title: Frontalis suspension in the treatment of essential blepharospasm unresponsive to botulinum-toxin therapy: long-term results.
abstract: Thirty-one patients with essential blepharospasm or lid opening disorder of the levator-inhibiting type, unresponsive to treatment with botulinum toxin, underwent frontalis suspension. Twenty-eight patients received bilateral surgery (three patients with bilateral complaints of different severity were operated on the more affected side; these patients were not included in the statistical analysis). The mean age was 62.4 years +/- 8.52 (range 42-80 years). The individual improvement of complaints was assessed by the patients using a percentage scale (0% = no improvement; 100% = no complaints). Objective and subjective improvement was achieved in 26 of 28 patients. The mean subjective improvement was 57.7% +/- 31.4. In 23 cases an additional treatment with botulinum toxin was administered. During follow-up period (mean 22.1 months +/- 11.6; range 5-40 months) the effect of surgery remained stable. There were no serious complications, in a 5 of 56 operated eyes suture granuloma had developed. Unlike other surgeries for treatment of blepharospasm (excision of the orbicularis muscle, resection of facial nerve branches) frontalis suspension can be considered as a minimally invasive, but very effective and (if desired) reversible procedure. Moreover, additional treatment with botulinum toxin can bring about further improvement.
authors.affiliation: Universitäts-Augenklinik der Rheinischen Friedrich-Wilhelms-Universität, Bonn, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Roggenkämper
authors.forename: Z
authors.initials: Z
authors.lastname: Nüssgens
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018726:Anti-Dyskinesia Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001764:Blepharospasm / Q000188:drug therapy / Q000601:surgery*; D001905:Botulinum Toxins / Q000008:administration & dosage / Q000627:therapeutic use*; D005152:Facial Muscles / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins