Restoration of movement to the upper eyelid in facial palsy

Barclay, T.L.; Roberts, Ag

doi:10.1016/s0007-1226(69)80115-3

Cited by 39 publications

(14 citation statements)

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“…O ouro permanece o material de escolha para o peso palpebral devido à sua alta densidade, baixo índice de reação e coloração que permite bom resultado estético 1 . Pesos de platina podem ser usados em pacientes com alergia ao ouro 3 .…”

Section: Discussionunclassified

Uso de peso de ouro palpebral para correção do lagoftalmo em pacientes com paralisia facial

Testa

Aumond

Figueiredo

2002

Rev. Bras. Otorrinolaringol.

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Introdução: O lagoftalmo decorrente da paralisia facial periférica deve ser corrigido a fim de se evitar complicações oculares. O uso de implantes de ouro como uma alternativa à tarsorrafia vem sendo estudado, mostrando bons resultados. Objetivo: O objetivo deste trabalho foi estudar os efeitos da implantação de peso de ouro em pálpebra superior para correção do lagoftalmo. Forma de estudo: clínico retrospectivo não randomizado. Material e método: Foram estudados retrospectivamente durante seis anos 59 pacientes com lagoftalmo secundário à paralisia facial de diversas etiologias e que foram submetidos à colocação de peso de ouro palpebral. Resultados: Em todos os pacientes foi conseguido o fechamento ocular completo. As complicações do procedimento foram raras e incluíram a extrusão do peso em 8,5% dos pacientes e infecção em 5%. O tempo de permanência do peso variou de 6 meses a 6 anos, tendo sido removido em 20,3% por melhora da paralisia facial periférica. Discussão: Vários métodos têm sido utilizados para promover a proteção ocular nos casos de paralisia facial com graus variáveis de sucesso e aceitação pelo paciente. O implante de peso de ouro em pálpebra superior é um método simples, de fácil reversão e com bom resultado estético. O tempo de permanência do peso palpebral é variável na literatura e as complicações do procedimento são raras. Conclusão: O uso do peso de ouro palpebral em pacientes com paralisia facial traz bons resultados na correção do lagoftalmo e prevenção de complicações oculares. Palavras-chave: peso de ouro, lagoftalmo, paralisia facial.

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Section: Discussionunclassified

Uso de peso de ouro palpebral para correção do lagoftalmo em pacientes com paralisia facial

Testa

Aumond

Figueiredo

2002

Rev. Bras. Otorrinolaringol.

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“…Several materials, such as tantalum wire and mesh [9], have been used for lid loading, but gold has become the material of choice because of its inertness, high density and good color match for the skin [1,10].…”

Section: Discussionmentioning

confidence: 99%

“…These may include exposure of the eye, asymmetry of facial expression, and the inability to close the upper eyelid completely. Various methods of treatment for the management of lagophthalmos have been described, including the use of gold to weight the upper eyelid [1,10]. The popularity of this method is due to a number of reasons.…”

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confidence: 99%

Gold weights in facial paralysis (revisited)

et al. 1994

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A retrospective study of 11 patients with facial paralysis was undertaken. Correction of lagophthalmos was accomplished by inserting a dental gold weight into the upper eyelid. All weights were assessed and adjusted to fit the patient's individual need. The primary objective was to achieve adequate eyelid closure and corneal protection. The advantages and disadvantages we experienced with this procedure are discussed.Paralysis of the facial nerve causes a variety of functional and cosmetic disabilities. These may include exposure of the eye, asymmetry of facial expression, and the inability to close the upper eyelid completely. Various methods of treatment for the management of lagophthalmos have been described, including the use of gold to weight the upper eyelid [1, 10]. The popularity of this method is due to a number of reasons. Firstly, the surgical technique is relatively simple. Secondly, it can be performed under local or general anaesthesia, and thirdly, it is easily reversible if necessary.In order to accomplish a successful implantation, it is in our opinion essential that, in addition to the surgical technique, special care should be taken when assessing the desired form and weight of the implant preoperatively. To realize this goal, the assistance of a maxillofacial prosthodontist was requested. In this study, the results at our department with gold weight eyelid implantations are discussed. Material and methods Patients

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“…Lid loading of the upper eyelid after seventh and fifth cranial nerve palsies, first described in the English literature by Smellie 1 in 1966, is an accepted method for enhancing eyelid closure and corneal protection 1‐3 . Gold remains the material of choice for passive lid loading procedures owing to its high density, low reactivity, and good color match through the overlying skin 4 . Complications related to gold weight design initially included infection, migration, and extrusion.…”

Section: Introductionmentioning

confidence: 99%

Complications of Gold Weight Eyelid Implants for Treatment of Fifth and Seventh Nerve Paralysis

Dinces¹,

Mauriello²,

Kwartler³

et al. 1997

The Laryngoscope

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Complications occurred in six patients after gold weights were implanted into the upper eyelid tissues for fifth and seventh nerve palsies. These complications included implant infection without extrusion (in one patient); entropion with trichiasis and presumed inflammatory reaction to the gold weight material (in one patient); upper eyelid distortion and poor eyelid contour with corneal ulceration and scarring (in one patient); significant residual lagophthalmos with exposure keratitis (in one patient); and blepharoptosis obscuring the pupillary access (in two patients). Resolution of the complications required 1. implant removal in four of six patients without reinsertion of a second weight, 2. recession of the retractors of the upper eyelids with medial and lateral canthoplasty (in four patients), and 3. permanent tarsorrhaphy (in one patient). The authors conclude that complications may be minimized by careful preoperative determination of the optimum implant size, weight, and placement within the eyelid as well as meticulous attention to the surgical technique of implantation. The use of other eyelid protective procedures is often necessary to augment corneal protection especially in patients with combined fifth and seventh cranial nerve palsies. Endogenous implant infection without extrusion of the gold weight may be distinguished from presumed inflammation due to gold allergy by clinical response to antibiotics in the former and requirements of steroids or removal of the implant in the latter.

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Restoration of movement to the upper eyelid in facial palsy

Cited by 39 publications

References 1 publication

Uso de peso de ouro palpebral para correção do lagoftalmo em pacientes com paralisia facial

Uso de peso de ouro palpebral para correção do lagoftalmo em pacientes com paralisia facial

Gold weights in facial paralysis (revisited)

Complications of Gold Weight Eyelid Implants for Treatment of Fifth and Seventh Nerve Paralysis

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