Laryngorhinootologie 2017; 96(10): 691-697
DOI: 10.1055/s-0043-113040
Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Das endoskopische Browlift mittels Endotine Forehead Device bei Fazialisparese

Endoscopic Browlift via Endotine Forehead Device in Patients with Facial Palsy
Laura Holtmann
1   Universitätsklinikum Essen, Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie
,
Kerstin Büchsenschütz
1   Universitätsklinikum Essen, Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie
,
Anja Eckstein
2   Universitatsklinikum Essen, Klinik für Augenheilkunde
,
Anke Schlüter
1   Universitätsklinikum Essen, Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie
,
Stephan Lang
1   Universitätsklinikum Essen, Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie
,
Stefan Mattheis
1   Universitätsklinikum Essen, Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
30. Juni 2017 (online)

Zusammenfassung

Hintergrund: Die Augenpartie ist sowohl in funktioneller Hinsicht als auch für die Expression von Emotionen von zentraler Bedeutung. Eine chronische Fazialisparese mit Lähmung des Stirnastes kann zu einer Brauenptosis mit Einschränkungen des Gesichtsfeldes und einer deutlichen Asymmetrie des Gesichts führen. Das endoskopische Browlift mit resorbierbarem Endotine Forehead Device stellt ein attraktives Konzept zur Korrektur der Brauenptosis und Symmetrisierung der Stirn-/Brauenregion dar.

Material und Methoden Das endoskopische Augenbrauen- und Stirnlift unter Anwendung des Endotine Forehead Devices wurde in unserer Klinik bisher an 9 Patienten mit Fazialisparese durchgeführt. Das intraoperative Handling, Komplikationen und das postoperative Ergebnis wurden analysiert. Die Symmetrisierung der Augenbrauen wurde durch die FACEgram-Software erfasst. Zur postoperativen Abfrage der Patientenzufriedenheit wurde nach durchschnittlich 10 Monaten der Glasgow Benefit Inventory Fragebogen eingesetzt.

Ergebnisse Mit Hilfe des endoskopischen Stirnlifts mit dem Endotine Forehead Device gelang eine minimal-invasive, komplikationsarme Symmetrisierung der Stirn- und Augenbrauenregion. Operationsbedingte Morbiditäten wurden nicht kaum beobachtet. Folgende Komplikationen wurden beobachtet: Eine Patientin erlitt eine Rezidivptosis bei postoperativem Hämatom. Eine weitere empfand die Palpabilität des Device als störend. Die Patienten berichteten über eine postoperative Steigerung der Lebensqualität, d.er durchschnittliche Punktwert im Glasgow Benefit Inventory nach der Operation lag bei + 29,2 (SD 13,6).

Schlussfolgerungen Das endoskopische Brow- und Stirnlift mit dem Endotine Forehead Device stellt eine erfolgreiche, komplikationsarme Therapieoption bei Brauenptosis in Folge einer Fazialisparese dar.

Abstract

Objective Forehead and brows form a critical aesthetic and functional subunit of the face. Chronical pPeripheral paralysis of the facial nerve or its frontal branch may cause brow ptosis and eyelid deformities with a limited field of vision and loss of facial symmetry. Techniques, especially endoscopic methods have evolved significantly. Endotine Forehead Device, an adsorbable device, is a promising tool for brow suspension.

Material and Methods 9 patients underwent brow and forehead lift surgery via Endotine Forehead Device. Intraoperative handling, complications, and the surgical outcome were assessed. To analyze postoperative symmetry FACEgram software was used. Follow-up was about 3,6 months after surgery. As a patient oriented outcome parameter the Glasgow Benefit Inventory Questionnaire was assessed about 10 months after surgery.

Results Using the Endotine Forehead Device via an endoscopic approach was helpful to recreate a symmetrical upper third of the face. Few adverse effects could be observed:. One relapse was detected, one patient complained about the palpability of the device. Patients stated an improved quality of life after surgery, overall benefit in quality of life was +29,2 (SD 13,6).

Conclusions Endotine Forehead Device is a successful minimally invasive tool for endoscopic brow and forehead lift surgery in patients with facial paralysis.

 
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