Eye Plastic, Orbital and Facial Cosmetic Surgery Service, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan 48105, USA.
Ophthalmology. 2010 Jul;117(7):1447-52. doi: 10.1016/j.ophtha.2009.11.014. Epub 2010 Feb 25.
To evaluate the clinical features including eyelid excursion and management of Marcus Gunn jaw-winking synkinesis (MGJWS).
Observational case series.
Forty-eight consecutive patients with MGJWS.
Clinical features and management of 48 patients with MGJWS were reviewed retrospectively. Upper eyelid excursion was measured and graded. Complications of surgical intervention were evaluated.
Resolution of MGJWS and symmetry of upper eyelids in primary position.
Excursion of the ptotic eyelid with jaw movement in MGJWS was graded as mild (<2 mm) in 16% of patients, moderate (2-4 mm) in 76% of patients, and severe (> or = 5 mm) in 8% of patients. Thirty patients with moderate or severe MGJWS underwent disabling of the involved levator muscle and bilateral or unilateral frontalis suspension and had more than 6 months of follow-up. After a mean follow-up of 62 months, MGJWS resolved in 29 (97%) patients and improved from 6 mm to 2 mm in 1 (3%) patient. Relative upper eyelid height was within 1 mm in 87% of patients in primary position and within 1 mm in 80% of patients in downgaze. Twenty-six patients had bilateral frontalis suspension with disabling of unilateral levator muscle on the involved side. Relative upper eyelid height was within 1 mm in 88% of patients in the primary position and within 1 mm in 88% of patients in downgaze. Four non-amblyopic patients had unilateral frontalis suspension with levator muscle disabling. Relative upper eyelid height was symmetrical in 75% of the patients in primary position and in 25% of patients in downgaze. Complications included eyelash ptosis in 10% of the patients, loss of eyelid crease in 10%, and entropion in 3%.
Most of the patients with MGJWS exhibited moderate eyelid excursion. Disabling of the involved levator muscle and bilateral frontalis suspension and, in selected cases, disabling of the involved levator muscle and unilateral frontalis suspension were effective in the treatment of MGJWS. Eyelash ptosis and loss of eyelid crease were the most common complications, each occurring in 10% of the patients.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
评估包括眼睑运动和 Marcus Gunn 眨眼联动（MGJWS）治疗在内的临床特征。
观察性病例系列。
48 例连续的 MGJWS 患者。
回顾性分析 48 例 MGJWS 患者的临床特征和治疗情况。测量并分级上眼睑的运动幅度。评估手术干预的并发症。
MGJWS 的缓解情况和睁眼时上眼睑的对称性。
MGJWS 患者在张口时眼睑的下垂幅度为轻度（<2mm）的占 16%，中度（2-4mm）的占 76%，重度（≥5mm）的占 8%。30 例中、重度 MGJWS 患者行受累提上睑肌麻痹和双侧或单侧额肌悬吊术，随访时间超过 6 个月。平均随访 62 个月后，29 例（97%）患者的 MGJWS 得到缓解，1 例（3%）患者的下垂程度从 6mm 改善至 2mm。87%的患者在睁眼位时相对上睑高度相差 1mm 以内，80%的患者在向下注视时相差 1mm 以内。26 例在受累侧行单侧提上睑肌麻痹联合双侧额肌悬吊术，88%的患者在睁眼位时相对上睑高度相差 1mm 以内，88%的患者在向下注视时相差 1mm 以内。4 例非弱视患者行单侧提上睑肌麻痹联合单侧额肌悬吊术，75%的患者在睁眼位时相对上睑高度对称，25%的患者在向下注视时相对上睑高度对称。并发症包括 10%的患者出现睫毛下垂，10%的患者出现上睑皱襞消失，3%的患者出现倒睫。
大多数 MGJWS 患者的眼睑运动幅度为中度。受累提上睑肌麻痹和双侧额肌悬吊术，以及在某些情况下行受累提上睑肌麻痹和单侧额肌悬吊术，可有效治疗 MGJWS。最常见的并发症为睫毛下垂和上睑皱襞消失，各占 10%。
作者没有与本文讨论的材料有关的专有或商业利益。
Zotero 插件