title: Surgical treatment of the periocular complex and improvement of quality of life in patients with facial paralysis.
abstract: OBJECTIVE
  A devastating sequela of facial paralysis is the inability to close the eye. The resulting loss of corneal protection can potentially lead to severe consequences. Eyelid weight placement, lower eyelid suspension, and brow ptosis correction are frequently performed to protect the eye. We sought to measure and report the change in quality of life (QOL) after surgical treatment of the periocular complex, using the validated Facial Clinimetric Evaluation (FaCE) QOL instrument.
  
  
  METHODS
  From March 2009 to May 2010, 49 patients presenting to the Facial Nerve Center with paralytic lagophthalmos requiring intervention were treated with static periocular reanimation. Thirty-seven of the patients completed preoperative and postoperative FaCE surveys.
  
  
  RESULTS
  Overall QOL, measured by the FaCE instrument, significantly improved following static periocular treatment. Mean FaCE scores increased from 44.1 to 52.7 (P < .001). Patients also reported a significant decrease in the amount of time their eye felt dry, irritated, or scratchy (P < .001). The amount of artificial tears and/or ointment also significantly decreased (P = .03). There were 2 cases of localized cellulitis with 1 eyelid weight extrusion.
  
  
  CONCLUSIONS
  We report the first series of postoperative QOL changes following static periocular treatment for paralytic lagophthalmos. Patients report a notable improvement in periocular comfort and overall QOL.
authors.affiliation: Facial Nerve Center, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, 243 Charles St., Boston, MA 02114, USA.
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Henstrom
authors.forename: Robin W
authors.initials: RW
authors.lastname: Lindsay
authors.forename: Mack L
authors.initials: ML
authors.lastname: Cheney
authors.forename: Tessa A
authors.initials: TA
authors.lastname: Hadlock
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019882:Blepharoplasty / Q000379:methods; D005141:Eyelid Diseases / Q000209:etiology / Q000601:surgery*; D005158:Facial Paralysis / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult