Dr.Rwituja Thomas

, Dr. GUPTA ROSHMI, Dr. SUSHMA A.

Abstract

Performing an orbicularis myectomy has proven to be one of the few procedures that can help a patient with refractory blepharospasm (insufficiently relieved by botulinum chemodenervation)by upper lid orbicularis muscle and myotomy of corrugator and procerus,with/out limited blepharoplasty and levator reattachment. We describe a simple step-by-step technique of this procedure. Under local anesthesia using Klein’s solution, an upper lid crease incision was made. Pretarsal and preseptal orbicularis muscle exposure and myectomy were performed. On the first postoperative day, blepharospasm had decreased. No eye had lymphedema. Subsequent follow-ups showed that patients required fewer doses of botulinum toxin and at larger intervals than prior to surgery or no injections at all. Therapeutic myectomy technique provides effective treatment for refractory blepharospasm with good functional outcome with ease of performing daily activities