Surgical Outcomes of Unilateral Marcus Gunn Jaw Winking Ptosis Correction: A Novel Whitnall’s Ligament Approach
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Purpose: To evaluate the surgical, functional, and cosmetic outcome in moderate to severe ptosis with Marcus Gunn jawwinking phenomenon and recurrence of disease after ptosis correction. This procedure has been emphasized on a child. Methods: This was a prospective, non-comparative, interventional study conducted over 4 years on 30 people. The agesrange from 7 to 40 years. The eyelid was approached from behind to identify the Whitnall’s ligament. Levator palpebraesuperioris was first disinserted then dissected up to the superior border of the tarsal plate followed by 20 to 25 mm by resectionwhich causes disabling of the levator palpebrae superioris action. Subsequently, “tarso frontalis sling with silicon rod” forptosis correction. Compared with the preoperative and postoperative photograph. Results: Margin reflex distance 1 values are in the affected eye preoperative 1.8 ± 0.87 mm to postoperative 3.96 ± 0.41 mm. Preoperative palpebral fissure height are means 5.05 ± 0.62 mm to postoperative palpebral fissure height means 9.3 ± 0.71mm. Ptosis significantly improved which is statistically significant (p < 0.05). Lid excursion or Flickering’s in affected eyes preoperativemeans 6.1 ± 3.47 mm to postoperative after 1 year means are 0.43 ± 0.81 mm. Follow-up period is 1 year. Conclusions: Unilateral posterior approach (Whitnall’s ligament approach) is found better in surgical, functional, and cosmeticoutcomes in the correction of Marcus Gunn jaw winking syndrome, especially in children. The risk of bilateral extensive surgeryis avoided. After the surgery, the primary gaze face photo identity was well-accepted in official government documents. This study is stressed on bilateral lid height similarity in primary gaze unlike the traditional method of downgaze similarities. The patients were highly satisfied both physically and mentally.
Abstract
Purpose: To evaluate the surgical, functional, and cosmetic outcome in moderate to severe ptosis with Marcus Gunn jawwinking phenomenon and recurrence of disease after ptosis correction. This procedure has been emphasized on a child. Methods: This was a prospective, non-comparative, interventional study conducted over 4 years on 30 people. The agesrange from 7 to 40 years. The eyelid was approached from behind to identify the Whitnall’s ligament. Levator palpebraesuperioris was first disinserted then dissected up to the superior border of the tarsal plate followed by 20 to 25 mm by resectionwhich causes disabling of the levator palpebrae superioris action. Subsequently, “tarso frontalis sling with silicon rod” forptosis correction. Compared with the preoperative and postoperative photograph. Results: Margin reflex distance 1 values are in the affected eye preoperative 1.8 ± 0.87 mm to postoperative 3.96 ± 0.41 mm. Preoperative palpebral fissure height are means 5.05 ± 0.62 mm to postoperative palpebral fissure height means 9.3 ± 0.71mm. Ptosis significantly improved which is statistically significant (p < 0.05). Lid excursion or Flickering’s in affected eyes preoperativemeans 6.1 ± 3.47 mm to postoperative after 1 year means are 0.43 ± 0.81 mm. Follow-up period is 1 year. Conclusions: Unilateral posterior approach (Whitnall’s ligament approach) is found better in surgical, functional, and cosmeticoutcomes in the correction of Marcus Gunn jaw winking syndrome, especially in children. The risk of bilateral extensive surgeryis avoided. After the surgery, the primary gaze face photo identity was well-accepted in official government documents. This study is stressed on bilateral lid height similarity in primary gaze unlike the traditional method of downgaze similarities. The patients were highly satisfied both physically and mentally.
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