title: Primary surgical management for rehabilitation of the paralyzed eye.
abstract: Protection of the eye is the primary concern in managing the patient with facial paralysis; however, the aesthetic consequences cannot be overlooked. Lagophthalmos has traditionally been treated with frequent ocular lubrication, medical eye care, and tarsorrhaphy. This approach is fraught with the difficulties of poor patient compliance and unacceptable cosmesis. We suggest a protocol for the complete ocular management with emphasis on immediate rather than delayed surgical rehabilitation as a primary therapy in facial paralysis. Gold weight implantation to the upper lid and tightening of the lower lid at the lateral canthus are simple and reliable procedures that provide immediate functional and aesthetic improvement. This surgical technique has extremely low morbidity and is reversible should facial function return. We have used this protocol in more than 30 patients with excellent results.
authors.affiliation: Department of Otolaryngology, University of California, San Francisco 94117.
authors.forename: C S
authors.initials: CS
authors.lastname: Maas
authors.forename: J E
authors.initials: JE
authors.lastname: Benecke
authors.forename: J B
authors.initials: JB
authors.lastname: Holds
authors.forename: L D
authors.initials: LD
authors.lastname: Schoenrock
authors.forename: F
authors.initials: F
authors.lastname: Simo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002985:Clinical Protocols; D004954:Esthetics; D005141:Eyelid Diseases / Q000503:physiopathology / Q000601:surgery*; D005143:Eyelids / Q000503:physiopathology / Q000601:surgery; D005154:Facial Nerve / Q000503:physiopathology; D020220:Facial Nerve Injuries; D005158:Facial Paralysis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006047:Gold Alloys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000503:physiopathology / Q000601:surgery; D017060:Patient Satisfaction; D011183:Postoperative Complications; D019736:Prostheses and Implants / Q000009:adverse effects
chemical_list: D006047:Gold Alloys