Question:medium
A child has ptosis and poor levator function. What surgery will you do?
A child has ptosis and poor levator function. What surgery will you do?
Show Hint
Poor levator function means borrow power from the frontalis muscle.
Updated On: Jun 23, 2026
- Levator muscle resection
- Mullerectomy
- Fasanella Servat surgery
- Frontalis suspension surgery
Show Solution
The Correct Option is D
Solution and Explanation
Step 1: Anchor the decision on a single number: how strong is the levator? Here it is poor, which immediately rules out muscle-shortening operations.
Step 2: Mullerectomy and Fasanella-Servat are reserved for small ptosis with adequate function, and a levator resection needs a functioning levator to shorten. None of these can lift a lid that has little intrinsic power.
Step 3: The work-around is to borrow power from a different muscle. Frontalis suspension connects the lid to the brow with a sling so the frontalis muscle does the lifting whenever the patient raises the eyebrow.
Step 4: This is the standard solution in congenital ptosis with poor levator function.\[\boxed{\text{Frontalis suspension surgery}}\]
Step 2: Mullerectomy and Fasanella-Servat are reserved for small ptosis with adequate function, and a levator resection needs a functioning levator to shorten. None of these can lift a lid that has little intrinsic power.
Step 3: The work-around is to borrow power from a different muscle. Frontalis suspension connects the lid to the brow with a sling so the frontalis muscle does the lifting whenever the patient raises the eyebrow.
Step 4: This is the standard solution in congenital ptosis with poor levator function.\[\boxed{\text{Frontalis suspension surgery}}\]
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