Surgical Management of the Paralyzed Eyelid

1993 ◽  
Vol 72 (10) ◽  
pp. 692-701 ◽  
Author(s):  
Monte S. Keen ◽  
John D. Burgoyne ◽  
Scott L. Kay
Keyword(s):  
Critical Analysis ◽  
Lower Eyelid ◽  
Facial Nerve Paralysis ◽  
Upper Eyelid ◽  
Nerve Paralysis ◽  
Eyelid Closure ◽  
Corneal Abrasion ◽  
Tarsal Plate ◽  
Analysis Of Results ◽  
Upper Lid

The most devastating sequelae of the facial nerve paralysis is the loss of eye lid function. The inability to blink, lubricate and protect the globe can lead to exposure keratitis, corneal abrasion and even the loss of vision. Eyelid closure is approximately 85% upper eyelid and 15% lower eyelid. In order to ensure adequate protection of the globe, deficiencies of both eyelids must be addressed. We report our experience with 20 patients with eyelid paralysis. Upper lid reanimation was performed by the placement of gold lid weights on the tarsal plate. Lower lid reanimation procedures included lateral canthopexy and horizontal lid shortening. A discussion of the above-mentioned procedures, the timing of the procedures and a critical analysis of results will be included. A comprehensive approach to the management of the paralyzed eye will be presented.

Determination of Palpebral Closure Using a Hall Sensor Magnet Pair

1994 ◽  
Vol 110 (2) ◽  
pp. 174-176 ◽  
Author(s):  
Steven R. Hamiel ◽  
Martin R. Tubach ◽  
Joel N. Bleicher ◽  
James C. Cronan
Keyword(s):  
Eye Movements ◽  
Human Subjects ◽  
Saccadic Eye Movements ◽  
Lower Eyelid ◽  
Hall Sensor ◽  
Facial Nerve Paralysis ◽  
Upper Eyelid ◽  
Nerve Paralysis ◽  
Eyelid Closure ◽  
Facial Prosthesis

A small device that can detect eyelid closure was designed using a Hall sensor and magnet. The ability of the sensor to differentiate blinks from saccadic motion is of vital interest in development of a device to alleviate complications of facial nerve paralysis. Twelve physically normal human subjects were used in this study. A small Hall sensor (3 × 2.5 × 1.1 mm), a device that detects magnetic fields, was attached to the lower eyelid near the lid margin, and an opposing small magnet (3 × 2 × 1 mm) was attached to the upper eyelid, also near the lid margin. Output potentials from the Hall sensor were monitored during eye blinks and saccadic eye movements to correlate sensor potentials with eye movements. Results indicate that the Hall sensor is effective at determining palpebral closure and discriminating eye closure from other eye movements. Therefore, we conclude that the Hall sensor is a reliable means for determining palpebral closure and is ideally suited for use in a facial prosthesis that uses the normal blink as a trigger to reanimate the contralateral paralyzed eyelid.

scholarly journals Schwannoma of upper eyelid: A rare differential diagnosis of eyelid swellings

2010 ◽  
Vol 43 (02) ◽  
pp. 213-215
Author(s):  
Surendra B. Patil ◽  
Satish M. Kale ◽  
Sumeet Jaiswal ◽  
Nishant Khare
Keyword(s):  
Differential Diagnosis ◽  
Lower Eyelid ◽  
Lateral Part ◽  
Upper Eyelid ◽  
Eyelid Skin ◽  
Rare Differential Diagnosis ◽  
History Of ◽  
Upper Lid ◽  
Painless Mass ◽  
Rare Benign Tumour

ABSTRACTSchwannoma is a relatively rare benign tumour of peripheral nerve origin. The occurrence of Schwannoma in eyelid is extremely rare. As per our knowledge, only 11 such cases have been reported in the literature so far. We present a case of a 40-year-old man who presented to us with a 2-year history of slowly enlarging, painless mass in his left upper lid with resultant progressive ptosis. Ocular examination was suggestive of a firm, non-tender nodule of size 2 × 1.5 × 1 cm on the left upper lid. The mass was non-adherent to the skin or the underlying tissue. The eyelid skin and conjunctiva were indurated and signs of inflammation were present. The lateral part of eyelid showed presence of an ulcer and the lid function was severely hampered. Provisional clinical diagnosis was that of an eyelid malignancy. With this in mind, the medial part of the lid was excised and reconstructed using a tarso-conjunctival flap from the lower eyelid in conjunction with a skin graft. The histopathology and immunohistochemistry established the diagnosis of Schwannoma. We recommend that Schwannoma be considered in the differential diagnosis of well-circumscribed eyelid swellings.

Method of eyelid closure in facial nerve paralysis

1982 ◽  
Vol 57 (5) ◽  
pp. 722-723 ◽  
Author(s):  
Ephraim I. Zlotnik ◽  
Arnold F. Smeyanovich ◽  
Eugene P. Tyappo
Keyword(s):  
Facial Nerve Paralysis ◽  
Total Removal ◽  
Nerve Paralysis ◽  
Content Type ◽  
Eyelid Closure ◽  
Prevention And Treatment ◽  
Acoustic Neurinomas ◽  
Conjunctival Inflammation ◽  
Subcutaneous Connective Tissue ◽  
Fine Print

✓ The authors present a method of temporary eyelid closure consisting of air inflation of the subcutaneous connective tissue. This method is effective for prevention and treatment of conjunctival inflammation due to facial paralysis developing after total removal of acoustic neurinomas.

Facial Nerve Paralysis: An Unrecognized Cause of Lower Eyelid Entropion in the Pediatric Population

2007 ◽  
Vol 23 (2) ◽  
pp. 126-129 ◽  
Author(s):  
Nonette Y. Pasco ◽  
Don O. Kikkawa ◽  
Bobby S. Korn ◽  
Karim G. Punja ◽  
Marilyn C. Jones
Keyword(s):  
Facial Nerve ◽  
Pediatric Population ◽  
Lower Eyelid ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis

scholarly journals Meibomian gland carcinoma of the lower eyelid: a rare case

2020 ◽  
Vol 8 (11) ◽  
pp. 4152
Author(s):  
Madhusmita Behera ◽  
Subhra Dhar
Keyword(s):  
Rare Case ◽  
Sebaceous Gland ◽  
Lower Eyelid ◽  
Meibomian Gland ◽  
Upper Eyelid ◽  
Tarsal Plate ◽  
Inappropriate Treatment ◽  
Gland Carcinoma ◽  
Meibomian Glands ◽  
Slow Growing

Meibomian gland carcinoma (MGC) is a rare but highly malignant slow growing tumor of the eyelid. MGC usually arises from meibomian gland located in the tarsal plate although rarely it can originates in the gland of zeis, sebaceous gland of caruncle, and periocular skin. MGC is more common in cases of elderly females. Upper eyelid is more commonly affected where the meibomian glands are more. Early diagnosis is very important but in most of the cases the diagnosis is delayed as it mimics chalazion or blepharo-conjunctivitis. This leads to inappropriate treatment and increase in morbidity and/or mortality. Special feature of this carcinoma is that it spread intra-epithelial and causes skipped lesions.

scholarly journals The analysis of complications due to the erroneous strategy of the surgical treatment of the upper lid ptosis

2016 ◽  
Vol 11 (2) ◽  
pp. 89-92 ◽  
Author(s):  
I. A Filatova ◽  
S. A Shemetov
Keyword(s):  
Surgical Treatment ◽  
Surgical Intervention ◽  
Levator Muscle ◽  
Clinical Group ◽  
Upper Eyelid ◽  
Incorrect Choice ◽  
Tarsal Plate ◽  
Short Period ◽  
Frontalis Suspension ◽  
Upper Lid

Objective. The purpose of the present study was to analyze the complications developing as a result of the application of the incorrect strategy of the surgical treatment of the upper lid ptosis. Material and methods. The analysis of the clinical material covers the period of 10 years. A total of 275 patients presenting with the upper lid ptosis underwent the surgical intervention. A separate clinical group consisting of 89 patients (32.4%) was distinguished, each having been previously operated from 1 to 4 times (m = 1.8) either without effect, with a poor effect, or suffering various complications. The age of the patients varied from 3 to 63 (mean 14.7 ± 5.3) years. The children (n = 61) accounted for 68.5% of the total number of the patients. All the patients underwent the surgical treatment consisting of the revision and cutting of the scar, the excision of inadequate “frontalis suspensions”, resection of the levator muscle, and frontalis sling suspension of the upper eyelid to a brow with the use of the mersilen mesh. Results. The analysis of the available clinical materials has demonstrated the following mistakes in the choice of the strategy of the surgical treatment of the upper lid ptosis: (1) Inadequate frontalis sling suspensions in 72.5% of the cases were performed. Nevertheless, the surgery of the suspension type was carried out in 38.3% of the cases of the mild and moderately severe ptosis when the levator function remained intact and sufficient. (2) In the majority of the patients, the technical errors resulting in inadequate “frontalis suspensions” took place, with the suspensions being either mistakenly fixed to the soft tissues of the upper eyelid or rigidly attached to the periosteum of the upper edge of the orbit rather than to the upper tarsal plate. Moreover, 21.4% of the patients presented with the cicatrices at the internal surface of the upper eyelids following frontalis suspension even though the surgical intervention envisaged neither the opening of the conjunctiva nor the resection of the tarsal plate. (3) The inadequate choice of a material for frontalis suspension (strings, rigid tapes, fishing line, and elastics). (4) The large number of repeated surgical interventions during a short period of time. In all the cases, the surgical treatment caused the improvement of the patients’ conditions as appeared from the reduction of the degree of ptosis, the better expression of the crease of the upper eye lid, and lagophthalmia of 1-3 mm. In addition, the mobility of the upper eyelids increased upon the resection of the levator muscle (m = 3.9 mm). In the presence of complications of the previous operations for the resection of the levator, its function also increased (m = 2.3 mm). Conclusion. The majority of the complications have been caused by the incorrect choice of the method for the surgical treatment of the upper lid ptosis which suggests the necessity of the differential approach to the diagnostics and surgical treatment of this pathological condition taking into consideration its cause and severity. Of primary importance is the choice of the treatment by the pathogenetically substantiated method.

A Modified Cutler-Beard Technique to manage Extensive Sebaceous Gland Carcinoma of Upper Eyelid

2016 ◽  
Vol 1 (4) ◽  
pp. 188-190
Author(s):  
Etti Goyal ◽  
Y Rizvi ◽  
Pranav Gupta
Keyword(s):  
Sebaceous Gland ◽  
The Elderly ◽  
Lower Eyelid ◽  
Sebaceous Gland Carcinoma ◽  
Upper Eyelid ◽  
Ear Cartilage ◽  
Upper Lid ◽  
Lid Reconstruction ◽  
Gland Carcinoma ◽  
Contralateral Eye

ABSTRACT Introduction Sebaceous gland carcinoma (SGC) is a rare tumor affecting the elderly, with a predisposition for females arising from the meibomian glands and occurring more commonly on the upper eyelid. Diagnosis is difficult because the tumor mimics chalazion or blepharitis. Sebaceous gland carcinoma has a mortality rate of about 5 to 10%. Aim To present a modified Cutler-Beard technique of lid reconstruction to manage a case of extensive SGC of upper lid. Materials and methods A 65-year-old male presented with a rapidly growing extensive mass of right upper eyelid (size 4.2 × 4 × 2.1 cm) causing mechanical ptosis. Histopathology confirmed the diagnosis as SGC. Wide excision of the lesion was performed sacrificing the whole upper eyelid. Lid reconstruction was done employing lower eyelid as per the bridged flap technique with the use of 4 mm silicon band to enhance lid stability. Patient achieved a satisfactory functional and cosmetic result following the second stage of the procedure. Conclusion Total loss of upper eyelid is often dealt with classical lid sharing technique of reconstruction first described by Cutler-Beard. For lid stability, use of tarsus from contralateral eye, ear cartilage has their attendant problems. A 4.0 silicon band was used to replace the sacrificed tarsus, achieving good results. How to cite this article Gupta P, Rizvi Y, Goyal E. A Modified Cutler-Beard Technique to manage Extensive Sebaceous Gland Carcinoma of Upper Eyelid. Int J Adv Integ Med Sci 2016;1(4):188-190.

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