Levator aponeurosis advancement with partial orbicularis oculi muscle resection for the treatment of Marin Amat syndrome with aponeurotic ptosis: two Case reports

Marin Amat syndrome is a phenomenon in which eyelids close upon opening of the mouth during the recovery phase after facial nerve paralysis. In this report, we present two surgically treated cases of Marin Amat syndrome with aponeurotic ptosis. Case 1: A 66-year-old man had developed left Bell's palsy a year prior to presentation and underwent rehabilitation at the Neurology Department of Japan Community Healthcare Organization Chukyo Hospital. He was subsequently referred to the Ophthalmology Department for left eyelid ptosis. Case 2: A 75-year-old man developed left Bell's palsy more than 10 years prior to presentation and was referred to the Ophthalmology Department for left eyelid ptosis. Both patients had Marin Amat syndrome with aponeurotic ptosis. Levator aponeurosis advancement surgery and partial orbicularis oculi muscle resection were performed on the affected eyes. Both patients showed favorable postoperative outcomes. Simultaneous surgery involving levator aponeurosis advancement and partial orbicularis oculi muscle resection is effective for treating Marin Amat syndrome with aponeurotic ptosis.