Publication: Estudio comparativo entre la cirugía de la ptosis palpebral mediante sutura de la aponeurosis al tarso vs sutura combinada al ligamento de Whitnall
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2019-08-02
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Universidad Complutense de Madrid
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Abstract
La ptosis palpebral es una patología frecuente que sigue suponiendo un reto para el cirujano oculoplástico ya que no es sencillo alcanzar resultados satisfactorios que a su vez sean duraderos en el tiempo. Existen diferentes tipos de ptosis palpebral siendo la aponeurótica adquirida la más frecuente, este tipo de ptosis palpebral está asociada a la edad y la base fisiopatológica se encuentra en la desinserción de la aponeurosis del elevador del párpado superior (EPS) de la placa tarsal. Anatómicamente el sistema elevador del párpado superior está formado por tres arcos paralelos entre sí que son estructuras básicas del sistema elevador: el tarso, la aponeurosis del EPS y el ligamento de Whitnall. Entre el ligamento de Whitnall y la aponeurosis del EPS se encuentra un área anatómica poco estudiada hasta la fecha, la zona de transición superior (ZTS). En condiciones normales el ligamento de Whitnall emite unas proyecciones ligamentosas hacia la aponeurosis del EPS siendo la ZTS estrecha (1-3 mm), en cambio, en determinados pacientes puede existir una desinserción de la ZTS, produciéndose grandes separaciones entre el ligamento de Whitnall y la aponeurosis del EPS. Existen múltiples técnicas quirúrgicas descritas para el tratamiento de esta patología siendo la reinserción de la aponeurosis al tarso (A-T) la más extendida hasta la fecha...
Palpebral ptosis is a frequent pathology that is a challenge for the oculoplastic surgeon as it is not easy to achieve satisfactory results lasting over time. There are different types of palpebral ptosis, the acquired aponeurotic is the most frequent, this type of palpebral ptosis is associated with age and the pathophysiological basis is found in the dislocation of the aponeurosis of the upper eyelid elevator of the tarsal plate. Anatomically, the elevating system of the upper eyelid is formed by three parallel arcs that are basic structures of the elevator system: the tarsus, the aponeurosis and the Whitnall ligament. Between the Whitnall ligament and the aponeurosis there is an anatomical area not studied to date, the upper transition zone (UTZ). Under normal conditions the Whitnall ligament emits ligamentous projections towards the aponeurosis being a narrow UTZ (1-3 mm), however, in certain patients there may be a deinsertion of the UTZ, producing large separations between the Whitnall ligament and the aponeurosis. There are multiple surgical techniques described for the treatment of this pathology, with the reinsertion of the aponeurosis to tarsal (A-T) the most widespread to date...
Palpebral ptosis is a frequent pathology that is a challenge for the oculoplastic surgeon as it is not easy to achieve satisfactory results lasting over time. There are different types of palpebral ptosis, the acquired aponeurotic is the most frequent, this type of palpebral ptosis is associated with age and the pathophysiological basis is found in the dislocation of the aponeurosis of the upper eyelid elevator of the tarsal plate. Anatomically, the elevating system of the upper eyelid is formed by three parallel arcs that are basic structures of the elevator system: the tarsus, the aponeurosis and the Whitnall ligament. Between the Whitnall ligament and the aponeurosis there is an anatomical area not studied to date, the upper transition zone (UTZ). Under normal conditions the Whitnall ligament emits ligamentous projections towards the aponeurosis being a narrow UTZ (1-3 mm), however, in certain patients there may be a deinsertion of the UTZ, producing large separations between the Whitnall ligament and the aponeurosis. There are multiple surgical techniques described for the treatment of this pathology, with the reinsertion of the aponeurosis to tarsal (A-T) the most widespread to date...
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Tesis de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 08/04/2019