[Small-incision, minimal dissection procedure (Frueh's procedure) in correction of involutional and congenital ptosis: A retrospective study of 119 cases]

How far we have come: A review of the evolution of posterior approach ptosis surgery

We revisit the evolution of posterior approach ptosis surgery. We address the early attempts at ptosis surgery, assess the more modern approach by de Blaskovics, followed by the division into "open sky" and "closed" techniques. The simultaneous developments occurring in America and Europe are described, along with refinement of surgical approaches such as conjunctival-sparing posterior approach ptosis surgery.

[Whitnall's ligament suspension technique in ptosis surgery]

INTRODUCTION

We report our experience in ptosis surgery using the technique of Whitnall's ligament suspension in congenital ptosis.

MATERIALS AND METHODS

A retrospective study of 20 cases of congenital ptosis treated by the technique of Whitnall's ligament suspension, 8 by the posterior approach and 12 by the anterior approach. Patients were randomized into 3 groups according to upper eyelid levator function. Postoperative follow-up was obtained on day 1, one week, one month, three months and one year.

RESULTS

All patients had good correction; 3 had an under-correction as a three-month final result, of which only one required reoperation for an unsatisfactory result. There was no abnormal curvature of the lid margin or malposition of the lid crease. All lids required initial over-correction, which yielded a good end result. The success rate was 85%.

DISCUSSION

The technique of Whitnall's ligament suspension for the treatment of ptosis has rarely been described in the literature, but the few studies reported show its equivalence in terms of results to other surgical techniques for treatment of ptosis and also confirm its superiority in terms of respect for anatomy and physiology of the eyelid.

CONCLUSION

This technique is particularly suited to the treatment of congenital ptosis with moderate levator function, and the results are promising.

Efficacy comparison of the anterior low small incision and the traditional incision for treatment of thyroid adenoma

Objective: To compare the clinical efficacy and surgical effects of the anterior low small incision and the traditional incision in the treatments of thyroid adenomas.

Methods: Eighty cases of thyroid adenoma patients were randomly divided into a control group and an experimental group. Forty patients in the control group received the traditional incision, whereas the experimental group received the anterior low small incision treatment. The clinical efficacy and complications were compared between these two groups.

Results: The surgeries were all successfully completed. The surgical blood loss, incision length, length of stay, patient satisfaction and health care costs in the experimental group were significantly better than those in the control group, with differences statistically significant (P < 0.05).

Conclusions: The advantages of the anterior low small incision in the treatment of thyroid adenoma patients include smaller incision, lower costs, and fewer complications, when compared with the traditional incision.