site ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Case Report: Botulinum Toxin-A for Complication of Exposure Keratopathy Following Frontalis-Orbicularis Oculi Muscle Flap Shortening

Lai

Lin

2022

Front. Med.

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BackgroundLagophthalmos with exposure keratopathy is a potential vision-threatening complication following surgery for blepharoptosis. We report three cases successfully treated with botulinum toxin-A (Botox®, Allergan, Irvine, USA) for this complication.CasesThree patients presented with severe blepharoptosis after surgery for orbital and frontal base tumors. They obtained good appearances after frontalis-orbicularis oculi muscle (FOOM) flap shortening. However, exposure keratopathy developed after the surgery despite frequent use of topical lubricants and autologous serum eye drops. We injected 5-10 units of botulinum toxin-A around the central supra-brow area, which was near the origin of the FOOM flap. One week later, they developed ptosis and could close the eye completely. The corneal defect gradually resolved. They recovered from ptosis 3 months later and never required a second injection.ObservationsLagophthalmos with exposure keratopathy is a potential vision-threatening complication following FOOM flap surgery. In severe cases, surgical revision should be considered to partially or totally release the FOOM flap attachment, which also decreases its function permanently. In this case series, we demonstrated that injecting botulinum toxin-A may be a promising method to manage this complication without permanently affecting the function of the FOOM flap.ConclusionsA botulinum toxin-A injection may be an effective treatment for patients developing exposure keratopathy after FOOM flap surgery.

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The Function-Preserving Frontalis Orbicularis Oculi Muscle Flap for the Correction of Severe Blepharoptosis With Poor Levator Function

Cited by 10 publications

References 33 publications

Frontalis Suspension in Muscular Dystrophy: 16-years Follow-up

Frontalis Suspension in Muscular Dystrophy: 16-years Follow-up

Application of e-PTFE Frontalis Suspension in the Treatment of Congenital Ptosis in Children

Case Report: Botulinum Toxin-A for Complication of Exposure Keratopathy Following Frontalis-Orbicularis Oculi Muscle Flap Shortening

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