Ptosis palpebral severa : evolución de la técnica de la suspensión frontal con fascia lata Hospital del Niño Francisco Ycaza Bustamante 2008-20011
Fecha
2013
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
La ptosis palpebral severa es la patologìa palpebral congénita màs frecuente, se define como una alteración de la dinámica y la estàtica del pàrpado superior, producida por una anomalía en el desarrollo del mùsculo elevador. El manejo de la ptosis palpebral severa, conlleva, la necesidad de utilizar el mùsculo frontal como opción para la elevación del pàrpado superior y conferirle algún grado de función. La suspensión frontal ha sido el procedimiento electivo para la corrección, empleándose diversos materiales , de los cuales la fascia lata , como injerto autòlogo es el que ha demostrado una mayor eficacia y menor número de complicaciones asociadas. El objetivo de esta propuesta es describir los resultados postoperatorios de la corrección de la ptosis palpebral severa con la técnica de suspensión frontal con fascia lata y la incidencia de complicaciones mediante un estudio descriptivo , de diseño no experimental, longitudinal , retrospectivo desde enero 2008 a enero 2011, en el hospital del niño Francisco De Ycaza Bustamante , con un universo de 102 pacientes de los cuales se tomaron 78 como muestra y se consideraron las variables: edad ,sexo,apertura palpebral intraoperatoria, postoperatoria al año, complicaciones. La técnica de recolección de datos fue a partir de las historias clínicas de observación indirecta. Los resultados fueron evaluados según el cambio en la apertura palpe bral preoperatoria y postoperatoria. De los 78 pacientes operados El 64% corresponden gènero masculino y el 36 % gènero femenino, El grupo etàreo que predominò fue de 5 a 10 años con un 68% , El promedio de apertura palpebral preoperatorio fue 4+-1mm y el postoperatorio fue significativamente mayor con 8+-1mm, obteniendo una ganancia de 4+-1mm. Hubieron 2 casos de recidiva. Las complicaciones en la zona donante fue de 6,4% siendo la principal la dehiscencia, y en la zona receptora un 12,4% ; la principal fue la conjuntivitis. En conclusión la suspensión frontal con fascia lata es una técnica eficaz en un 97,4% para el tratamiento de la ptosis palpebral severa , dando resultados estables en los pacientes durante el primer año postoperatorio.
The severe ptosis congenital eyelid pathology is more common, is defined as an alteration of the dynamic and static upper eyelid, caused by an abnormality in the development of the levator muscle. The management of severe ptosis, entails the need to use the frontalis muscle as an option for lifting the upper eyelid and confer some degree of function. The front suspension has been the elective procedure for the correction, using various materials, of which the fascia lata, as an autologous graft is one that has shown greater efficacy and fewer complications. The objective of this proposal is to describe the postoperative results of correction of severe ptosis with front suspension technique with fascia lata and the incidence of complications, a descriptive, non-experimental design, longitudinal, retrospective study from January 2008 to January 2011, in the hospital of Francisco De Ycaza Bustamante child, with a universe of 102 patients of whom 78 were taken as sample and the variables were considered: age, sex, eyelid opening intraoperative postoperative year, complications. The technique of data collection was from the medical records of indirect observation. The results were evaluated according to the change in preoperative and postoperative eyelid opening. Of the 78 patients operated, 64% were male and 36% female, the age group that predominated was 5-10 years with a 68% Mean preoperative eyelid opening was 4 +-1mm and postoperatively was significantly more with 8 +-1mm, a gain of 4 +-1mm. There were 2 cases of recurrence. The donor site complications was 6.4% being the main dehiscence at the recipient site and 12.4% being the main conjunctivitis. In conclusion front suspension with fascia lata is an effective technique at 97.4% for the treatment of severe ptosis, giving stable results in patients during the first postoperative year. KEYWORDS SEVERE PTOSIS, front suspension,
The severe ptosis congenital eyelid pathology is more common, is defined as an alteration of the dynamic and static upper eyelid, caused by an abnormality in the development of the levator muscle. The management of severe ptosis, entails the need to use the frontalis muscle as an option for lifting the upper eyelid and confer some degree of function. The front suspension has been the elective procedure for the correction, using various materials, of which the fascia lata, as an autologous graft is one that has shown greater efficacy and fewer complications. The objective of this proposal is to describe the postoperative results of correction of severe ptosis with front suspension technique with fascia lata and the incidence of complications, a descriptive, non-experimental design, longitudinal, retrospective study from January 2008 to January 2011, in the hospital of Francisco De Ycaza Bustamante child, with a universe of 102 patients of whom 78 were taken as sample and the variables were considered: age, sex, eyelid opening intraoperative postoperative year, complications. The technique of data collection was from the medical records of indirect observation. The results were evaluated according to the change in preoperative and postoperative eyelid opening. Of the 78 patients operated, 64% were male and 36% female, the age group that predominated was 5-10 years with a 68% Mean preoperative eyelid opening was 4 +-1mm and postoperatively was significantly more with 8 +-1mm, a gain of 4 +-1mm. There were 2 cases of recurrence. The donor site complications was 6.4% being the main dehiscence at the recipient site and 12.4% being the main conjunctivitis. In conclusion front suspension with fascia lata is an effective technique at 97.4% for the treatment of severe ptosis, giving stable results in patients during the first postoperative year. KEYWORDS SEVERE PTOSIS, front suspension,
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Blefaroptosis, Suspensión frontal, Fascia lata, Hospital del Niño Francisco de Icaza Bustamante, Cantón Guayaquil, Ecuador