Ben Rayana N, Ben Hadj Hamida F, Touzani F, Chahed N, Knani L, Krifa F, Yakoubi S, Mahjoub H
Service d'ophtalmologie, CHU Farhat Hached, Sousse, Tunisie.
J Fr Ophtalmol. 2011 Feb;34(2):95-107. doi: 10.1016/j.jfo.2010.10.009. Epub 2011 Jan 28.
Synkinetic movements of the upper eyelids may be noted in association with movements of either extraocular muscles or other muscles of the face. Patients with oculopalpebral or facial-palpebral synkinesis may also have ptosis of the involved eyelid. The clinical and therapeutic features of this association are specific. We mainly distinguish two forms of synkinetic movements, characterized either by the elevation of the ptotic eyelid such as in Marcus Gunn phenomenon and in the Fuchs sign or by the falling of the upper lid such as in Marin Amat syndrome. Many surgical techniques have been used to correct the blepharoptosis and the synkinetic movement. Levator resection is often advocated for correction of blepharoptosis with a mild degree of synkinesis. However, when the ptosis is major, eyelid lag is a possible outcome. For moderate or major synkinesis, bilateral frontalis suspension with disinsertion of the levator has been suggested. This procedure generally provides satisfactory cosmetic results.
上睑联带运动可能与眼外肌或面部其他肌肉的运动相关。患有眼睑或面睑联带运动的患者受累眼睑也可能出现上睑下垂。这种关联的临床和治疗特征是特定的。我们主要区分两种联带运动形式，其特征要么是下垂眼睑的上抬，如Marcus Gunn现象和Fuchs征，要么是上睑下垂，如Marin Amat综合征。许多手术技术已被用于矫正上睑下垂和联带运动。提上睑肌切除术常被提倡用于矫正轻度联带运动的上睑下垂。然而，当上睑下垂严重时，可能会导致眼睑滞后。对于中度或重度联带运动，有人建议采用提上睑肌离断的双侧额肌悬吊术。该手术通常能提供令人满意的美容效果。
