title: Transnasal tendon suspension for the paralyzed lower eyelid.
abstract: BACKGROUND
  Paralytic ectropion is a significantly functional and esthetic problem leading to problems with lacrimation, corneal exposure, and poor palpebral closure. Limitations with traditional corrective procedures include poor apposition of the lid to the globe, suboptimal medial canthal position, and high recurrence rates.
  
  
  OBJECTIVE
  The objective of this study was to develop a technique of lower-lid suspension using transnasal wiring for the long-term maintenance of lid position.
  
  
  METHODS
  Twenty-three consecutive patients with complete unilateral facial nerve paralysis underwent the procedure, and they were followed up for a median of 27 months (1-73 months).
  
  
  RESULTS
  Fifteen of 18 patients maintained their intraoperative lower-lid position beyond the 12-month follow-up. Three patients had a minimal scleral show at 3 months. One of these patients also developed lid laxity seen on the snap test. No perioperative complications were experienced.
  
  
  CONCLUSIONS
  Transnasal wiring of the lower-lid tendon suspension provides consistent results that are maintained over time.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Center, Victoria Hospital, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Yoo
authors.affiliation: Department of Surgery, Division of Plastic and Reconstructive Surgery, London Health Sciences Center, Victoria Hospital, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Electronic address: Damir.Matic@lhsc.on.ca.
authors.forename: Damir
authors.initials: D
authors.lastname: Matic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019882:Blepharoplasty; D004483:Ectropion / Q000209:etiology / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000150:complications / Q000601:surgery*; D013710:Tendons / Q000637:transplantation*; D055815:Young Adult
keywords: Ectropion; Facial paralysis; Facial reanimation; Lower-lid suspension; Static reanimation; Transnasal wiring