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Correction of paralytic lagophthalmos

 

George E. Anastassov1 / Regina H. Khater2 / Yourii K. Anastassov3
1Department of Maxillofacial Surgery, Mount Sinai School of Medicine, new York, USA
2Division of Plastic and Craniofacial Surgery, St. George University Hospital, Plovdiv, Bulgaria
3Division of Plastic and Craniofacial Surgery, St. George University Hospital, Plovdiv, Bulgaria
Correspondence and reprint request to: G. Anastassov, Dept. of Maxillofacial Surgery, Mount Sinai School of MedicineE-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.; Mob.: +001 917 607 2057Mount Sinai School of Medicine; One Gustave L. Levy Place, New York, NY10029-6574

Citation Information: Folia Medica. Volume 54, Issue 1, Pages 24–29, ISSN (Online) 1314-2143, ISSN (Print) 0204-8043, DOI: 10.2478/v10153-011-0074-x, October 2012
Publication History:
Published Online:
2012-10-24


ABSTRACT

 

INTRODUCTION: Bell’s palsy causes lagophthalmos of the involved eyelids. Secondary to the atonicity of the eyelids, xerophthalmia, conjunctivitis and epiphora develops. There are dynamic (muscle transfers) and static (gold weights, tarsorrhaphy) approaches to alleviate these problems.

The GOALS of this study are to present a technical note for a surgical method for lengthening the retracted upper eyelid with autogenous temporalis fascia and elevation of the lower eyelid with transplantation of autogenous morselized conchal cartilage graft via standard blepharoplasty incisions.

MATERIAL AND METHODS: The proposed technique is illustrated in details with an example of a patient with paralytic lagophtalmos.

The 4 years follow up of the case operated by this technique shows a stable occlusion of the eyelids with a lowering of the upper eyelid and elevation of the lower eyelid margin.

CONCLUSION: If the paralysis is complete this technique will not accomplish adequate relieve of symptoms. In this cases re-animation of the eyelids with either temporalis muscle transfers or free micro neurovascular muscle transfers are indicated.