New Operative Technique for Blepharoptosis using Fronto-Orbicularis Oculi Muscle Advancement

Kim, Seok Kwun

Abstract

Blepharoptosis due to functional deficit of superior levator palphebralis muscle or its aponeurosis is the most common deformity of the upper eyelids complicated problems not only function but aesthetics of upper eyelids. Many operative techniques for blepharoptosis such as Fasanella-Servat method, levator palphebralis muscle shortening and resection, frontalis muscle or frontalis myofascial flap transfer and frontalis muscle suspension operation have been developed and applied as the degree of blepharoptosis. Author has treated 17 cases of blepharoptosis in the 12 patients during 3 years from September 1999 to August 2002 using the fronto-orbicularis oculi muscle advancement technique which is a modification of the frontalis muscle transfer technique. This technique includes the elevation of frontalis and orbicularis oculi muscle flap as a single unit but doesn't make medial and lateral vertical incision of orbicularis oculi muscle flap. The advanced flap is fixed to the tarsal plate with horizontal mattress suture of 6-0 nylon. After fixation, remaining muscle flap is excised. Author's method is more simple than other technique. The incidence of supraorbital N. damage and lagophthalmos is also very low. Fronto-orbicularis oculi advancement technique could be applied in all case of blepharoptosis from mild to severe cases.