A modified levine palpebral spring for the treatment of myogenic ptosis

Spontaneous improvement of levator palpebrae superioris function after traumatic transection

Direct traumatic injury to the levator palpebrae superioris aponeurosis typically results in upper eyelid ptosis. The mechanisms can involve mechanical or neurogenic etiologies. Prompt surgical exploration and repair are required for restoration of normal function. In cases where prompt surgical intervention is not performed or the levator palpebrae superioris aponeurosis cannot be repaired, the restorative options are limited. The options are further restricted by concurrent ipsilateral frontalis paresis. This report details a spontaneous return of levator function nine months after complete traumatic transection of the levator palpebrae superioris aponeurosis complicated by concurrent ipsilateral frontalis paresis.

Recent Advances in Ophthalmic Plastic Surgery: Part 1-Eyelid

PURPOSE

The objective of this study was to provide an update of the current literature in ophthalmic and facial plastic surgery, specifically related to disorders of the eyelid.

DESIGN

This was a review of published literature from January 2012 to June 2013 METHODS: The authors conducted a PubMed literature search of English-language articles published between January 2012 and June 2013 using the following search terms: eyelid, congenital, acquired, infection, inflammation, trauma, tumor, ptosis, entropion, ectropion, lagophthalmos, botulinum toxin, fillers, blepharoplasty, and miscellaneous topics related to the disorders of the eyelid. The authors included original articles, review articles, and case reports with relevant new information that is of potential clinical use to a comprehensive ophthalmologist as well as to the subspecialist.

RESULTS

Current literature on the disorders of the eyelid is replete with useful clinical information of relevance to a practicing ophthalmologist. Major advances have been reported in understanding of the surgical anatomy and its applications, ptosis, entropion, ectropion, lagophthalmos, infection, inflammation, trauma, and tumors.

CONCLUSIONS

There seems to be tremendous excitement in revisiting the anatomy and pathology and modifying the management protocols and surgical procedures to achieve optimal results, as the subspecialty continues to advance at a brisk pace.

Facial reanimation procedures depicted on radiologic imaging

Various facial reanimation procedures can be performed for treating patients with chronic facial nerve paralysis. The radiologic imaging features of static and dynamic techniques are reviewed in this article with clinical correlation, including brow lift, eyelid weights and springs, gracilis free flaps, fascia lata grafts, temporalis flaps, and Gore-Tex suspension slings. Although the anatomic alterations resulting from facial reanimation surgery may not necessarily be the focus of the imaging examination, it is important to recognize such changes and be familiar with MR imaging compatibility of the associated implanted materials. Furthermore, imaging is sometimes used to specifically evaluate the postoperative results, such as vessel patency following free gracilis transfer.