title: Alternating ptosis after bilateral frontalis muscle suspension for congenital ptosis.
abstract: OBJECTIVE
  To report an unusual response to bilateral frontalis suspension surgery for congenital ptosis.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  A 6-year-old child with infantile esotropia and bilateral congenital ptosis received a homologous fascia lata frontalis suspension. After surgery, the patient exhibited an alternating ptosis, caused by alternating unilateral frontalis muscle contraction, which has persisted throughout 3 years of postoperative observation.
  
  
  CONCLUSIONS
  Symmetric frontalis muscle activation may not always occur after bilateral frontalis muscle suspension surgery for congenital ptosis. Amblyopia, strabismus, or fixation preference may predispose patients to use unilateral brow elevation, despite bilateral frontalis muscle suspension surgery.
authors.affiliation: Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Egbert
authors.forename: N J
authors.initials: NJ
authors.lastname: Lucchese
authors.forename: R K
authors.initials: RK
authors.lastname: Dortzbach
mesh_terms: D001763:Blepharoptosis / Q000151:congenital / Q000503:physiopathology* / Q000601:surgery*; D005152:Facial Muscles / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D007223:Infant; D009119:Muscle Contraction; D011184:Postoperative Period