Treatment for ophthalmic paralysis: functional and aesthetic optimization

Abstract

Facial nerve palsy has an effect on a person's well-being functionally and psychologically. Therefore, comprehensive patient management is essential. One of the most common uncomfortable and potentially debilitating features is associated with the incapacity for eye closure. Restoration of eye closure is a key consideration during the surgical management of facial palsy. In this article, we introduce simple surgical methods-which are relatively easy to learn and involve the upper and lower eyelids-for achieving eye closure. Correcting upper eyelid function involves facilitating the component of eye closure that is in the same direction as gravity and is, therefore, less complicated and favorable outcomes than correction of lower lid. Aesthetic aspects should be considered to correct the asymmetry caused by facial palsy. Lower eyelid function involves a force that opposes gravity for eye closure, which makes correction of lower eyelid ectropion more challenging than surgery for the upper eyelid, particularly in terms of effecting a sustained correction. Initially, proper ophthalmic evaluation is required, including identifying the chronicity and severity of ectropion. Also, it is important to determine whether or not lateral canthoplasty is necessary. The lateral tarsal strip procedure is commonly used for lower lid correction. However, effective lower lid correction can be achieved with better cosmesis when extensive supporting techniques are applied, including those involving cheek tissue.

Clinical association between serum cholesterol level and the size of xanthelasma palpebrarum

“…In this study, surgical excision was performed in all xanthelasma patients. Since the eyelids are the important structure that protects and lubricates the globes and cornea, it is essential to preserve their structure [ 9 , 10 ]. In most cases, simple excision followed by primary closure was enough.…”

Comparative Blink Analysis in Patients With Established Facial Paralysis Using High-Speed Video Analysis

“…Furthermore, since their orbicularis oculi muscles were flaccid, it was presumed that the upper eyelids moved downward due to their own weight during the blink; muscle relaxations of the levator palpebrae superioris muscle usually occurred simultaneously with the contraction of the orbicularis muscle. In these patients, corneal disorders are inevitable with only blinking, but the cornea is sufficiently protected by conscious eyeclosing and Bell's phenomenon; otherwise, it is necessary to perform blepharoplasty 20,21 …”

Dynamische Verfahren zur Gesichtsnervenrekonstruktion

“…Die Wiederherstellung der frontalen, mentalen oder zervikalen Gesichtsmuskulatur ist dem untergeordnet. Dabei ist eine Wiederherstellung der Lidschlussfunktion operativ relativ einfach durch statische Eingriffe zu erreichen [9,10]. Das Wiederherstellen eines Lächelns hingegen erfordert dynamische Rekonstruktionsverfahren [11].…”