A Modified Levator Resection Without Extirpation for the Treatment of Marcus Gunn Jaw Wink Ptosis: Ignoring the Wink!
Author: Aaron Zhao
Base Hospital / Institution: Children’s Hospital of Philadelphia
ePoster presentation
Abstract ID: 25-379
Purpose
To evaluate the outcome of a modified levator resection without extirpation for the treatment of ptosis associated with a Marcus Gunn jaw wink.
Methods
This is a retrospective series of subjects who underwent a modified levator resection for ptosis associated with a unilateral jaw wink in pediatric patients. The medical records from 2009-2012 were reviewed from a single surgeon at the Children’s Hospital of Philadelphia. Inclusion criteria were Marcus Gunn jaw wink with associated ptosis, levator function above 6mm, and no previous eyelid surgery. All pre- and post-operative eyelid measurements were recorded. All patients underwent a modified unilateral levator resection with a full thickness blepharotomy-like incision and a resection of both levator and Müller’s muscles together. In all cases, the lateral horns of the levator muscle were lysed and a small separate conjunctival resection was performed. The outcomes recorded were any change to the eyelid wink, margin reflex distance and need for re-operation.
Results
A total of five subjects were included in this series. The average age at the time of surgery was 1.95 years (range 0.5-5.5). The average follow up was 7.8 years (range 1-12.3). The average change in eyelid height was 3.0mm (range of Margin Reflex Distance 2.5-4mm). All patients were noted to have a decrease in the appreciable jaw wink. There were no subjects that required a second surgery. There were no post-operative complications.
Conclusion
Levator muscle extirpation is a popular approach when treating the wink associated with Marcus Gunn jaw wink and ptosis. Furthermore, levator resection surgery for this problem has been associated with a worsening of the jaw wink. This small series demonstrates a modified levator resection surgery can successfully treat both a patient’s ptosis and wink. Future comparative studies are warranted.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Yasaman | Ataei | The Children’s Hospital of Philadelphia |
| William | Katowitz | The Children’s Hospital of Philadelphia |
