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Marcus Gunn jaw-winking phenomenon: a new supplemental test in the preoperative evaluation.

AbstractPURPOSE:
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.
AuthorsJ F Wong, J F Thériault, C Bouzouaya, F Codère
JournalOphthalmic plastic and reconstructive surgery (Ophthalmic Plast Reconstr Surg) Vol. 17 Issue 6 Pg. 412-8 (Nov 2001) ISSN: 0740-9303 [Print] United States
PMID11766020 (Publication Type: Journal Article)
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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