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Modified auricular cartilage sling for paralytic ectropion.

Akihide Watanabe1, Nobutada Katori2, Dinesh Selva3

  • 1Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS
|April 5, 2015
PubMed
Summary

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A modified auricular cartilage sling effectively treats paralytic ectropion, improving eyelid position and function. This surgical technique offers good anatomical and functional outcomes with no major complications.

Area of Science:

  • Ophthalmology
  • Oculoplastic Surgery
  • Reconstructive Surgery

Background:

  • Paralytic ectropion, often associated with lower eyelid ptosis, can lead to significant ocular surface issues.
  • Conventional surgical treatments for paralytic ectropion may have limitations regarding eyelid mobility and fixation.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of a modified auricular cartilage sling technique for correcting paralytic ectropion.
  • To assess the functional and anatomical results, including eyelid mobility and patient comfort, following this surgical intervention.

Main Methods:

  • A cohort of 17 patients with paralytic ectropion underwent repair using a modified auricular cartilage sling.
  • The surgical technique involved harvesting auricular cartilage and securing it with four-point fixation to the medial canthal tendon, lateral orbital rim, inferior tarsus, and lower eyelid retractors.
Keywords:
Auricular cartilageLagophthalmosLower eyelid retractorsMargin reflex distanceParalytic ectropion

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  • The average follow-up period was 40 months.

    • Main Results:

    • Significant improvements were observed in lower eyelid margin reflex distance (L-MRD) and lagophthalmos.
    • Preoperative corneal exposure resolved completely in 12 out of 16 affected patients.
    • All patients achieved satisfactory anatomical and functional results, with relief of symptoms and no need for reoperation or graft-related complications.

    Conclusions:

    • The modified auricular cartilage sling with four-point fixation is a safe and effective treatment for paralytic ectropion.
    • This technique preserves normal eyelid mobility during down-gaze and effectively addresses lower eyelid malposition without complications.