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KMID : 1038220180450020135
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Archives of Plastic Surgery
2018 Volume.45 No. 2 p.135 ~ p.139
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The vertical orbicularis oculi muscle turn-over procedure for the correction of paralytic ectropion of the lower eyelid
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Azuma Ryuichi
Aoki Shimpo
Aizawa Tetsushi
Kuwabara Masahiro
Kiyosawa Tomoharu
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Abstract
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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.
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KEYWORD
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Eyelids, Facial paralysis, Ectropion, Reconstructive surgical procedures
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