Headache-Related QoL Improves After Ptosis Repair

By Reuters Staff

March 10, 2017

NEW YORK (Reuters Health) - Ptosis repair or blepharoplasty may reduce tension-type headaches and improve headache-related quality of life (QoL), new research hints.

“This type of headache can be another functional indication for ptosis repair and blepharoplasty,” Dr. Ilke Bahceci Simsek of Yeditepe University Medical School in Istanbul concludes in her report, published online March 2 in JAMA Facial Plastic Surgery.

Drooping of the eyelids can interfere with the superior visual field and lead to reflex contraction of the occipitofrontalis muscles, potentially inducing tension-type headaches, Dr. Simsek notes. While the etiology of this headache type is uncertain, treatment options in the oculofacial literature include botulinum toxin injections and excision of the corrugator superciliaris muscle.

To investigate whether upper eyelid blepharoplasty or ptosis repair might also improve tension headache, Dr. Simsek studied 152 patients, including 108 treated with bilateral blepharoplasty (group 1) and 44 who received ptosis repair (group 2, including 17 who underwent levator resection, 22 who had Muller muscle resection, and five who had frontalis suspension). Patients completed the Headache Impact Test-6 (HIT) before surgery and at least three months afterward.

About one-third of patients in group 1 and about two-thirds in group 2 had tension type headache before surgery. In group 1, HIT scores averaged 55.9 before treatment and 46.4 after surgery. For group 2, HIT scores improved from 60.0 to 42.3. Both improvements were statistically significant.

Within the ptosis group, results on the marginal reflex distance test 1 (MRD1) were negatively correlated with change in HIT score. Patients who underwent levator resection had a significantly greater improvement in HIT scores with surgery (30.0) than those who had Muller muscle resection (18.6) or frontalis suspension (9.9).

“Especially for the ptosis patients with lower results on the MRD1, correction of ptosis improves symptoms of chronic headache,” Dr. Simsek concludes in her report.

SOURCE: http://bit.ly/2nhYs4C

JAMA Facial Plast Surg 2017.