title: Ocular outcomes after gold weight placement and facial nerve resection.
abstract: OBJECTIVE
  To assess the effectiveness of acute gold weight placement after facial nerve resection and to determine the role of concomitant lower eyelid procedures.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Twenty-two patients who received an upper eyelid gold weight at the time of parotidectomy and facial nerve resection were reviewed to assess ocular outcomes.
  
  
  RESULTS
  After gold weight placement, twelve patients (12 of 22, 54.5%) subsequently presented with symptomatic ectropion (n = 9) and/or lagophthalmos (n = 5). Nine patients received a lower eyelid procedure (7 tarsal strips only, 1 tarsal strip combined with a lateral tarsorrhaphy, and 1 lateral tarsorrhaphy only). Six patients, in addition to a gold weight, also underwent a static sling to the midface at the time of facial nerve resection. None of these 6 received a subsequent lower eyelid procedure. Two patients required gold weight upsizing. Two patients required weight removal.
  
  
  CONCLUSIONS
  Insertion of 1.2 gm upper eyelid weight with placement of midface sling is recommended at the time of facial nerve resection. Due to the need to tighten the lower eyelid in many of these patients, we now also consider performing a tarsal strip procedure at the time of facial nerve resection in any patient with pre-existing lower lid laxity.
authors.affiliation: Division of Plastic and Reconstructive Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Razfar
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Afifi
authors.forename: Ernest K
authors.initials: EK
authors.lastname: Manders
authors.forename: Eugene N
authors.initials: EN
authors.lastname: Myers
authors.forename: Jonas T
authors.initials: JT
authors.lastname: Johnson
authors.forename: Robert L
authors.initials: RL
authors.lastname: Ferris
authors.forename: Frederic W-B
authors.initials: FW
authors.lastname: Deleyiannis
mesh_terms: D005143:Eyelids / Q000503:physiopathology* / Q000601:surgery; D005154:Facial Nerve / Q000601:surgery*; D005158:Facial Paralysis / Q000601:surgery*; D005260:Female; D006046:Gold; D006801:Humans; D008297:Male; D008875:Middle Aged; D010306:Parotid Gland / Q000601:surgery; D010307:Parotid Neoplasms / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D006046:Gold