CORRECTION OF PTOSIS AND OF EPICANTHUS

Abstract
In the absence of any action of the levator palpebrae muscle, the patient is apt to attain some elevation of the paralyzed lid by overaction of the occipitofrontalis muscle. This has suggested that a direct fixation of the tarsus of the upper lid to the occipitofrontalis muscle would give much better elevation of the lid than does the simple continuity of the somewhat fixed tissues of the brow. Various plans have been proposed for doing this, but it is our belief that the most satisfactory is the direct connection by means of a live tendon cut from autogenous tissue. For this purpose we, with others, have used thin strips of fascia lata, which, as has been clearly demonstrated by Gallie in his work on abdominal hernia, will give permanent live and approximately natural connective tissue fixation. Even when previously inactive, this extra load may stimulate a lagging occipitofrontalis muscle