April 05, 2018
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Improvements reported in patients with facial paralysis who undergo lateral eyelid coupling

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Coupling of the lateral eyelid in patients with flaccid facial paralysis and paralytic ectropion improved ocular symptoms, eyelid appearance and quality of life, according to a study.

Researchers evaluated patient-reported outcomes and photograph analysis of 16 patients with flaccid facial paralysis who underwent a single-stage tarsal strip canthoplasty and modified tarsoconjunctival flap to correct eyelid malposition.

The researchers did not develop the technique of coupling the upper and lower eyelids together, but found it to be an effective way to help patients with facial paralysis, Travis T. Tollefson, MD, study co-author, told Healio.com/OSN.

“When the facial muscles do not function due to paralysis, the eyelids do not close properly. The health of the eye itself depends on staying moist with tears and protection from a blinking eyelid. When the eye doesn’t blink properly, it can be painful and lead to dangerous exposure to the outside air, which can lead to injury to the cornea. The hybrid tarsoconjunctival flap, along with traditional lower eyelid tightening, has been an effective surgical method to improve eye-related symptoms in patients with facial paralysis,” he said.

Epiphora, the most commonly reported symptom, was significantly reduced from 75% before surgery to 25% after surgery. Lagophthalmos and scleral show also experienced significant reductions. The Moe Ectropion Grading Scale was used before and after surgery, and 88% of patients experienced a decrease to a score of 2 or less.

Additionally, mean lacrimal scores improved to 47.5 from 37.5, but the improvement was not statistically significant. Complete quality of life Facial Clinimetric Evaluation questionnaires were available for 10 patients, all reporting improvements in mean eye comfort scores. – by Robert Linnehan

Disclosures: The authors report no relevant financial disclosures.