Related Experiment Video

Updated: Jan 2, 2026

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
19:53

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer

Published on: March 1, 2015

106.3K

Unilateral Levator Aponeurosis Excision for Marcus Gunn Syndrome and Risk Factors of Residual Jaw Winking

Qingyao Ning1, Jing Cao1, Jiajun Xie1

  • 1Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China.

Journal of Ophthalmology
|November 30, 2019
PubMed
Abstract

Insights

Marcus Gunn jaw-winking synkinesis (MGJWS) involves ptosis and levator dysfunction. Unilateral levator excision and frontalis suspension effectively treats MGJWS, though severe jaw winking increases residual synkinesis risk.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Oculoplastics

Background:

  • Marcus Gunn jaw-winking synkinesis (MGJWS) is a rare congenital condition.
  • It presents with abnormal eyelid movement associated with jaw function.
  • Understanding the interplay between ptosis, levator function, and jaw winking is crucial for effective management.

Purpose of the Study:

  • To investigate the association between ptosis, levator function, and jaw winking in MGJWS.
  • To evaluate the outcomes of unilateral levator excision and frontalis suspension for MGJWS.
  • To identify risk factors for residual synkinesis after surgical intervention.

Main Methods:

  • Retrospective review of 42 MGJWS cases from 2011-2018.
  • Statistical analysis of the correlation between jaw winking severity, ptosis, and levator function.
  • Evaluation of surgical outcomes following unilateral levator excision and frontalis suspension (silicone rod or fascia lata).

Main Results:

  • A strong positive correlation was found between ptosis severity and jaw winking excursion (R=0.785, P<0.01).
  • Mild jaw winking correlated with mild ptosis and fair levator function; severe cases showed moderate-to-severe ptosis and poor levator function (P<0.05).
  • All 34 surgically treated patients achieved ptosis correction, but severe preoperative jaw winking significantly increased the risk of residual synkinesis (18.05 times, P<0.05).

Conclusions:

  • Eyelid excursion in MGJWS is directly correlated with ptosis and levator muscle dysfunction.
  • Unilateral levator aponeurosis excision and frontalis suspension is an effective surgical approach for MGJWS.
  • Severe preoperative jaw winking is a significant risk factor for persistent synkinesis post-surgery.

More Related Videos

Surgical Correction for Pediatric Epiblepharon and Trichiasis03:59

Surgical Correction for Pediatric Epiblepharon and Trichiasis

Published on: July 8, 2025

380
Treatment of Facial Deformities using 3D Planning and Printing of Patient-Specific Implants07:11

Treatment of Facial Deformities using 3D Planning and Printing of Patient-Specific Implants

Published on: May 23, 2020

7.8K

Related Concept Videos

Muscles of the Eye01:20

Muscles of the Eye

The muscles of the eye are sophisticated structures that control eye movement and focus, allowing for the precise and rapid adjustments necessary for vision. The human eye is controlled by ten muscles — six extraocular muscles, three intraocular muscles, and one primary eyelid retractor muscle.
Extraocular Muscles
The six extraocular muscles surround the eyeball and control its movements. They are responsible for a wide range of eye motions, including looking up, down, left, right, and...
3.5K
Accessory Structures of the Eye01:17

Accessory Structures of the Eye

Optical perception, or vision, is an extraordinary sense dependent on converting light signals received via the ocular organs. These organs, known as eyes, are securely positioned within the bony cavities of the skull, called orbits. The orbits serve a dual purpose: a protective shield for the ocular globes and a stable attachment point for the soft ocular tissues. The eye's external protective mechanisms include the eyelids, which are edged with lashes that act as a barrier against foreign...
3.2K
Cranial Nerves: Types Part I01:14

Cranial Nerves: Types Part I

Cranial nerves are responsible for transmitting motor and sensory information between the brain and various parts of the body. There are twelve pairs of cranial nerves, with the first six being essential in sensory perception, motor control, and autonomic functions related to the head and neck.
Olfactory Nerve (Cranial Nerve I)
The olfactory nerve, or cranial nerve I, is unique as it is purely sensory and dedicated to the sense of smell. This nerve originates in the olfactory epithelium of the...
4.5K
Muscles for Facial Expressions01:14

Muscles for Facial Expressions

The craniofacial muscles are a collection of approximately 20 thin skeletal muscles situated beneath the skin of the face and scalp. These muscles, primarily responsible for the vast array of human facial expressions, originate from the bones or fibrous structures of the skull and extend outwards to connect with the skin. While most skeletal muscles in the body are enveloped in thick fascia, facial muscles generally have a more delicate fascial covering, with the buccinator muscle being a...
4.5K
Assessment of Airway, Skin Color, and Use of Accessory Muscles01:30

Assessment of Airway, Skin Color, and Use of Accessory Muscles

A thorough assessment of respiratory health is paramount in clinical settings to identify and manage respiratory distress and ensure adequate oxygenation. This article elaborates on the critical aspects of respiratory evaluation, including airway assessment, skin color examination, and the observation of accessory muscle use, which are integral to effectively diagnosing and managing patients with respiratory conditions.
Introduction
The initial evaluation of a patient's respiratory system...
1.5K
Angle Closure Glaucoma: Treatment01:28

Angle Closure Glaucoma: Treatment

Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
1.1K