Abstract | PURPOSE: To introduce a new method for the evaluation of Marcus Gunn jaw-winking ptosis that more precisely defines the severity of blepharoptosis. METHODS: A retrospective review of 16 consecutive patients with Marcus Gunn jaw-winking ptosis presenting to our institution between 1993 to 1999 was performed. The position of the affected eyelid was observed after applying a technique of jaw immobilization and disruption of fusion with temporary occlusion of the ipsilateral side. RESULTS: In patients presenting with mild to moderate Marcus Gunn jaw-winking, the majority (62.5%) demonstrated a positive test, uncovering complete or near complete ptosis. Test results were partially positive in 3 patients (18.8%) with increased but not complete ptosis and negative in 3 patients (18.8%) with no change in eyelid position. CONCLUSIONS:
Blepharoptosis associated with Marcus Gunn jaw-winking phenomenon is often more severe than found by conventional clinical evaluation. This finding may explain the frequent undercorrection and unpredictable results following levator resection. In patients exhibiting a positive jaw-winking ptosis test, disappointing outcomes with levator resection may be avoided by instead proceeding with a frontalis suspension with levator disinsertion as recommended for ptosis with severe jaw winking.
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Authors | J F Wong, J F Thériault, C Bouzouaya, F Codère |
Journal | Ophthalmic plastic and reconstructive surgery
(Ophthalmic Plast Reconstr Surg)
Vol. 17
Issue 6
Pg. 412-8
(Nov 2001)
ISSN: 0740-9303 [Print] United States |
PMID | 11766020
(Publication Type: Journal Article)
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Topics |
- Adolescent
- Adult
- Blepharoptosis
(congenital, diagnosis, surgery)
- Blinking
- Child
- Child, Preschool
- Diagnostic Techniques, Ophthalmological
- Eyelids
(innervation)
- Facial Muscles
(innervation, surgery)
- Humans
- Infant
- Jaw
(innervation)
- Middle Aged
- Oculomotor Muscles
(innervation, surgery)
- Preoperative Care
- Retrospective Studies
- Syndrome
- Trigeminal Nerve
(abnormalities, surgery)
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