A dynamic technique for the treatment of severe or recurrent blepharoptosis: frontalis-orbicularis oculi muscle flap shortening.
BACKGROUND
Severe or recurrent blepharoptosis remains a great challenge to most plastic surgeons. A variety of techniques have been developed according to the function of the levator palpebrae superioris and frontalis muscles. In this study, the frontalis-orbicularis oculi (FOO) muscle flap is designed as an entity to treat severe or recurrent blepharoptosis with satisfactory results.


METHODS
Between January 1997 and July 2007, FOO muscle flap shortening was applied to correct severe or recurrent blepharoptosis in 29 patients (38 eyelids), aged from 3 to 77 years. There were 11 males and 18 females, with bilateral ptosis in 9 patients. The follow-up period ranged from 10 to 52 months.


RESULTS
Twenty-four patients (82%) had good results, with the degree of ptosis less than 2 mm. The remaining 5 patients had fair results, and received readjustment in 2 cases.


CONCLUSIONS
In our study, fresh cadaver dissection revealed that the frontalis muscle is connected and interdigitated very closely with the orbicularis oculi muscle. Based on the anatomic study and literature review, we suggest that the FOO muscle flap shortening is a good alternative to treat severe or recurrent blepharoptosis.
Lai
Chung-Sheng
CS
Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Chang
Kao-Ping
KP
Lai
Ching Hung
CH
Huang
Shu-Hung
SH
Tsai
Chih-Cheng
CC
Lin
Sin-Daw
SD
D000293:Adolescent; D000328:Adult; D000368:Aged; D001763:Blepharoptosis / Q000473:pathology / Q000601:surgery*; D002102:Cadaver; D002648:Child; D002675:Child, Preschool; D004210:Dissection; D005143:Eyelids / Q000033:anatomy & histology / Q000601:surgery*; D005152:Facial Muscles / Q000033:anatomy & histology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D055502:Secondary Prevention; D012720:Severity of Illness Index; D013524:Surgical Flaps; D055815:Young Adult