Arch Plast Surg.  2018 Mar;45(2):135-139. 10.5999/aps.2017.01235.

The vertical orbicularis oculi muscle turn-over procedure for the correction of paralytic ectropion of the lower eyelid

• Azuma R
• Aoki S
• Aizawa T
• Kuwabara M
• Kiyosawa T

• KMID: 2409457
• DOI: http://doi.org/10.5999/aps.2017.01235

Abstract

BACKGROUND
Static reconstruction surgery that tightens the tension of the inferior tarsus, thereby raising the lax lower eyelid, is a common treatment for paralytic ectropion of the lower eyelid. We present one such operative procedure, in which an orbicularis oculi muscle flap was used.
METHODS
The surgical technique involves partial resection of the tarsus and the skin, as well as a superior-based orbicularis oculi muscle flap that is sutured to the firm tissue present on the Whitnall tubercle. The muscle flap is approximately 7 mm in width and 15 mm in length, with a superior pedicle that is attached to the tarsus at the medial point of the resected tarsus. The procedure results in contact between the ocular surface and the lower eyelid.
RESULTS
The procedure was performed in 11 patients with lower eyelid ectropion due to facial paralysis. Ten cases showed a favorable outcome following surgery, with stable results seen over an average follow-up period of 4.5 years. In one case, recurrence of ectropion was observed 2 months after surgery due to an insufficient correction, and the patient required repeat surgery.
CONCLUSIONS
The orbicularis oculi muscle flap was an effective means of suspension and was able to maintain long-term traction tension. This procedure can therefore be considered a favorable treatment option for lower eyelid ectropion due to facial paralysis.

Keyword

Eyelids; Facial paralysis; Ectropion; Reconstructive surgical procedures

MeSH Terms

Ankle
Ectropion*
Eyelids*
Facial Paralysis
Follow-Up Studies
Humans
Reconstructive Surgical Procedures
Recurrence
Reoperation
Skin
Surgical Procedures, Operative
Traction