[Atypical oculoplastic surgery in children (author's transl)].

The problems of restorative surgery for inborn eyelid-alterations are indicated here with examples. The following experiences result. 1. Inborn eyelid colobomas without disfigurement of the inner canthus are in general readily correctable. 2. Inborn eyelid colobomas with a disfigured inner canthus and atresia of the canaliculi hardly ever permit the production of a cosmetically satisfactory inner canthus, and never permit a functionally satisfactory one. The use of lacoductorhinostomy, according to L. Jones, is problematic here. 3. The correction of inborn eyelid colobomas in the case of Goldenhar's syndrome is difficult because, due to additional dermoids and fibromas, irregular excisions become necessary. Thus, the lid margin becomes significantly deformed. A considerable temporal displacement of the skin cannot be avoided. 4. Any plastic correction of an inborn, genuine eyelid tumor is difficult, if the important structures of the eyelid--especially the tarsus and levator muscles--are only fragmentarily developed. In the case of the large, soft fibroma of the upper eyelid in neurofibromatosis, only a static eyelid in middle position can be accomplished. 5. Very often, motility problems arise in this connection. Both in Goldenhar's disease and in Recklinghausen's disease, primary dysplasis of the rectus externus muscle occurs.