Frontalis Sling Procedure for Blepharoptosis Following Trauma to the Head
Downloads
Blepharoptosis is a relatively common condition and the treatment remains unpredictable as the choice of one of the many surgical options relies on the cause of the ptosis. We report a case of severe blepharoptosis, the surgical technique, the materials that were used for the post-op outcomes. Frontalis suspension is a commonly used surgery that is indicated in patients with blepharoptosis and poor levator muscle function. This surgery connects the eyelid to the brow with a sling material and utilizes the power of the frontalis muscle to elevate the poorly functioning eyelid. In our, discussion we propose possible treatments in severe blepharoptosis such as resection and advancement of the levator aponeurosis, The Whitnall sling procedure, the frontalis muscle flap procedure, use of fascia lata, and Müller's muscle-conjunctival resection surgery. We elaborate on our predilection for use of the Frontalis sling procedure. Even though our patients may suggest that using general anesthesia is better for their comfort we prefer, and recommend the use of local anesthesia with intravenous sedation due to the advantage of the ease in balancing the lids during surgery. Deciding on which technique to use depends on many factors such as the operator experience, their comfort level with various techniques, the degree of ptosis of levator muscle function.
Sakol PJ, Mannor G, Massaro BM. Congenital and acquired blepharoptosis. Curr Opin Ophthalmol. 1999 Oct;10(5):335-9. DOI: 10.1097/00055735-199910000-00010. PMID: 10621548.
Chen TH, Yang JY, Chen YR. Refined frontalis fascial sling with proper lid crease formation for blepharoptosis. Plast Reconstr Surg. 1997 Jan;99(1):34-40. DOI: 10.1097/00006534-199701000-00006. PMID: 8982184.
Takahashi, Yasuhiro et al. "Frontalis suspension surgery in upper eyelid blepharoptosis." The open ophthalmology journal vol. 4 91-7. 14 Dec. 2010, doi:10.2174/1874364101004010091
Koka K, Patel BC. Ptosis Correction. 2020 Aug 12. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 30969650.
Al Mansory AS. Factors Affecting the Outcome of Frontalis Sling Surgery in Patients with Severe Blepharoptosis. Plast Reconstr Surg Glob Open. 2020 Sep 24;8(9):e3125.
DOI: 10.1097/GOX.0000000000003125.
PMID: 33133970; PMCID: PMC7544182.
Allard, Felicia D, and Vikram D Durairaj. "Current techniques in surgical correction of congenital ptosis." Middle East African journal of ophthalmology vol. 17,2 (2010): 129-33.
DOI:10.4103/0974-9233.63073
Betharia SM. Frontalis sling: A modified simple technique. Br J Ophthalmol. 1985;69:443–5.
Cates CA, Tyers AG. Outcomes of anterior levator resection in congenital blepharoptosis. Eye (Lond). 2001 Dec;15(Pt 6):770-3.
DOI: 10.1038/eye.2001.247. PMID: 11827000.
Anderson RL, Jordan DR, Dutton JJ. Whitnall's sling for poor function ptosis. Arch Ophthalmol. 1990 Nov;108(11):1628-32. DOI: 10.1001/arch. 1990.01070130130043. PMID: 2244848.
Goldey SH, Baylis HI, Goldberg RA, Shorr N. Frontalis muscle flap advancement for correction of blepharoptosis. Ophthal Plast Reconstr Surg. 2000;16:83–93
Mercandetti M, Putterman AM, Cohen ME, Mirante JP, Cohen AJ. Internal levator advancement by Müller's muscle-conjunctival resection: technique and review. Arch Facial Plast Surg. 2001 Apr-Jun;3(2):104-10.
DOI: 10.1001/arch.3.2.104. PMID: 11368662.
Ali, Ali Adawal et al. "Surgical Treatment of Severe Ptosis by Modified Brow Suspension Technique." Plastic surgery (Oakville, Ont.) vol. 28,1 (2020): 40-45. doi:10.1177/2292550319880923
Balaji SM. Efficacy of autogenous fascia lata and silicone aurosling correction of congenital blepharoptosis by frontalis suspension. Indian J Dent Res. 2018 Mar-Apr;29(2):166-170. DOI: 10.4103/IDR. IJDR_147_18. PMID: 29652008.
Aletaha, Maryam et al. "Modified frontalis sling procedure with lid crease formation." Journal of ophthalmic & vision research vol. 8,2 (2013): 134-8.
Amer S. Al Mansory "Factors affecting the Outcome of Frontalis Sling Surgery in Patients with Severe Blepharoptosis" Plastic and Reconstructive Surgery - Global Open: September 2020 - Volume 8 - Issue 9 - p e3125
All Content should be original and unpublished.