Ptosis likuvannya. Treatment of ptosis of the upper groin. Prices for likuvannya with ptosis of the capital.

Others can be used to guard people in the presence of old-fashioned eyelids, if one povka nibi is omitted. Such a pathology is called drooping of the lower back and develops both in children and in adults. Most of the omission is progressive and progresses over time for various reasons.

At the edge upper lining is guilty of twisting the radii of the casing by approximately 1.5 mm. If it overlaps more than 2 mm, or if it overlaps the chin, you can talk about pathology.

Causes of the lowering of the capital

M'yaz, what do you say upper collar pratsyuє on vіdkrittі okа i raztashovana at the upper stolіttі under the fat ball. This m'yaz is attached from the protineous sides to the tarsal cartilage and to the upper collarbone. The reasons for the omission of the capital are most often associated with the same zim m'yaz.

The main causes of pathology:

• congenital illness, as if due to an insufficient development of the m'yaz, called to raise the upper arm;
• traumatization of the m'yaz, which raises the upper groin, or trauma of the parietal nerve;
• stretching the tendon of the m'yaz, which lifts the upper hand (stretches at the summer wind);
• paralysis of the cervical sympathetic nerve due to the formation of Horner's syndrome;
• circulatory diabetes;
• stroke;
• chubby process in the brain.

In case of rapt signs of pathology, one should consult a doctor and undergo the indicated diagnostic procedures.

The omission of the century after Botox

The Botox procedure is supposed to be carried out in order to smooth out visible wrinkles around the eyes. As a rule, such methods are used in quiet situations, if cosmetic procedures no longer help and cause the need for more effective visits. Lifting with Botox treatment is one of such procedures.

The first step is to inject botox, fahivets is guilty of looking at signs and symptoms of the zone of malignant hyperactivity. As if robiti іn'єktsії itself at tsі zone, m'yazi navkoly eyes deshcho to relax and zmorshki zniknik.

Some times after such a procedure, it develops a low degree, in the middle of them - a lowering of the eye. Such a camp can be blamed for the lack of qualifications of a specialist to carry out the procedure. It’s wrong to administer Botox, otherwise it’s necessary to overdosing injections, m’yaz, which lifts the upper hand, you can use force and stop violating your confession.

According to statistics, the omission of a hundred years after Botox procedures is trapleyaetsya in 20% of complications, the prote is practically connected with an unqualified approach to the end of this technique.

Lowering of the lower extremities after Botox is unacceptable, but, fortunately, it is not possible to treat serious pathology, the signs of lowering without additional therapy appear again after 3-4 days after the injection of the drug.

Before the speech, as if you were suffering from lowering of the bowels before the procedure, building Botox is no longer a cure for illness. Clinical fahivtsy don’t always get ahead of yourself about it, so think about it, chi varto rizikuvati.

Lowered upper lower back

Such a camp, like a lowered upper band, is more likely to create a transition and to encircle the visibility of the sound of the eye gap. Therefore, the reasons for the omission should be taken into account for ophthalmological pathology, as it can provoke a disrupted function of the organs of the eye. The difference in visibility is especially noticeable, as the omission may be one-sided. Such a camp cannot be ignored and given to an ophthalmologist or a neurologist.

For such symptoms, should you be wary and think about seeing a doctor?

• difficulty with blinking and folded eyes;
• the sensitiveness of the eyes was raised through the squinting of the eyes;
• postiyna vtom eyes;
• impairment of oral functions, the appearance of twins in one's eyes;
• it is possible to automatically throw the head back and the tension of the frontal m'yazіv to ease the opening of the eyes and lift the eyes;
• the appearance of a skewed bone and a lowering of the starry morning.

The upper arch can collapse with singing difficulties, or it doesn’t collapse in a flash. Some pathology can be caused by broken work full-time apple burn out: at times the function appears to be broken.

In case of dysfunction of the tongue, which lifts the upper head, one may be afraid of the position of the brows and the head thrown back - the position is disturbed to increase the visibility of the eyes. The fold on the upper stolіtі іnоdі є from the side of the drooping, otherwise it is signifi- cantly higher.

There are warning signs of folding:

• myasthenia, which manifests itself as a development of a squint, twin. Symptoms increase in the other half of the dobi, may be accompanied by weakness and a little bit of it;
• myopathy, in which case twins are also suspected, omission of both legs, in case of which the prevalence of m'yaza, which raises the case, is weakened, but present;
• palpebromandibular synkinesia - mimic sympathetic ruhi that accompanies chewing, the introduction of that opening of the lower cleft. For example, when the company is lowered, it can suddenly appear, after the company is closed;
• the appearance of a palpebral syndrome, which is characterized by a lowering of the upper flank with a torsion of the lower flank, as well as by a shortening of the internal gap and other manifestations;
• appearing in Bernard Horner's syndrome, which manifests itself in the lowering of the eyelids, the sound of the eyelids and the pits of the apple of the eye. Some pathology manifests itself in aphids of advanced sweating on the guise of non-uniform paralysis of the brachial nerves from an ailing side.

In view of the scale of the lowering of the upper arch, it is impossible to lie in the middle of the steps of the golden ruins: you can watch out for an insignificantly lowered dawn, and it’s a waste.

Lower back lowering

If the edge of the lower arch of the omissions is lower than between the arches of the lining of the flooring, which can be used to guard the white part of the eye, it can be said about the lowering of the lower arches. This aesthetic defect is blamed on the weakness of the lower hip, which can also be blamed after the plasticity of the appearance of the folded part of the skin curves. Such a defect is easy to correct. The best thing for this is to go into surgical lifting or transplantation of the shkir on the lower capital. The transplanted skin, unfortunately, is often seen in the right curve, which is far from being taken away from the effect of the state patients.

The descent of the lower pelvis may be at risk after the transfer of operative injuries. Crimson esthetic moments, are also additional signs of pathology, for example, the loss of a new flattening of the eye. Lower pelvic drooping can be an independent symptom, or it can be caused by the dropping of the eye apple, which can aggravate the pathology.

The omission can be guarded when looking directly at objects, it can develop on the aphids of the visible appearance of the function of the upper eyelid when looking down, or it can imitate a sigh and a flicker in the eyes when looking at a focused look.

Patients with drooping lower hips sound like they are tired and richly older for their age.

Diagnosis of omission of the capital

The initial stage of diagnosing omission of the century includes the selection of anamnestic data, the possibility of a decrease in pathology, the fact of injuries and surgical interventions in the facial zone are clarified.

When looking around, add respect:

• rasterization of the upper lining by extending to the radii of the tunic;
• the width of the eye gap;
• vіdmіnnostі roztashuvannya povіk on the right and lіvomu otsі;
• the maximum amplitude of the movement of the upper fork;
• rotting the folds of the upper lining;
• the ability to collapse with eyebrows and full-length apples;
• the position of the shii.

If the doctor suspects an infection with a venom, conduct an adrenaline test: put a tampon with adrenaline on the area of ​​the varicose vein under the upper vein. After five hvilin, look around. In order to check if the affected upper limb is affected by the proliferative healthy limb, the test is assessed as positive.

There is no need for laboratory analyzes when the capital is omitted. To suspect an injury or a pathology of the brain, a radiograph is prescribed for the procedure of magnetic resonance imaging and computed tomography.

Sometimes an ophthalmologist may need to consult a neurologist and a surgeon.

Jubilant lowering of the century

Conservative methods of raising the omission of the century are rare. Such methods can treat the disease of neurogenic etiology, as well as timely raise the possibility of conducting a surgical intervention.

All the same, a part of the pathology of the lowering of the century is still more important than the surgical path. For children, such an operation can be carried out in 3 ways: the next step is to make sure that it is ahead of the functionally reduced vision and the development of the squint. With the method of removing a cosmetic defect (if the zir is not broken), the operation is performed after the period of state maturation, if there are residual formations of the facial skeleton.

As if the omission is caused by trauma, the operation can be carried out without intermediary with the bud treatment of the wound surface by the surgeon, or after the wound, then after 6-12 months.

In other situations, the decision about the term of the operation performed, the doctor takes a fallow in a particular case.

How to carry out the operation when the stump is omitted:

3. Razrіzaє levatorny m'azovy aponeurosis.
4. You see a part of the aponeurosis and sew it on lower.

How to perform an operation for congenital prolapse of the upper pelvis:

1. The surgeon saw a part of the skin curves of the upper collar.
2. Open the membrane, which closes the entrance to the eye.
3. It shows levatorny m'yaz.
4. Shorten the levator for additional stitching.
5. Place a cosmetic suture on the wound.

In case of a significant congenital omission of the levator membrane, which lifts the upper collar, the crypt of the skull is sewn to the membrane. In such a rank, povіka can be lifted by a strong m'yazіv chola.

After the completion of the operation, the doctor applies an occlusive dressing, as you know already for a year.

Such vtruchannya to carry out under general or mass anesthesia. Trivality of the operation is close to 60 hvilin.

Shvi can be taken for 5-6 doba. Before normal life, the patient turns, as a rule, after 1-2 days, after signs of swelling and hematoma appear.

Most often, after surgery, doctors prescribe drug therapy for prevention possible easy. Such a splendid transfer of recognition of offensive drugs:

• antiseptic treatment (boric acid 2% or zinc sulfate 0.25% for washing 3 times for doba for 1-2 runs);

An important moment in the prevention of the omission of the century is its own exaltation, whether they are ill, which can provoke tsyu pathology. For example, neuritis of the facial nerves should be discussed with a neuropathologist, and the possibility of lowering the condition after injection of Botox should be discussed with a doctor and a lifter.

Yakshcho you mark the weakness of povik, pov'yazanu z century-old changes, then here you can be helped by cosmetic and folk remedies.

The easiest way is to apply lifting cream. Which one of the creams you choose, you will be pleased with the beauty salon and shops. However, if you are safe from allergies, choose your own from a hypoallergenic warehouse.

Folk methods of prevention include the use of lifting masks, oils and massage procedures.

To prepare a mask, you need to take a beaten egg and drop sesame seeds into it. The mask should be slid into the hands, stripped, after which it should be washed after 20 strands with warm water.

The mask with grated potatoes also helps: the potatoes are washed, rubbed on the grated, placed in a cold place for a quarter of the year, then we spread the mask on the upper arms. It is recommended to lie down for about 20 minutes. Take off the mask and blot your eyes with a servlet.

It seems that the choice of such procedures zmіtsnyuє povіki, as well as usuvaє drіbnі zmorshki around the eyes.

Massage of the hips of the hips should be carried out when the hips are lowered. Before the procedure, you can wipe the pimples with lotion to remove the sebaceous patches and see the ducts of the sebaceous deposits. Massage for the help of a cotton swab or disc, leaked with an antiseptic ointment or ointment: 1% ointment synthomycin, ointment sodium sulfacyl, 1% tetracycline ointment and in. . You can lightly beat the povіki with the pads of your fingers. Massage is practiced daily for 10-15 days.

Special gymnastics for the eyes for the weakness of the mind.

Outside camp - standing.

1. We stare straight ahead, without raising our heads, then sharply down. Repeat ruhi 6 to 8 times.
2. We look uphill and to the right, then diagonally down and to the left. Repeat ruhi 6 to 8 times.
3. We look uphill and to the left, then down and to the right. Repeat ruhi 6 to 8 times.
4. We wonder as much as possible levoruch, then as much as possible right-handed. Repeat ruhi 6 to 8 times.
5. Vityaguєmo hand forward, trymaєmo її straight. We marvel at the tip of the eye-catching finger and step by step we approach yoga, without admiring marveling, until the picture begins to “double”. Repeat ruhi 6 to 8 times.
6. We put an eye-catching finger on the transfer. We shift our glance at the finger, alternately we rule with that left eye. Repeat up to 12 times.
7. Ruhayemo eyes on the stake to the right and to the left. Repeat ruhi 6 to 8 times.

After the glee, the forecast is favorable.

As omission goes down with the paralysis of full-time m'yaziv, the effectiveness of glee can be private.

The launch of a neuro-malignant pathology does not guarantee a positive result.

Ignorant of the possibility of deacing fahivtsiv, the best glee The lowering of the povіk at the given hour is important for surgical interventions. Clinic, yakі fork omissions of the century, dosit rich. Golovne - choose a good qualified doctor, who will spare you a short time.

Ptosis of the upper pelvis (syn. blepharoptosis) is an abnormally low position of the upper pelvis, which may be congenital or nabutim.

Classification of ptosis of the century

1. neurogenic
   • paresis of paroxysmal nerve
   • Horner's syndrome
   • Marcus Gunn syndrome
   • paroxysmal nerve aplasia syndrome
2. Myogenic
   • myasthenia gravis
   • m'yazova dystrophy
   • ophthalmoplegic myopathy
   • simple malformation
   • blepharophimosis syndrome
3. aponeurotic
   • involutionary
   • postoperative
4. Mechanical
   • dermatochalasis
   • puffy
   • anterior orbital earache
   • scarring

Non-mandatory ptosis of the capital

Unexplained ptosis of a century of calls to damaged innervation of the III pair of black nerves and paralysis of the nerve n. oenlosympathetic.

Cranial nerve aplasia III syndrome

Cranial nerve aplasia syndrome III may be congenital, or it may be due to paresis of the paresis of the parotid nerve, the remaining cause is more pronounced.

Symptoms of the syndrome of aplasia III of cranial nerve parotid

Pathological ruptures of the upper groin. scho suprovodzhuyut ruhi full-time apple.

Treatment of the syndrome of aplasia III of cranial nerve palsy

Resection of the tendon of the levator and subtraction to the eyebrow.

Myogenic ptosis of the capital

Myogenic ptosis of the capital is due to the underlying myopathy of the levator of the capital or the impairment of neuromuscular transmission (neuromyopathy). Myogenic ptosis develops with myasthenia gravis, myotonic dystrophy and ocular myopathies.

Aponeurotic ptosis

Aponeurotic ptosis of the ruptures of ruptures, tendon ruptures or stretching of the lavator aponeurosis, which intermediates the transmission of susilla from the normal levator mucosa to the upper eyelid. The basis of this pathology is most often to lie age-old degenerative changes.

Symptoms of aponeurotic ptosis of the capital

• 1. Sound bilateral ptosis of different variability due to the lateral function of the levator.
  
  
  2. High fold of the upper collar (12 mm or more). fragments of the posterior attachment to the aponeurosis to the tarsal cartilage are destroyed, while the anterior attachment to the scruff has become non-shocked and pulls the scruff of the scruff uphill.
  3. AT heavy upheavals the upper fold of the stolіttya may be worn out, the upper fold above the tarsal plate is thinned, the upper furrow is dipped.

Treatment of aponeurotic ptosis of the century includes resection of the levator, refractory or restoration of the aponeurosis of the anterior levator.

Mechanical ptosis of the century

Mechanical ptosis is due to the damage to the frilliness of the upper back. Among the reasons: dermatochalasis, large swellings of the century, for example, neurofibroma, scarring, important bulges on the front side of the orbit.

Causes of mechanical ptosis of the century

Dermatochalasis

Dermatochalasis is wider, sounds like a bilateral disease, swells mainly in summer patients and is characterized by a “superfluous” skin of the upper groin, sometimes it can go behind the hernia of the cellular tissue through a weakened orbital septum. Sposter_gayut sagging skins of pov_k with atrophic folds.

Jubilation at important points of view near the distant superficial skies (blepharoplasty).

Blepharochalasis

Blepharochalasis is a rare ailment that calls out with painless blisters of the upper arms, as if it sounds spontaneously subside after a few days. Illness begins in the period of state maturation due to succumbing, the frequency of which changes from time to time. At important points, there is a stretching, sagging and thinning of the upper collars, similar to a cigar paper. In other cases, the weakening of the orbital septum leads to the establishment of a hernia of the cellular tissue.

Syndrome of atonic doby

Syndrome of an atonic (“clapping”) capital is a rare, one-or two-sided disease, which is often not diagnosed. Tse damage is caused by smooth people, as they suffer from chronic and apnea during the hour of sleep.

Symptoms of atonic ("clapping") capital

• M'yaki and mlyavі upper povіki.
• Vivorit povik pіd hour of sleep cause to poshkodzhennya uncovered tarsal conjunctivitis and chronic papillary conjunctivitis.

The jubilation of the atonic ("clapping") century in light fluctuations includes the use of full-time protective ointment or bandages on the legs for nothing. In important vipadkah, you need a horizontally short century.

Principles of surgical treatment of mechanical ptosis

Fasanella-Servat technique

• Indication. Pomіrniy ptosis from the function of the levator is not less than 10 mm. Most of the depressions in Horner's syndrome and moderately severe congenital ptosis are observed.
• Technique. The upper edge of the tarsal cartilage is right next to the lower edge of the müller's muzzle and lies above it with the conjunctiva.

Resection of the lavator

• Indication. Ptosis of a different stage due to the function of the levator is not less than 5 mm. Obyag resection to lie down in the function of the levator and the variability of ptosis.
• Technique. Shortening of the levator through the anterior (shkir) or posterior (conjunctiva) pidkhid.

Pіdvіshuvannya to frontal m'yaza

Indication

• Excessive ptosis (>4 mm) with even low levator function (
• Marcus Gunn Syndrome.
• Aberrant regeneration of the parotid nerve.
• Blepharophimosis syndrome.
• New paresis of the parotid nerve.
• Unsatisfactory result of anterior resection of the levator.

Technique. Suspension of the tarsal cartilage to the frontal mass with a ligature of the wide fascia, or a synthetic material that cannot be disassembled, such as proline or silicone.

Reinforcing the aponeurosis

1. Indication. Aponeurotic ptosis due to the high function of the levator.
2. Technique. Moving and subscribing the intact aponeurosis to the tarsal cartilage through the anterior or posterior pidhid.

Congenital ptosis of the capital

Congenital ptosis of the capital is an illness with an autosomal dominant type of decline, in which case dystrophy of the miaza develops, which raises the upper groin (myogenic), or aplasia of the nucleus of the parotid nerve (neurogenic). Distinguish between congenital ptosis due to the normal function of the upper direct mucus of the eye (the most common type of congenital ptosis) and ptosis due to weak mucosa. Ptosis is often unilateral, but may show two eyes. In case of partial ptosis of the child, the legs are lifted, the forehead is covered with vicorist, and the head is thrown back (the pose of the "stargazer"). The upper palpebral furrow is pronounced weakly or during the day. When looking straight ahead, the upper flank is pubescent, and when looking down, it is ruffled behind the protylezhne.

Symptoms of congenital ptosis

1. Unilateral or bilateral ptosis of different variability.
2. Visibility of the upper palpebral fold and reduced function of the levator.
3. When looking down, the ptosis of the ptosis is roztashovana more than healthy, due to lack of relaxation of the levator mucosa; in case of swollen ptosis, the swelling is affected on the equal or lower than the healthy one.

Treatment of congenital ptosis

Likuvannya can be carried out at the preschool child after all the necessary diagnostic procedures have been carried out. However, in important cases, for the prevention of amblyopia, it is recommended to rozpochinati likuvannya at a greater early age. Most often, resection of the levator is needed.

Palpebromandibular syndrome (Hun's syndrome) is rarely associated with congenital, as a rule, unilateral ptosis, due to synkinetic retraction of the drooping upper pelvis during stimulation of the wing-like mass on the side of the ptosis. Mimovilne lowering of the lowered upper forefoot is observed when chewing, opening the mouth or lowering, and inserting the lower fissure into the hip, protile ptosis, and can also be accompanied by retraction of the upper forefoot. With this syndrome of m'yaz, which lifts the upper vein, otrimuє _innervation in the motor nerves of the trigeminal nerve. Pathological synkinesia of this kind is afflicted with lesions of stovbur to the brain, often aggravated by amblyopia or squint.

Marcus Gunn Syndrome

Marcus Gunn Syndrome (palpebromandibular) shows approximately 5% of cases of congenital ptosis, mostly unilateral. Regardless of those whose etiology of the illness is not clear, the pathological innervation of the levator centrum is allowed to be treated with the motor tricuspid nerve.

Symptoms of Marcus Gunn Syndrome

1. Retraction of the omitted dobi with teasing of the ipsilateral krylopodibny m'yaz for an hour of chewing, opening the mouth, opening the crack in the opposite side of the ptosis.
2. With less wide stimulation, you can see hanging cracks, a smile, forging and clenching of teeth.
3. Marcus Gunn's syndrome is not known for a long time, but patients can be masked.

Celebrating the Marcus Gunn Syndrome

It is necessary to recognize that this syndrome and its association with ptosis is a significant functional and cosmetic defect. For those scho, scho z hirurgichnomu likuvanni yaky zavzhdy reach zadovolnі results, vikoristovuyut such techniques.

1. Unilateral resection of the levator in the lower jaws due to the function of the levator 5 mm or more.
2. Unilateral resection and resection of the levator tendon with insilateral extension to the eyebrow (frontal area) in more important falls.
3. Bilateral resection and resection of the levator tendon with insilateral extension to the eyebrow (frontal area) to achieve a symmetrical result.

Blepharophimosis

Blepharophimosis is an anomaly of development, which rarely swells, is associated with shortened and ringing of the frontal line, bilateral ptosis, with an autosomal dominant type of decline. It is characterized by a weak function of the m'yaza, which raises the upper povіka, epicanthus and vivorit the lower povіka.

Symptoms of blepharophimosis

1. Symmetric ptosis of different variability due to lack of levator function.
2. Shortening of the eye gap at the horizontal straight line.
3. Telecanthus and inverted epicanthus.
4. Lateral ectropion of the lower capital.
5. The hypoplasia of the upper orbital edge was slightly retarded.

Treatment of blepharophimosis

Treatment of blepharophimosis includes postal correction of epicanthus and telecanthus, after a few months, bilateral frontal fixation. It is also important to consider amblyopia, as there may be approximately 50% of the cases.

Nabutius ptosis of the capital

Nabutiy ptosis of the century is significantly more frequent, lower births. Fallow vіd vіdzhennya razryznyayut neurogenic, myogenic, aponeurotic and mechanical swelling ptosis.

Neurogenic ptosis of the capital in paralysis of the parotid nerve sounds unilateral and recurrent, most often it is associated with diabetic neuropathy and intracranial aneurysms, swellings, injuries and inflammation. In case of total paralysis of the parotid nerve, the pathology of extraocular masses and clinical manifestation internal ophthalmoplegia: loss of accommodation and reflex lines, mydriasis. Thus, an aneurysm of the internal carotid artery in the middle of the cavernous sinus can lead to total ophthalmoplegia with anesthesia of the area of ​​innervation of the eye and infraorbital nerve of the trigeminal nerve.

The ptosis of the century can be called out from a zahisnoy method when the horn is pierced, so that it does not go through an open gap in the case of lagophthalmos. The effect of chemical denervation with botulinum toxin of the m'yaza, which lifts the upper pelvic floor, is timcha (about 3 months), and it sounds enough for the hornicular process to be adopted. This method of lubrication is an alternative to blepharoraphy (zshivannya povik).

Ptosis of the capital in Horner's syndrome (call nabutium, or may be congenital) due to damage to the sympathetic innervation of Muller's smooth muscle. For this syndrome, it is typical to have a ringing of the eyelids, followed by pubescence of the upper flank by 1-2 mm and a slight drooping of the lower flank, miosis, impaired sweating on the upper half of the individual or the flank.

Myogenic ptosis of the century due to myasthenia gravis, often bilateral, may be asymmetrical. The severity of ptosis changes with the skin day, vin is provoked by anxiety and can be combined with twins. The endorphin test timchasovo suvay m'yazovu weakness, corygo ptosis, confirming the diagnosis of myasthenia gravis.

Aponeurotic ptosis - a type of perennial ptosis, which is often more common; it is characterized by the fact that the tendon of the meat, that it lifts the upper forearm, often winds up in the tarsal (cartilage-like) plate. Aponeurotic ptosis can be post-traumatic; It is important that the majority of postoperative ptosis can develop such a mechanism.

Mechanical ptosis of the eyelid is due to the horizontal shortness of the eyelid of the chubby or cicatricial walk, and also for the presence of the full-time apple.

In children preschool age cause ptosis to a steady decrease in dawn. Early surgical treatment of severe ptosis may prevent the development of amblyopia. In case of poor friability of the upper lining (0-5 mm), it is possible to slightly lift it up to the frontal muzzle. For the obviousness of a moderately pronounced excursion of the century (6-10 mm), ptosis is corrected with a path of resection of the m'yaza, which lifts the upper vein. In case of congenital ptosis with impaired function of the upper direct meatus, the resection of the levator tendon should be performed in a greater extent. The high excursion of the century (more than 10 mm) allows vikonat resection (duplication) of the aponeurosis of the levator or Müller.

Excitement of the acquired pathology to lie down in terms of etiology and magnitude of ptosis, as well as in terms of the fragility of the capital. A great number of methods have been propagated, but the principles of exuberance remain unchanged. In case of neurogenic ptosis in mature adults, it is necessary to conservative exuberance. Have reshti vipadkіv dotsіlno kіrurgichіchne lіkuvannya.

When the capital is lowered by 1-3 mm, this good frilliness transconjunctivally marks the resection of Müller's muzzle.

In times of moderately pronounced ptosis (3-4 mm) and good or moderate frilliness of the capital, surgery is indicated on the m'yazy, which raises the upper fold (tendon plasty, refixation, resection or duplication).

With a minimum friability of the century, it is necessary to lift it up to the frontal area, which will ensure the mechanical lifting of the century when lifting the eyebrows. The cosmetic and functional results of this operation are higher, the lower effect is on the levators of the upper ankle, and the category of ailments is given, there are no alternatives.

pseudoptosis

For ptosis, such pathologies can be pardoned.

• Insufficient pіdtrimka pіdіk nіm nіm apple nаslіdо change vіstu vіstu orbіti (piece eye, microphthalmos, enophthalmos, phthisis nіc apple).
• The contralateral retraction of the century is observed when the upper folds are aligned, while the upper folds normally curve the horn by 2 mm.
• Hypotrophy is ipsilateral, with any upper bulge descends to the bottom, following the full-time apple. Pseudoptosis is known, as the patient fixes a glance with a hyotrophic eye when a healthy one is closed.
• Ptosis of the eyebrow through the "superfluous" skin of the superciliary brow, or in case of paralysis of the facial nerve, which can be revealed by raising the eyebrow with your hand.
• Dermatochalasis. with some "overdish" skin of the upper povіk є the cause of the formation of a superb or pseudoptosis.

Vimiryuvannya

• Leave the edge of the century - a reflex. Tsya stand between the upper edge of the century and the corneal fermentation, exchange the handle-lichtarika, at which the patient is able to marvel at.
• The height of the eye slit is between the upper and lower edges of the povka, wimmiryan in the meridian, which is to pass through the zinitsa. The edge of the upper collar sounds about 2 mm lower than the upper limb, the lower collar - 1 mm or less than the lower limb. In men, the height is smaller (7-10 mm), lower in women (8-12 mm). Unilateral ptosis is assessed by the height difference with the cotralateral side. Ptosis is classified as mild (up to 2 mm), moderate (3 mm) and important (4 mm or more).
• The function of the levator (excursion of the upper leg). Vimiryuyut with the thumb of the patient's eyebrows when looking down at the patient to turn off the frontal m'yaza. Let's let the patient marvel as much as possible uphill, the excursion of the century will be controlled by a line. Normal function - 15 mm and more, good - 12-14 mm, sufficient - 5-11 mm, and deficient - 4 mm and less.
• The upper palpebral furrow is vertical between the edge of the century and the fold of the century when looking down. In women, it is about 10 mm thick. in humans - 8 mm. The presence of a fold in a patient with congenital ptosis is an indirect sign of a lack of levator function, with a temporal fold indicating a defect in the aponeurosis. Peel fold є with a marker of the cob cut.
• Pretarsal v_dstan - vіdstan between the edge of the century and the fold of the shkіri when fixing a distant object.

Associative signs

1. Stronger innervation can be injected into the levator on the side of the ptosis, especially when looking uphill. In the future, the strengthening of the innervation of the contralateral non-shocked levator should be brought up to a staggering century. It is necessary to raise a finger to the ptosis-affected scrotum and prostegize the lowering of the intact scapular. In this case, the patient is to blame for some delays, which surgical correction of ptosis can stimulate the lowering of the contralateral capital.
2. The follow-up of stomlyuvannost is carried out for 30 s, the patient does not bleed. Progressive lowering of one or both povіk or nezdatnіst direct a glance down to the pathognomonic signs of mastonia. In case of myasthenic ptosis, the upper groin is visible on saccades from looking down to looking straight (symptom of Cogan smirking) or “stringing” when looking down.
3. Impaired frilliness of the eye (especially dysfunction of the upper direct meatus) must be restored in patients with congenital ptosis. Correction of ipsilateral hypotrophy can change ptosis.
4. The palpebromandibular syndrome manifests, as the patient develops chewing ruhi, or else to slit the slit.
5. The Bell phenomenon is being traced by trying to see the patient's appearance with hands, when you try to close your eyes, you can see the vision of the apple of the eye. In the case of an untreated phenomenon, there is a risk of post-operative exposure keratopathies, especially after large resections of the levator or the technique of repositioning.