Outcomes of lower eyelid retractor recession and lateral horn lysis in lower eyelid elevation for facial nerve palsy
Autor: | J Wong, P Tan, Raman Malhotra, W F Siah |
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Rok vydání: | 2017 |
Předmět: |
Adult
Male medicine.medical_specialty Lagophthalmos Lid lag Facial Paralysis Ophthalmologic Surgical Procedures 03 medical and health sciences 0302 clinical medicine Humans Medicine In patient 030223 otorhinolaryngology Aged Retrospective Studies business.industry Eyelids Ectropion Retrospective cohort study Middle Aged medicine.disease Surgery Retractor Ophthalmology medicine.anatomical_structure Oculomotor Muscles Anesthesia Eyelid Diseases Clinical Study 030221 ophthalmology & optometry Facial nerve palsy Female Eyelid Facial Nerve Diseases business |
Zdroj: | Eye. 32:338-344 |
ISSN: | 1476-5454 0950-222X |
Popis: | PurposeTo report outcomes and complications of lower eyelid retractor recession and lateral horn lysis (RR) for lower eyelid elevation in patients with facial nerve palsy (FNP).Patients and methodsRetrospective review. Patients with FNP undergoing RR alone (group 1) or with adjunctive procedures (canthal suspension-group 2, tarsorrhaphy-group 3, and full-thickness skin graft-group 4) during a 5-year period were included. Patient demographics, lagophthalmos, occurrence of eyelid malpositions, recurrent retraction, and repeat procedures were noted from medical records. Measures of lower eyelid height (LEH) and lid lag on downgaze were obtained from standard photographs.ResultsForty-two patients (23 females, mean age was 59 years) were included. Mean follow-up was 24 months (range 6-77). Median improvement in LEH following surgery was significant in Group 1 (0.90 mm, IQR: 0.37-0.91, P=0.20) and in Group 2 (0.51 mm, IQR: 0.30-1.37, P0.001), respectively. Median improvement in blink lagophthalmos was 3.00 mm (IQR: 3.00-3.50, P=0.02) in Group 1 and 3.50 mm (IQR: 1.75-5.00, P0.001) in Group 2. Median improvement in lagophthalmos on gentle eye closure was 2.00 mm (IQR: 1.50-3.00, P=0.02) in Group 1 and 1.00 mm (IQR: 0-2.13, P=0.006) in Group 2. No new cases of ectropion were noted. 23.5% of patients required a repeat RR at a mean interval of 20 (range 1-70) months and a further 9.8% required a third procedure at a mean interval of 21 (range 18-29) months.ConclusionRR improves lower eyelid retraction and lagophthalmos in FNP either alone or when combined as an adjunctive procedure. It does not aggravate paralytic ectropion although repeated retractor recessions may be required to improve retraction. |
Databáze: | OpenAIRE |
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