The effects of using spacer grafts on lower-eyelid retraction surgery in patients with facial nerve palsy

Purpose To evaluate the effects of the concomitant use of spacer grafts in lateral tarsal strip surgery in patients with facial nerve palsy-related lower-eyelid retraction. Methods Patients who underwent lateral tarsal strip surgery to correct facial nerve palsy-related lower-eyelid retraction were retrospectively reviewed. Postoperative decreases in marginal reflex distance-2 values at 1, 2 and 6 months were measured along with the effects of spacer grafts. Results Forty-five patients (28 males) were included (mean age: 59.56 years). Mean preoperative marginal reflex distance-2 was 6.87 ± 1.34 mm. Twenty patients underwent lateral tarsal strip surgery only (lateral tarsal strip-only); 25 patients underwent lateral tarsal strip surgery using spacer grafts (lateral tarsal strip + graft). Median (interquartile range) follow-up duration was 12.0 (6.0–23.0) months. Retraction was significantly improved and maintained at 1, 2 and 6 months postoperatively in all patients (mean marginal reflex distance-2: 3.78 ± 1.06 mm, 4.30 ± 1.23 mm and 4.72 ± 1.11 mm, respectively). Surgical outcomes were significantly better in the lateral tarsal strip + graft than in the lateral tarsal strip-only group (Δmarginal reflex distance-2: 3.92 vs. 2.05 mm at 1 month, p < 0.001; 3.38 vs. 1.61 mm at 2 months, p = 0.001; 2.88 vs. 1.69 at 6 months, p = 0.042). Subgroup analyses by spacer graft type revealed no significant differences. Conclusion The concomitant use of spacer material in lateral tarsal strip surgery yielded better surgical outcomes than lateral tarsal strip surgery alone. The use of spacer grafts should be considered for correcting severe facial nerve palsy-related lower-eyelid retraction.

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Subperiosteal Midface Lift: Its Role in Static Lower Eyelid Reconstruction after Chronic Facial Nerve Palsy

Orbit ◽

10.3109/01676830.2011.574770 ◽

2011 ◽

Vol 30 (3) ◽

pp. 140-144 ◽

Cited By ~ 9

Author(s):

Carlo Graziani ◽

Claudio Panico ◽

Giovanni Botti ◽

Richard J. Collin

Keyword(s):

Facial Nerve ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Lower Eyelid ◽

Eyelid Reconstruction ◽

Lower Eyelid Reconstruction ◽

Midface Lift

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Outcomes of lower eyelid retractor recession and lateral horn lysis in lower eyelid elevation for facial nerve palsy

Eye ◽

10.1038/eye.2017.174 ◽

2017 ◽

Vol 32 (2) ◽

pp. 338-344 ◽

Cited By ~ 3

Author(s):

P Tan ◽

J Wong ◽

W F Siah ◽

R Malhotra

Keyword(s):

Facial Nerve ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Lower Eyelid ◽

Lateral Horn

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Potential association between recurrent facial nerve palsy and migraines

The Journal of Laryngology & Otology ◽

10.1017/s0022215120001905 ◽

2020 ◽

Vol 134 (9) ◽

pp. 822-825

Author(s):

G Kontorinis ◽

A Tyagi

Keyword(s):

Facial Nerve ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Case Series ◽

Contralateral Side ◽

Tertiary Referral Centre ◽

Potential Association ◽

Motor Neuron Facial Nerve ◽

Prospective Case Series

AbstractObjectiveThis study aimed to investigate the possible association between recurrent facial nerve palsy and migraines.MethodThis study was a prospective case series with a two-year follow-up at an academic, tertiary referral centre and included patients with at least four episodes of recurrent lower motor neuron facial nerve palsy. All patients underwent standardised diagnostic tests.ResultsFour patients fulfilled the inclusion criteria. The patients were all female with an average age at presentation of 40.75 years (range, 33–60 years) and an average age at the initial episode of 14 years (range, 12–16 years). The number of episodes varied between six and nine. All patients had at least one episode of facial nerve palsy on the contralateral side. Two patients were diagnosed and treated for migraine with aura remaining asymptomatic following prophylactic medication for migraines.ConclusionThe results raise the possibility of an association between recurrent facial nerve palsy and migraines. Prospective studies in patients with even fewer episodes of facial nerve palsy could shed more light on this association.

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03 / PERIPHERAL FACIAL NERVE PALSY IN CHILDREN IN A BORRELIA HIGH ENDEMIC AREA: EPIDEMIOLOGY AND EVALUATION OF CLINICAL RECOVERY A RETROSPECTIVE ONE-YEAR FOLLOW UP

10.26226/morressier.5ad774d9d462b80296ca6641 ◽

2018 ◽

Author(s):

Sigurdur Arnason

Keyword(s):

Facial Nerve ◽

Endemic Area ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Clinical Recovery ◽

Peripheral Facial Nerve Palsy ◽

One Year

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Nervus intermedius dysfunctions after vestibular schwannoma surgery: a prospective clinical study

Journal of Neurosurgery ◽

10.3171/2018.4.jns1818 ◽

2019 ◽

Vol 131 (2) ◽

pp. 555-560 ◽

Cited By ~ 1

Author(s):

Hussam Metwali ◽

Katja Kniese ◽

Babak Kardavani ◽

Venelin Gerganov ◽

Madjid Samii

Keyword(s):

Facial Nerve ◽

Prospective Study ◽

Vestibular Schwannoma ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Nasal Secretion ◽

Prospective Clinical Study ◽

Taste Sensation ◽

Nervus Intermedius

OBJECTIVEThe purpose of this prospective study was to evaluate the dysfunction of the nervus intermedius (NI) after vestibular schwannoma (VS) surgery. The authors present a clinically feasible method for this purpose.METHODSIn this prospective study, the authors included 30 patients who underwent surgery at the International Neuroscience Institute between May 2014 and February 2017 for resection of VS. The patients’ taste sensation was examined using taste strips. Lacrimation was tested using the Schirmer I test. The clinical evaluation was performed before surgery and repeated at 2 weeks and at 6 months after surgery as well as during the follow-up, which extended up to 2 years. The authors tested the correlation between the NI dysfunctions and the House-Brackmann grade of facial nerve palsy.RESULTSThe taste sensation was lost on the side of surgery in 2 patients (6.6%) and decreased in 4 patients (13.3%). The disturbance of taste sensation was not statistically correlated with dysfunctions of the motor portion of the facial nerve. The taste impairment resolved in 4 patients within 6 months, but 2 patients suffered from persistent loss of the taste sensation on the side of surgery during the follow-up. In 23 patients (76.6%), the baseline lacrimation was lower on the side of surgery, and it was significantly correlated with outcome for dysfunctions of the motor portion of the facial nerve. During the follow-up, baseline lacrimation improved in correlation with the improvement in the dysfunctions of the motor portion of the facial nerve. None of the patients reported change in salivation or nasal secretion.CONCLUSIONSThe NI can be affected after VS surgery. The disturbance of baseline lacrimal secretion was correlated with dysfunctions of the motor portion of the facial nerve. However, the disturbance of the taste sensation was not correlated with the grade of facial nerve palsy. Dysfunctions of the NI should be evaluated and separately reported while analyzing facial nerve outcome after VS surgery.

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Müllerectomy for Upper Eyelid Retraction and Lagophthalmos Due to Facial Nerve Palsy

Archives of Ophthalmology ◽

10.1001/archopht.123.9.1221 ◽

2005 ◽

Vol 123 (9) ◽

pp. 1221 ◽

Cited By ~ 13

Author(s):

Adam S. Hassan

Keyword(s):

Facial Nerve ◽

Nerve Palsy ◽

Facial Nerve Palsy ◽

Eyelid Retraction ◽

Upper Eyelid ◽

Upper Eyelid Retraction

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Hypoglossal-Facial Anastomosis for Facial Nerve Reconstruction: Outcomes using the Side-to-End Surgical Technique

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0040-1718431 ◽

2020 ◽

Author(s):

Leonardo Gilmone Ruschel ◽

Joel Sanabria Duarte ◽

Jonathan De La Cruz ◽

Kristel Back Merida ◽

Gustavo Fabiano Nogueira ◽

...

Keyword(s):

Facial Nerve ◽

Nerve Palsy ◽

Hypoglossal Nerve ◽

Facial Nerve Palsy ◽

Nerve Transection ◽

Nerve Reconstruction ◽

Posterior Fossa Tumors ◽

Swallowing Problems ◽

Facial Nerve Reconstruction

Abstract Introduction The side-to-end hypoglossal-facial anastomosis (HFA) technique is an excellent alternative technique to the classic end-terminal anastomosis, because it may decrease the symptoms resulting from hypoglossal-nerve transection. Methods Patients with facial nerve palsy (House-Brackmann [HB] grade VI) requiring facial reconstruction from 2014 to 2017were retrospectively included in the study. Results In total, 12 cases were identified, with a mean follow-up of 3 years. The causes of facial paralysis were due to resection of posterior-fossa tumors and trauma. There was improvement in 91.6% of the patients (11/12) after the HFA. The rate of improvement according to the HB grade was as follows: HB III - 58.3%; HB IV - 16.6%; and HB II - 16.6%. The first signs of improvement were observed in the patients with the shortest time between the paralysis and the anastomosis surgery (3.5 months versus 8.5 months; p = 0.011). The patients with HB II and III had a shorter time between the diagnosis and the anastomosis surgery (mean: 5.22 months), while the patients with HB IV and VI had a longer time of paresis (mean: 9.5 months; p = 0.099). We did not observe lingual atrophy or changes in swallowing. Discussion and Conclusion Hypoglossal-facial anastomosis with the terminolateral technique has good results and low morbidity in relation to tongue motility and swallowing problems. The HB grade and recovery appear to be better in patients operated on with a shorter paralysis time.

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