title: Eyelid reanimation, neurotisation, and transplantation of the cornea in a patient with facial palsy.
abstract: Patients affected by facial palsy suffer from failure to fully close the eyelids; the resulting eye exposure can lead to dry eye syndrome, loss of epithelial integrity, corneal ulceration and infections. Corneal anaesthesia exacerbates risk of corneal damage in these patients. Eyelid paralysis-associated corneal lesions may induce severe visual impairment, for which the ideal treatment is corneal transplantation, a procedure contraindicated in patients with corneal sensitivity and inadequate eyelid closure. We present the case of a patient affected by unilateral facial palsy associated with corneal anaesthesia, due to seventh and fifth cranial nerve damage following homolateral eighth cranial nerve surgery. The patient underwent surgery to re-establish eyelid and corneal competence, and then received a corneal graft with consequent amelioration of visual acuity. This is the first case of associated corneal anaesthesia and facial palsy that was comprehensively treated with a set of surgical procedures, including a corneal transplant.
authors.affiliation: Department of Maxillofacial Surgery, San Paolo Hospital, Università degli Studi di Milano, Milan, Italy.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Allevi
authors.affiliation: Department of Ophthalmology, San Paolo Hospital, Università degli Studi di Milano, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Fogagnolo
authors.affiliation: Department of Ophthalmology, San Paolo Hospital, Università degli Studi di Milano, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Rossetti
authors.affiliation: Department of Maxillofacial Surgery, San Paolo Hospital, Università degli Studi di Milano, Milan, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Biglioli
mesh_terms: D003315:Cornea / Q000473:pathology / Q000601:surgery*; D003316:Corneal Diseases / Q000209:etiology / Q000601:surgery*; D016039:Corneal Transplantation; D020209:Cranial Nerve Injuries / Q000150:complications / Q000601:surgery*; D003391:Cranial Nerves / Q000601:surgery; D005143:Eyelids / Q000473:pathology / Q000601:surgery*; D005158:Facial Paralysis / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016067:Nerve Transfer; D011183:Postoperative Complications / Q000601:surgery; D014792:Visual Acuity