title: Frontalis suspension surgery to treat patients with essential blepharospasm and apraxia of eyelid opening-technique and results.
abstract: BACKGROUND
  We describe the results of 15 patients suffering from essential blepharospasm with apraxia of eyelid opening who underwent frontalis suspension surgery.
  
  
  METHODS
  Patients with apraxia of eyelid opening and unresponsive to botulinum toxin injections were studied. Bilateral frontalis suspension surgery was performed (sling operation) using polytetrafluoroethylene (Gore-Tex®) sutures. The patients reported the degree of improvement using a subjective rating scale to evaluate the benefit of the operation at two times after surgery (0-10 days and 180-360 days).
  
  
  RESULTS
  The patients reported a high degree of subjective improvement. In the early postoperative period (0-10 days) the mean degree of subjective improvement was 74.6% (standard deviation (SD) 26.4%). At 180-360 days after surgery the mean improvement was 70.0% (SD 26.7%). Small hematomas of the upper lid occurred postoperatively in all patients. Other complications were suture extrusions (9.1%), suture granulomas (6.1%), lacrimation (5.0%) and local infections (7.5%). Postoperatively, all patients needed additional botulinum toxin injections for optimal outcome.
  
  
  CONCLUSIONS
  Frontalis suspension surgery is a minimally invasive and effective treatment option for apraxia of eyelid opening in patients with essential blepharospasm unresponsive to botulinum toxin injections alone.
authors.forename: Chrisanthi
authors.initials: C
authors.lastname: Karapantzou
authors.forename: Dirk
authors.initials: D
authors.lastname: Dressler
authors.forename: Saskia
authors.initials: S
authors.lastname: Rohrbach
authors.affiliation: ENT-Department, University of Göttingen Medical Center, Göttingen, Germany. rlaskaw@gwdg.de.
authors.forename: Rainer
authors.initials: R
authors.lastname: Laskawi
mesh_terms: D001072:Apraxias / Q000150:complications* / Q000503:physiopathology; D019882:Blepharoplasty / Q000379:methods*; D001764:Blepharospasm / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005143:Eyelids / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome