[Suspension of the eyelid to the frontal muscle in the surgery of ptosis. Technic and indications].
Twenty seven frontalis sling procedures were performed with use of autogenous fascia-lata. The choice of this procedure was performed sometimes at the first stage for severe ptosis with poor levator function: isolated congenital ptosis, blepharophimosis syndrome, Marcus Gunn Jaw-Winking ptosis, ptosis with severe myopathy, some traumatic ptosis. This procedure was also performed in a second stage after failure of the useful procedures (levator resection) and after verification that the levator was not exploitable. Sometimes the choice of the procedure is done during the exploration of the eyelid and the levator because there is not always "parallelism" between the levator function and his anatomy. So operative technique must always be performed by a complete anterior palpebral approach, the surgeon can passed the suspensory material from the tarsus to the roof of the orbit, just anterior to the levator aponeurosis, and then out above the eyebrow. The pulley this created by the periosteum of the superior orbital margin prevents vertical traction lines. The skin crease is created with sutures which pick up the tarsus and the lid retractors. If, during the explorations the levator is "exploitable", a super maximum levator resection will be performed at the first stage, the frontalis suspension will be maintained in case of failure of the levator resection.
D001763:Blepharoptosis / Q000151:congenital / Q000209:etiology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005143:Eyelids / Q000293:injuries / Q000503:physiopathology / Q000601:surgery*; D005152:Facial Muscles / Q000601:surgery*; D005206:Fascia Lata / Q000637:transplantation; D005260:Female; D005546:Forehead; D006801:Humans; D008297:Male; D009132:Muscles / Q000503:physiopathology; D009886:Ophthalmoplegia / Q000150:complications; D009915:Orbit; D012086:Reoperation
La suspension de la paupière au muscle frontal dans la chirurgie du ptosis. Technique et indications.