Comparative evaluation of supra-brow single-stab and conventional fox-pentagon frontalis sling surgery

• Author Details:   
• Himanto Nath Hazarika
• Suranjana Chaliha Hazarika
• Shibashis Deb ^*
• Garima Rani

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Background: Ptosis is a condition that can impair vision and affect facial aesthetics. Diverse surgical techniques have been devised for its correction, of which conventional Fox-Pentagon technique is widely accepted for severe ptosis. Supra-brow Single-Stab (SBSS) technique has been devised recently to reduce the number of incisions in the conventional approach.

Aim and Objective: This study was aimed to compare functional and cosmetic outcome of Supra-brow Single-Stab (SBSS) and Conventional Fox-Pentagon Frontalis Sling Surgery

Materials and Methods: 28 eyelids of 24 patients where 20 patients had unilateral ptosis and 4 patients had bilateral ptosis. The patients were divided via Block Randomization into two groups – the study group (A) underwent SBSS, whereas the control group (B) underwent Conventional Fox-Pentagon Frontalis Sling surgery. All patients underwent thorough ptosis evaluation before surgery. The SBSS surgery modified conventional technique by giving a single supra-brow incision while maintaining the basic pentagon-shape. Functional outcomes were assessed in both groups using parameters - margin reflex distance 1, lagophthalmos, and lid closure. Cosmetic grading was done via parameters - lid crease height, lagophthalmos, and presence of scars. All patients were followed up as Day 01, Day 30, 3rd month, and 6th month. The variables were compared and statistically evaluated by t-test and Fisher's exact test analysis using online calculator. Design: Prospective case control study.

Results: The study group and the control group were comparable at all points of time in functional and cosmetic outcomes, the study group faired significantly better than the control group (p-value <0.05), predominantly due to reduced scarring and fewer number of suprabrow scars.

Conclusions: This technique has a simple learning curve, decreased intraoperative bleeding, fewer number of sutures, fewer postoperative scars, and enhanced cosmesis, while retaining the usual advantages and functional results of standard sling procedures. No specific complications were noted.