Marcus-Gunn jaw-winking ptosis: classification and surgical management

Area of Science:

• Ophthalmology
• Plastic Surgery

Background:

• Marcus-Gunn jaw-winking ptosis is a congenital condition characterized by abnormal eyelid movement.
• Existing surgical techniques for ptosis correction may not fully address the complex nature of jaw-winking.
• A standardized classification and tailored surgical approach are needed for optimal outcomes.

Purpose of the Study:

• To classify patients with Marcus-Gunn jaw-winking ptosis based on severity.
• To detail modifications of the Beard surgical procedure for improved jaw-winking ptosis correction.
• To present a surgical matrix guiding treatment based on ptosis and jaw-winking severity.

Main Methods:

• Examined twenty patients diagnosed with Marcus-Gunn jaw-winking ptosis.
• Developed a 3x3 matrix classifying ptosis (mild, moderate, severe) and jaw-winking (mild, moderate, severe).
• Modified the Beard surgical technique, including levator muscle excision and blepharoplasty.

Main Results:

• The proposed classification system categorizes patients into nine distinct combinations.
• Levator muscle excision significantly reduced jaw-winking.
• Upper eyelid blepharoplasty addressed excess skin, preventing postoperative overhang.

Conclusions:

• The 3x3 matrix provides a rational basis for surgical planning in jaw-winking ptosis.
• Modified surgical techniques offer improved correction of Marcus-Gunn jaw-winking ptosis.
• This approach enhances both functional and aesthetic outcomes for affected patients.