Araştırma Makalesi
BibTex RIS Kaynak Göster

Konjenital Myojenik Pitoziste Whitnall Askılama Sonuçlarımız

Yıl 2022, Cilt: 17 Sayı: 3, 49 - 54, 02.11.2022
https://doi.org/10.17517/ksutfd.946730

Öz

Özet
Amaç: Levator fonksiyonu kötü doğumsal üst göz kapağı düşüklüğünde Whitnall askılama ameliyatı uyguladığımız hastaların klinik özelliklerini ve cerrahi sonuçlarını sunmak.
Gereç ve Yöntemler: Haseki Eğitim ve Araştırma Hastanesi’nde 2003-2005 yıllarında Whitnall askı cerrahisi uygulanan 11 hastanın 15 gözü çalışmaya alındı. Hastaların dördü kadın, yedisi erkek olup, yaşları 5 ile 40 yıl arasındaydı. Göz kapağı düşüklüğü dışında sistemik ve oküler patolojileri olanlar çalışmaya alınmadı. Tüm hastalarda anterior yaklaşımla kapak kıvrım insizyonu ile Whitnall askı cerrahisi uygulandı. Üst göz kapağı konturunun düzenli olması ve kapak çizgisinin simetrik olması şartıyla, sonuçlar tam düzelme ve bir milimetreden (mm) az kapak düşüklüğü olanlarda ‘başarılı’, 1-2 mm kapak düşüklüğü olanlarda ‘tatminkâr’, iki mm den daha fazla kapak düşüklüğü olanlarda ise ‘başarısız’ olarak değerlendirildi.
Bulgular: Ameliyat sonrası 6. ayda hiçbir hastada kapak kontür düzensizliği ve enfeksiyon gibi komplikasyonlar izlenmedi. Bir hastada iki mm’den fazla kapak düşüklüğü olması nedeniyle sonuç başarısız kabul edildi. Bir hasta ise 1-2 mm arasında kapak düşüklüğü olmasına rağmen optik aks açık olduğu için sonuç tatminkâr olarak değerlendirildi. Dokuz hastanın 13 gözünde (%86.7) ise bir mm’nin altında kapak düşüklüğü vardı ve sonuç başarılı olarak değerlendirildi.
Sonuç: Kötü levator fonksiyonlu hastalarda Whitnall askı cerrahisi başarı oranı yüksek ve komplikasyon oranı düşük bir tekniktir. Uzun dönem sonuçlar için karşılaştırmalı geniş serili prospektif çalışmalara ihtiyaç vardır.

Teşekkür

Bu çalışmada tez dönemimde tez danışmanın Prof.Dr.Ayşe FEYZA ÖNDER hocama teşekkür ederim.

Kaynakça

  • McCord C.D. Jr. The evaluation and management of the patient with ptozis. Clin Plast Surg. 1988;15(2):169-184.
  • Edmonson BC, Wulc AE. Ptosis evaluation and management. Otolaryngol Clin North Am. 2005;38(5):921-946.
  • Leibovitch I, Leibovitch L, Dray JP. Long-term results of frontalis suspension using autogenous fascia lata for congenital ptosis in children under 3 years of age. Am J Ophthalmol 2003 Nov;136(5):866-871.
  • Carter SR, Meecham WJ, Seiff SR. Silicone frontalis slings for the correction of blepharoptosis: indications and efficacy. Ophthalmology. 1996;103(4):623-630.
  • Anderson RL, Jordan DR, Dutton JJ. Whitnall's sling for poorf ptosis. Arch Ophthalmol. 1990;108(11):1628-1632.
  • Payr E. Plastic mittels freier Faszientransplantation bei ptosis. Dtsch Med Wochenschr 1909;35:822.
  • Crawford JS. Repair of ptosis using frontalis muscle and fascia lata. Trans Am Acad Ophthalmol Otolaryngol 1956;60:672–678.
  • Wasserman BN, Sprunger DT, Helveston EM. Comparison of materials used in frontalis suspension. Arch Ophthalmol. 2001;119(5):687-691.
  • Naugle TC, Fry CL, Sabatier RE, Elliott LF. High leg incision fascia lata harvesting. Ophthalmology. 1997;104:1480–1488.
  • Morax S, Benia L. Suspension of the eyelid to the frontal muscle in the surgery of ptosis: Technique and indications. J Fr Ophtalmol 1986;9:461–470.
  • Crawford JS. Frontalis sling operation.J Pediatr Ophthalmol Strabismus.1982;19:253–255.
  • Wang HZ, Chang CH, Su MY, Guo SL. Use of Gore-Tex sling in brow suspension procedure. Gaoxiong Yi Xue Ke Xue Za Zhi. 1994;10(3):131-137.
  • Ben Simon GJ, Macedo AA, Schwarcz RM, Wang DY, McCann JD, Goldberg RA. Frontalis suspension for upper eyelid ptosis: evaluation of different surgical designs and suture material. Am J Ophthalmol. 2005;140(5):877–885.
  • Mehta P, Patel P, Olver JM. Functional results and complications of Mersilen mesh use for frontalis suspenson ptosis surgery. British Journal Ophthalmol. 2004;88(3):‏361-364.
  • Kataev MG. Filatova IA. Resection of the levator with transposition via Whitnall’s ligament. Vestnik Oftalmologii.1996;112(2):18-22.
  • Hesham AI, Heba NS. The use of Whitnall’s Ligament for sling redirection in frontalis suspension ptosis surgery .Ophthal Plast Recon Surg. 2015;31:53–57.
  • Daoudi C, Chahdi K.O, Lezrek O, Karim O. Whitnall’s ligament suspension technique in ptosis surgery. Journal Français d'Ophtalmologie. 2017;40(9):763-769.

Our Results of Whitnall Sling Surgery in Patients With Congenital Myogenic Ptosis

Yıl 2022, Cilt: 17 Sayı: 3, 49 - 54, 02.11.2022
https://doi.org/10.17517/ksutfd.946730

Öz

Abstract
Objective: To present the clinical features and surgical results of patients who underwent Whitnall sling surgery in congenital upper eyelid ptosis with poor levator function.
Material and Methods: Fifteen eyes of 11 patients who underwent Whitnall sling surgery in Haseki Education and Research Hospital between 2003-2005 were included in the study. Four of the patients were women and seven were men, and their ages were between 5 and 40 years. Those with systemic and ocular pathologies other than droopy eyelids were excluded from the study. Whitnall sling surgery was performed with an anterior approach. Provided that the upper
eyelid contour was regular and the lid line was symmetrical, the results in those with complete correction and upper eyelid drooping of less than one millimeter (mm) were considered ‘successful’, in those with 1-2 mm upper eyelid drooping were considered ‘satisfactory’, and in those with upper eyelid drooping two mm were considered ‘unsuccessful’.
Results: Complications such as upper eyelid contour irregularity and infection were not observed. In one patient the result was considered unsuccessful because of more than two mm ptosis. On the other hand, in one patient the result was considered satisfactory because the optic axis was open despite the 1 to 2 mm ptosis. Thirteen eyes of 9 patients (86.7%) had lower than 1 mm ptosis and the result was considered successful.
Conclusion: Whitnall sling surgery is a technique with a high success rate and low complication in patients with poor levator function. Prospective studies are needed for long-term results.

Kaynakça

  • McCord C.D. Jr. The evaluation and management of the patient with ptozis. Clin Plast Surg. 1988;15(2):169-184.
  • Edmonson BC, Wulc AE. Ptosis evaluation and management. Otolaryngol Clin North Am. 2005;38(5):921-946.
  • Leibovitch I, Leibovitch L, Dray JP. Long-term results of frontalis suspension using autogenous fascia lata for congenital ptosis in children under 3 years of age. Am J Ophthalmol 2003 Nov;136(5):866-871.
  • Carter SR, Meecham WJ, Seiff SR. Silicone frontalis slings for the correction of blepharoptosis: indications and efficacy. Ophthalmology. 1996;103(4):623-630.
  • Anderson RL, Jordan DR, Dutton JJ. Whitnall's sling for poorf ptosis. Arch Ophthalmol. 1990;108(11):1628-1632.
  • Payr E. Plastic mittels freier Faszientransplantation bei ptosis. Dtsch Med Wochenschr 1909;35:822.
  • Crawford JS. Repair of ptosis using frontalis muscle and fascia lata. Trans Am Acad Ophthalmol Otolaryngol 1956;60:672–678.
  • Wasserman BN, Sprunger DT, Helveston EM. Comparison of materials used in frontalis suspension. Arch Ophthalmol. 2001;119(5):687-691.
  • Naugle TC, Fry CL, Sabatier RE, Elliott LF. High leg incision fascia lata harvesting. Ophthalmology. 1997;104:1480–1488.
  • Morax S, Benia L. Suspension of the eyelid to the frontal muscle in the surgery of ptosis: Technique and indications. J Fr Ophtalmol 1986;9:461–470.
  • Crawford JS. Frontalis sling operation.J Pediatr Ophthalmol Strabismus.1982;19:253–255.
  • Wang HZ, Chang CH, Su MY, Guo SL. Use of Gore-Tex sling in brow suspension procedure. Gaoxiong Yi Xue Ke Xue Za Zhi. 1994;10(3):131-137.
  • Ben Simon GJ, Macedo AA, Schwarcz RM, Wang DY, McCann JD, Goldberg RA. Frontalis suspension for upper eyelid ptosis: evaluation of different surgical designs and suture material. Am J Ophthalmol. 2005;140(5):877–885.
  • Mehta P, Patel P, Olver JM. Functional results and complications of Mersilen mesh use for frontalis suspenson ptosis surgery. British Journal Ophthalmol. 2004;88(3):‏361-364.
  • Kataev MG. Filatova IA. Resection of the levator with transposition via Whitnall’s ligament. Vestnik Oftalmologii.1996;112(2):18-22.
  • Hesham AI, Heba NS. The use of Whitnall’s Ligament for sling redirection in frontalis suspension ptosis surgery .Ophthal Plast Recon Surg. 2015;31:53–57.
  • Daoudi C, Chahdi K.O, Lezrek O, Karim O. Whitnall’s ligament suspension technique in ptosis surgery. Journal Français d'Ophtalmologie. 2017;40(9):763-769.
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Semih Dogan 0000-0002-9348-3990

Erken Görünüm Tarihi 1 Kasım 2022
Yayımlanma Tarihi 2 Kasım 2022
Gönderilme Tarihi 2 Haziran 2021
Kabul Tarihi 13 Ağustos 2021
Yayımlandığı Sayı Yıl 2022 Cilt: 17 Sayı: 3

Kaynak Göster

AMA Dogan S. Konjenital Myojenik Pitoziste Whitnall Askılama Sonuçlarımız. KSÜ Tıp Fak Der. Kasım 2022;17(3):49-54. doi:10.17517/ksutfd.946730