Limits...
Lateral canthal repositioning in syndromic, antimongoloid slant

View Article: PubMed Central - PubMed

ABSTRACT

Introduction:: To report a single center's experience in correcting antimongoloid slant in Asian eyes using a minimally invasive approach.

Methods:: Retrospective analysis of patients undergoing correction for antimongoloid slant at author's center, from 2007 to 2013 formed the study group. Concomitant surgical procedures were recorded. Pre- and post-operative photographs at the longest follow-up visit were analyzed and graded for functional and cosmetic outcomes.

Results:: A total of 38 patients (76 eyelids) underwent successful correction to correct eyelid malposition. All patients’ eyelids underwent exclusive lateral canthoplasty through a small incision in the upper eyelid crease and re-suspension technique, and 6 of them underwent bilateral slant correction simultaneously with additional cosmetic or corrective surgeries including hemifacial microsomia and Crouzon's syndrome. Of the 38 patients, 25 were females and 13 were males. The age of the population ranged from 7 to 48 years with a mean age of 27 years. Few instances of transient postoperative chemosis lasting up to 2 weeks and minor infections were reported. All cases showed improvement in eyelid position (as assessed clinically and on photographs), 2 pediatric cases required reoperation in the following 2 years for the recurrent lower eyelid malposition and/or lateral canthal deformity owing to deviated basal bone growth.

Discussion:: Lateral canthoplasty with resuspension technique can effectively address antimongoloid slant for an esthetically desirable lateral canthus.

No MeSH data available.


(a and b) Preoperative Frontal and Lateral view. (c) Lateral canthotomy incision of the right eye. (d) Lateral Canthal tendon is sutured to the Whitnall's tubercle. (e and f) Postoperative Frontal and Lateral view
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4979343&req=5

Figure 1: (a and b) Preoperative Frontal and Lateral view. (c) Lateral canthotomy incision of the right eye. (d) Lateral Canthal tendon is sutured to the Whitnall's tubercle. (e and f) Postoperative Frontal and Lateral view

Mentions: All ocular surgeries were performed under standard general anesthetic care. Local infiltration of lidocaine with 2% epinephrine was copiously injected in the area to prevent bleeding. In the canthotomy procedure, a small lateral [Figure 1] incision along the natural skin creases was placed in the lateral part of the upper eyelid. Through the lateral part of the incision, using Steven's scissors, blunt and sharp dissection was carried to expose the lateral canthal tendon as well as the lateral aspect of the orbital rim. Stabilizing the one arm tip of scissors, the lateral canthal tendon fibers were dissected from their periosteal attachments. This is marked so that it serves as a landmark to avoid asymmetries. At all possible aspects, the Eisler's fat pad was preserved. Furthermore, if required, fat removal or additions, depending on the requirement in the lateral fat pocket was carried out. Debulking or grafting (with bolster stabilization) was also done.


Lateral canthal repositioning in syndromic, antimongoloid slant
(a and b) Preoperative Frontal and Lateral view. (c) Lateral canthotomy incision of the right eye. (d) Lateral Canthal tendon is sutured to the Whitnall's tubercle. (e and f) Postoperative Frontal and Lateral view
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4979343&req=5

Figure 1: (a and b) Preoperative Frontal and Lateral view. (c) Lateral canthotomy incision of the right eye. (d) Lateral Canthal tendon is sutured to the Whitnall's tubercle. (e and f) Postoperative Frontal and Lateral view
Mentions: All ocular surgeries were performed under standard general anesthetic care. Local infiltration of lidocaine with 2% epinephrine was copiously injected in the area to prevent bleeding. In the canthotomy procedure, a small lateral [Figure 1] incision along the natural skin creases was placed in the lateral part of the upper eyelid. Through the lateral part of the incision, using Steven's scissors, blunt and sharp dissection was carried to expose the lateral canthal tendon as well as the lateral aspect of the orbital rim. Stabilizing the one arm tip of scissors, the lateral canthal tendon fibers were dissected from their periosteal attachments. This is marked so that it serves as a landmark to avoid asymmetries. At all possible aspects, the Eisler's fat pad was preserved. Furthermore, if required, fat removal or additions, depending on the requirement in the lateral fat pocket was carried out. Debulking or grafting (with bolster stabilization) was also done.

View Article: PubMed Central - PubMed

ABSTRACT

Introduction:: To report a single center's experience in correcting antimongoloid slant in Asian eyes using a minimally invasive approach.

Methods:: Retrospective analysis of patients undergoing correction for antimongoloid slant at author's center, from 2007 to 2013 formed the study group. Concomitant surgical procedures were recorded. Pre- and post-operative photographs at the longest follow-up visit were analyzed and graded for functional and cosmetic outcomes.

Results:: A total of 38 patients (76 eyelids) underwent successful correction to correct eyelid malposition. All patients’ eyelids underwent exclusive lateral canthoplasty through a small incision in the upper eyelid crease and re-suspension technique, and 6 of them underwent bilateral slant correction simultaneously with additional cosmetic or corrective surgeries including hemifacial microsomia and Crouzon's syndrome. Of the 38 patients, 25 were females and 13 were males. The age of the population ranged from 7 to 48 years with a mean age of 27 years. Few instances of transient postoperative chemosis lasting up to 2 weeks and minor infections were reported. All cases showed improvement in eyelid position (as assessed clinically and on photographs), 2 pediatric cases required reoperation in the following 2 years for the recurrent lower eyelid malposition and/or lateral canthal deformity owing to deviated basal bone growth.

Discussion:: Lateral canthoplasty with resuspension technique can effectively address antimongoloid slant for an esthetically desirable lateral canthus.

No MeSH data available.