Objective To describe the surgical management for Marcus Gunn Jaw Winking Synkinesis and evaluate its efficacy.
Methods 11 patients (4 female, 7male, averaged 7.2 years) with Marcus Gunn Jaw Winking Synkinesis between 2005 and 2010 were retrospectively analyzed. Upper eyelid excursion was measured and graded. 5 patients with moderate Jaw wink (3-5mm) and others with severe (≥5mm),while 3 patients with moderate ptosis(≥3mm) and others with severe(≥4mm). All patients underwent that disable the levator aponeurosis on the involved side and elevate the eyelid using unilateral frontalis muscle suspension.
Results Followed from 6 to up to 24 months, 8 (72%) patients got satisfactory appearance. Ptosis was undercorrected in 2 (18%) patients, and 1 (10%) patient still had mild symptoms of upper lid blink. Complications included lid lag and lagophthalmos with all patients which last about 6 months, and a little asymmetry in both eyelids.
Conclusions Levator disinsertion combined with ipsilateral frontalis suspension were effective in the treatment of Marcus Gunn Jaw Winking Synkinesis. And cosmetic result is excellent. |