Abstract
Background
Despite of the advances in plastic surgery, the approach to inferior eyelid is still considered a potential area for complications. Inferior transcutaneous blepharoplasty, without a canthal support, can lead to malposition of the inferior eyelid in 15 to 20 % of the individuals. The purpose of the study was to evaluate orbicularis oculi muscle function through electroneuromyographic studies of the face and inferior eyelid after inferior transcutaneous blepharoplasty with musculocutaneous flap.
Methods
Fifteen individuals, 30 eyelids, were submitted to inferior blepharoplasty with musculocutaneous flap and lateral canthopexy. Electroneuromyography with standard needles and facial nerve conductive studies were performed before and after surgery on both sides of the face. Statistical analysis was used.
Results
All the operated eyelids showed electroneuromyographic activity during voluntary contraction of orbicularis oculi muscle. Blink reflexes and facial nerve studies revealed no signs of denervation in both sides (p > 0.01). Functional and aesthetical results were considered satisfactory.
Conclusions
Electroneuromyographic studies after inferior transcutaneous blepharoplasty showed a viable muscle, functional and electrically active to inferior eyelid. Denervation was not evidenced.
Level of Evidence: Level IV, prognostic study.
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References
Kanski JJ, Bowling B (2012) Oftalmologia clínica: Uma abordagem sistêmica. 7ª ed. Tradução Alcir Costa Fernandes et al. Elsevier, Rio de Janeiro, p 1–57
Lowry JC, Bartley GB (1994) Complications of blepharoplasty. Surv Ophthalmol 38(4):327–350
Zaren HA, Resnick JI (1999) Expanded applications for the transconjunctival lower lid blepharoplasty. Plast Reconstr Surg 103(3):1041–1045
Ramirez OM, Santamarina R (2000) Spatial orientation of motor innervation to the lower orbicularis oculi muscle. Aesthet Surg J 20(2):107–113
Ramirez OM (2001) Innervation of the lower eyelid in relation to blepharoplasty and midface lift: clínical observation and cadaveric study. Ann Plast Surg 47:5–7, discussion
Hwang K, Lee DK, Lee EJ, Chung IH, Lee SI (2001) Innervation of the lower eyelid in relation to blepharoplasty and midfacelift: clínical observation and cadaveric study. Ann Plast Surg 47(1):1–5
Byrd HS (2005) Discussion of-analysis of the nerve branches to the orbicularis oculi muscle of the lower eyelid in fresh cadavers. Plast Reconstr Surg 116:1750–1751
Lowry JC, Bartley GB, Litchy WJ (1995) Electromoyographic studies of the reconstructed lower eyelid after modified Hughes procedure. Am J Ophthalmol 119(2):225–228
Yun S, Son D, Yeo H, Kim S, Kim J, Han K, Lee S, Lee J (2014) Changes of eyebrow muscle activity with aging: functional analysis revealed by electromyography. Plast Reconstr Surg 133(4):455–463
Frigerio A, Cavallari P, Frigeni M, Pedrocchi A, Sarasola A, Ferrante S (2014) Surface electromyographic mapping of the orbicularis oculi muscle for real-time blink detection. JAMA Facial Plast Surg 16(5):335–342
Codner MA, Wolfi JN, Anzarut A (2008) Primary transcutaneous lower blepharoplasty with routine lateral canthal support: a comprehensive 10-year review. Plast Reconstr Surg 121(1):241–250
DiFrancesco LM, Anjema CM, Codner MA, McCord CD, English J (2005) Evaluation of conventional subciliary incision used in blepharoplasty: preoperative and postoperative videography and electromyography findings. Plast Reconstr Surg 116(2):632–639
Friedhofer H, Oliveira RR, Paula PRS, Limongi JCP, Ferreira MC (1999) Tratamento cirúrgico do blefaroespasmo essencial: Relato de dois pacientes. Arq Neuropsiquiatr 57(2-B):476–483
McCord CD, Shore J, Putnam JR (1984) Treatment of essential blepharosplasm. II. A modification of exposure for the muscle-stripping technique. Arch Ophthalmol 102(2):269–273
Hardin JW, Hilbe JM (2003) Generalized estimating equations. Chapma and Hall, Boca Raton
Venezuela MK, Botter DA, Sandoval MC (2007) Diagnostic techniques in generalized estimating equations. J Stat Comput Simul 77:879–888
Hughes WL (1937) New method for rebuilding a lower lid: report of a case. Arch Ophthalmol 17:1008
Graf R, Auerswald A, Bernardes A, Damasio RC, Araujo LRR, Graf CM (2001) Blefaroplastia inferior transconjuntival. Rev Soc Bras Cir Plást 16(2):59–74
Aston S (2001) Fórum: Blefaroplastia inferior. Rev Soc Bras Cir Plást 16(1):11–16
Netscher DT, Patrinely JR, Peltier M, Polsen C, Thornby J (1995) Transconjunctival versus transcutaneous lower eyelid blepharoplasty: a prospective study. Plast Reconstr Surg 96(5):1053–1060
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This study has been approved by the research ethics commitee of IAMSPE (Instituto de Assistencia Medica ao Servidor Publico Estadual de Sao Paulo) and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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Fernando Vicente de Araujo, Leão Faiwichow, Cidia Vasconcellos, An Wang Ching, Marcel Vinicius Aguiar Menezes, and Gustavo Henrique Araujo Pereira declare that they have no conflict of interest.
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de Araujo, F.V., Faiwichow, L., Vasconcellos, C. et al. Electroneuromyographic study of orbicularis oculi muscle for evaluation of denervation after a transcutaneous inferior blepharoplasty with musculocutaneous flap. Eur J Plast Surg 40, 11–16 (2017). https://doi.org/10.1007/s00238-016-1233-3
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DOI: https://doi.org/10.1007/s00238-016-1233-3