Treatment of Severe Blepharoptosis after Blow Out Fracture

안와 파열골절 후 발생한 중증 안검하수의 치료

  • Kim, Nam-Hun (Department of Plastic and Reconstructive Surgery, Chosun University College of Medicine) ;
  • Yang, Jeong-Yeol (Department of Plastic and Reconstructive Surgery, Chosun University College of Medicine) ;
  • Moon, Jae-Won (Department of Plastic and Reconstructive Surgery, Chosun University College of Medicine) ;
  • Kim, Gyu-Bo (Department of Plastic and Reconstructive Surgery, Chosun University College of Medicine) ;
  • Cheon, Ji-Seon (Department of Plastic and Reconstructive Surgery, Chosun University College of Medicine)
  • 김남훈 (조선대학교 의과대학 성형외과학교실) ;
  • 양정열 (조선대학교 의과대학 성형외과학교실) ;
  • 문재원 (조선대학교 의과대학 성형외과학교실) ;
  • 김규보 (조선대학교 의과대학 성형외과학교실) ;
  • 천지선 (조선대학교 의과대학 성형외과학교실)
  • Received : 2010.01.07
  • Accepted : 2010.04.07
  • Published : 2010.07.10

Abstract

Purpose: Blepharoptosis can result from either congenital or acquired causes. Blow out fracture or facial bone fracture including blow out fracture can be one of the causes. Authors experienced 3 cases of severe blepharoptosis after blow out fracture treated only with observation after reduction of associated fracture. Methods: Reconstruction of orbital wall was conducted on all cases diagnosed as blow out fracture using 3 dimensional computed tomography, and conservative treatment was done on accompanying severe blepharoptosis. Results: At the time of injury, all cases showed severe blepharoptosis requiring frontalis muscle transfer for correction. But blepharoptosis was recovered in an average of 18 weeks without any surgical procedure except reconstruction of orbital wall. Conclusion: Once Blepharoptosis occurred after blow out fracture, thorough evaluation must be done at first. If definitive cause of blepahroptisis cannot be found as authors' cases, injury of oculomotor nerve may result in blepharoptosis. So, as for blepharoptosis after blow out fracture, conservative treatment following reconstruction of fractured orbital wall can be one of good management.

Keywords

References

  1. Kang JS: Kang Jin Sung Plastic Surgery. 3rd ed, Seoul, Koonja, 2004, p 1003
  2. Finsterer J: Ptosis: causes, presentation, and management. Aesthetic Plast Surg 27: 193, 2003 https://doi.org/10.1007/s00266-003-0127-5
  3. Kim IS, Choi JB, Rah SH, Lee SY: Classification of ptosis in Korea. J Korean Ophthalmol Soc 46: 1262, 2005
  4. Choe KS, Kim YS, Lee TS: A clinical study of surgical results on 456 blepharoptosis. J Korean Ophthalmol Soc 36: 1093, 1995
  5. Stephen J. Mathes: Mathes Plastic Surgery Vol. 3. 2nd ed, Philadelphia, Saunders, 2006, p 328
  6. Frank H. Netter: The ciba collection of medical illustration Vol. 1, U.S.A, CIBA, 1983, p 98
  7. Park KH, Chang BL: The etiology and clinical feature of the third, fourth, and sixth cranial nerve palsy. J Korean Ophthalmol Soc 38: 1432, 1997
  8. Jung JW, Chi MJ: Temporary unilateral neurogenic blepharoptosis after orbital medial wall reconstruction: 3 cases. Ophthalmologica 222: 360, 2008 https://doi.org/10.1159/000149824