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Customised gold weight eyelid implantation in paralytic lagophthalmos

Published online by Cambridge University Press:  03 March 2008

N Jayashankar*
Affiliation:
Skull Base Group, Dr Balabhai Nanavati Hospital and Medical Research Centre, Mumbai, India
K P Morwani
Affiliation:
Skull Base Group, Dr Balabhai Nanavati Hospital and Medical Research Centre, Mumbai, India
M J Shaan
Affiliation:
Skull Base Group, Dr Balabhai Nanavati Hospital and Medical Research Centre, Mumbai, India
S R Bhatia
Affiliation:
Skull Base Group, Dr Balabhai Nanavati Hospital and Medical Research Centre, Mumbai, India
K T Patil
Affiliation:
Skull Base Group, Dr Balabhai Nanavati Hospital and Medical Research Centre, Mumbai, India
*
Address for correspondence: Dr Narayan Jayashankar, Narayan Clinic, 14-A Road, Ahinsa Marg, Khar West, Mumbai 400 052, India. Fax: +91 22 2600 5520 E-mail: drnarayanj@gmail.com

Abstract

Gold eyelid implantation is widely considered the procedure of choice to reanimate the upper eyelid in paralytic lagophthalmos. Commercially supplied implants are not readily available in all places and are sometimes cumbersome to import.

Objective:

We aimed to devise a method whereby every surgeon performing gold eyelid implantation could have easy and quick access to the implant. Furthermore, we aimed to develop a means of creating an implant of the exact weight required for complete eyelid closure.

Study design and setting:

A prospective study was performed from 1997 to 2005 in a tertiary research hospital, involving 50 subjects requiring gold upper eyelid implantation and using the technique in question.

Results:

Only patients with a minimum follow up of one year were included in the study group. Symptoms improved in 96 per cent of subjects, who were able to dispense with eyedrops and eye ointments. Visual acuity improved in 92 per cent of patients. There were two extrusions amongst the early cases.

Conclusion and significance:

Customised gold eyelid implantation offers an alternative in regions where commercial implants are not easily obtained.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2008

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Footnotes

Presented at the Otology, Neurotology and Lateral Skull Base Surgery Workshop, 23–25 December, 2006, January 2007 Mumbai, India.

References

1 Sheehan, JE. Progress in correction of facial palsy with tantalum wire and mesh. Surgery 1950;27:122–5Google ScholarPubMed
2 Morel-Faio, D, Lalardrie, JP. Palliative surgical treatment of facial paralysis. The palpebral spring. Plast Reconstr Surg 1964;33:446–56Google Scholar
3 Levine, RE. Lid reanimation with the palpebral spring. In: Tse, D, Wright, K, eds. Oculoplastic Surgery. Philadelphia: Lippincott, 1992Google Scholar
4 May, M. Gold weight and wire spring implants as alternatives to tarsorrhaphy. Arch Otolaryngol Head Neck Surg 1987;113:656–60CrossRefGoogle ScholarPubMed
5 Smellie, GD. Restoration of the blinking reflex in facial palsy by a simple lid-load operation. Brit J Plast Surg 1966;19:279–83CrossRefGoogle ScholarPubMed
6 Jobe, RP. A technique for lid loading in the management of the lagophthalmos of facial palsy. Plast Reconstr Surg 1974;53:2931CrossRefGoogle ScholarPubMed
7 Barclay, TL, Roberts, AC. Restoration of movement to the upper eyelid in facial palsy. Brit J Plast Surg 1969;22:257–61CrossRefGoogle Scholar
8 Kartush, JM, Linstrom, CJ, McCann, PM, Graham, MD. Early gold weight eyelid implantation for facial paralysis. Otolaryngol Head Neck Surg 1990;103:1016–23CrossRefGoogle ScholarPubMed
9 Linder, TE, Pike, VE, Linstrom, CJ. Early eyelid rehabilitation in facial nerve paralysis. Laryngoscope 1996;106:1115–18CrossRefGoogle ScholarPubMed
10 Tucker, SM, Santos, PM. Survey: management of paralytic lagophthalmos and paralytic ectropion. Otolaryngol Head Neck Surg 1999;120:944–5CrossRefGoogle ScholarPubMed
11 Chepeha, DB, Yoo, J, Birt, C, Gilbert, RW, Chen, J. Prospective evaluation of eyelid function with gold weight implant and lower eyelid shortening for facial paralysis. Arch Otolaryngol Head Neck Surg 2001;127:299303CrossRefGoogle ScholarPubMed
12 Harrisberg, BP, Singh, RP, Croxson, GR, Taylor, RF, McCluskey, PJ. Long term outcome of gold eyelid weights in patients with facial nerve palsy. Otol Neurotol 2001;22:397400CrossRefGoogle ScholarPubMed