Surgical Treatment of Facial Nerve Involvement Caused by Leprosy

Abstract

Complete and partial nerve paralysis can result from leprosy. The latter is more prevalent and results in lagophthalmos and corneal hypoesthesia. The former is characterized by loss of facial expression, deviation of the face to the nonparalyzed side, difficulty in chewing, and drooling, in addition to lagophthalmos and corneal hypoesthesia. Affected patients are at risk to develop blindness, as well as suffering social and economic deprivation because of the effects of facial nerve paralysis. Prevention of blindness and amelioration of the latter were successfully achieved by muscle transfer procedures, temporalis transfer to the eyelid, and masseter transfer to the mouth and nasolabial fold in small, minimally equipped hospitals in Africa.

Ocular Leprosy: A Case Report and Discussion of the Pathology

“…Temporalis muscle transfer to the lower lid allows a more physiological correction of the deformity by producing a voluntary lid closure. 17, 18 Eyebrow madarosis, if partial, may be corrected with cosmetics. A free graft of hairbearing post-mastoid skin may be used to correct total eyebrow loss.…”