A summary in the treatment of ptosis associated with Horner's syndrome using different surgical procedures via transcuta-neous incisions

TANG Weiya; LI Lu; LI Wenlin; XU Miao; ZHANG Huiying; XU Fei; YANG Chao

doi:10.3969/j.issn.1673-7040.2025.09.006

Abstract：Objective To evaluate the therapeutic efficacy of various surgical techniques performed through transcutaneous ap-proaches in the management of ptosis related to Horner's syndrome.Methods A retrospective review was conducted on clinical data from patients treated between June 2022 and June 2024.Patients underwent surgical correction via two different procedures:levator aponeurosis folding and levator aponeurosis-Müller's muscle advancement.Preoperative assessments included levator function and degree of ptosis.Postoperative follow-up focused on comparing outcomes such as the difference in marginal reflex distance 1(MRD1),incidence of complica-tions,and patient satisfaction.Results A total of 42 patients(42 eyes)with mild to moderate ptosis were included,with follow-up durations ranging from 8 to 15 months(mean:10.4 months).Twenty patients underwent levator aponeurosis folding,with an average operative time of(49.65±4.51)min.The preoperative MRD1 difference was(1.62±0.27)mm,which decreased to(0.16±0.17)mm at 6 months postoperative-ly,with 3 cases of recurrent ptosis.Twenty-two patients received levator aponeurosis-Müller's muscle advancement,with an average opera-tive time of(58.05±5.64)min.The preoperative MRD1 difference was(1.54±0.31)mm,reducing to(0.08±0.13)mm at 6 months,with 1 case of recurrent ptosis.Statistical analysis revealed significant differences only in operative duration between the two groups.Conclusion Both levator aponeurosis folding and levator aponeurosis-Müller's muscle advancement performed via transcutaneous approaches effectively im-prove ptosis associated with Horner's syndrome.These procedures also enhance eyelid morphology and yield high patient satisfaction.