Abstract：
Frontalis suspension (FS) is the treatment of choice in congenital ptosis with poor levator function. We report the surgical outcome of FS using a double triangle configuration of silicone slings in children.
A retrospective cohort study of all paediatric patients with simple myogenic congenital ptosis repaired with FS over a 12-year period (2009-2020). Each silicone sling was secured by simple knots. Pre- and post-operative margin reflex distance (MRD1 ) measurements were determined from clinical photographs using ImageJ Software. Main outcome measures were improvement in eyelid height, eyelid asymmetry, reoperation rate and timing.
One hundred and thirty nine patients (174 eyes) were included, with 35 (25%) having bilateral surgery. Mean (±SD) age was 1.4 ± 1.9 years. Mean follow up time was 32 ± 20.5 months. Sixteen patients (11%) had a history of previous ptosis repair surgery. Mean MRD1 improved by an average of 1.5 mm. The final MRD1 in the group of patients who did not have a second procedure was a mean of 2.1 mm. The MRD1 difference between both eyes in all unilateral cases improved from 2.5 mm preoperatively to 1.2 mm at final visit (p < 0.001). In the 123 cases without a history of previous ptosis surgery, repeat ptosis repair was performed in 37 (30%) patients, 34.9 ± 19.9 months after the initial procedure. Overall, repeat repair was performed in 47 patients (34%).
Double triangle silicone sling frontalis suspension has a favourable outcome in two-thirds of paediatric patients with simple myogenic congenital ptosis. Failed cases can be addressed with a second repair, using either autogenous fascia lata or a second silicone sling.
A retrospective cohort study of all paediatric patients with simple myogenic congenital ptosis repaired with FS over a 12-year period (2009-2020). Each silicone sling was secured by simple knots. Pre- and post-operative margin reflex distance (MRD1 ) measurements were determined from clinical photographs using ImageJ Software. Main outcome measures were improvement in eyelid height, eyelid asymmetry, reoperation rate and timing.
One hundred and thirty nine patients (174 eyes) were included, with 35 (25%) having bilateral surgery. Mean (±SD) age was 1.4 ± 1.9 years. Mean follow up time was 32 ± 20.5 months. Sixteen patients (11%) had a history of previous ptosis repair surgery. Mean MRD1 improved by an average of 1.5 mm. The final MRD1 in the group of patients who did not have a second procedure was a mean of 2.1 mm. The MRD1 difference between both eyes in all unilateral cases improved from 2.5 mm preoperatively to 1.2 mm at final visit (p < 0.001). In the 123 cases without a history of previous ptosis surgery, repeat ptosis repair was performed in 37 (30%) patients, 34.9 ± 19.9 months after the initial procedure. Overall, repeat repair was performed in 47 patients (34%).
Double triangle silicone sling frontalis suspension has a favourable outcome in two-thirds of paediatric patients with simple myogenic congenital ptosis. Failed cases can be addressed with a second repair, using either autogenous fascia lata or a second silicone sling.
摘要：
额骨悬吊术（FS）是先天性上睑下垂的首选治疗方法。我们报告了儿童使用双三角形硅胶吊索的FS手术结果。
一项回顾性队列研究，对12年（2009-2020年）的所有小儿单纯性肌源性先天性下垂患儿进行FS修复。每个硅胶吊带由简单的结固定。使用ImageJ软件从临床照片确定术前和术后边缘反射距离（MRD1）测量值。主要结局指标是改善眼睑高度，眼睑不对称，再手术率和时机。
纳入了139名患者（174只眼），35（25％）进行双侧手术。平均（±SD）年龄为1.4±1.9岁。平均随访时间为32±20.5个月。16例患者（11％）有既往上睑下垂修复手术史。平均MRD1平均改善1.5mm。未进行第二次手术的患者组中的最终MRD1平均为2.1mm。在所有单侧病例中，双眼之间的MR1差异从术前的2.5mm改善到最后一次就诊时的1.2mm（p<0.001）。在123例没有上睑下垂手术史的病例中，对37例（30%）患者进行了重复上睑下垂修复，初始手术后34.9±19.9个月。总的来说,47例患者(34%)进行了重复修复.
双三角硅胶额悬吊术在三分之二的小儿单纯性肌源性先天性上睑下垂患者中具有良好的预后。失败的案例可以通过第二次修复来解决，使用自体筋膜或第二个硅胶吊带。
一项回顾性队列研究，对12年（2009-2020年）的所有小儿单纯性肌源性先天性下垂患儿进行FS修复。每个硅胶吊带由简单的结固定。使用ImageJ软件从临床照片确定术前和术后边缘反射距离（MRD1）测量值。主要结局指标是改善眼睑高度，眼睑不对称，再手术率和时机。
纳入了139名患者（174只眼），35（25％）进行双侧手术。平均（±SD）年龄为1.4±1.9岁。平均随访时间为32±20.5个月。16例患者（11％）有既往上睑下垂修复手术史。平均MRD1平均改善1.5mm。未进行第二次手术的患者组中的最终MRD1平均为2.1mm。在所有单侧病例中，双眼之间的MR1差异从术前的2.5mm改善到最后一次就诊时的1.2mm（p<0.001）。在123例没有上睑下垂手术史的病例中，对37例（30%）患者进行了重复上睑下垂修复，初始手术后34.9±19.9个月。总的来说,47例患者(34%)进行了重复修复.
双三角硅胶额悬吊术在三分之二的小儿单纯性肌源性先天性上睑下垂患者中具有良好的预后。失败的案例可以通过第二次修复来解决，使用自体筋膜或第二个硅胶吊带。
