COMBINATION OF HIGH POROUS POLYETHYLENE LOWER EYELID SPACERS AND LATERAL TARSAL-STRIP PROCEDURE FOR RECONSTRUCTION OF EYELID CLOSURE FUNCTION IN PARALYTIC LAGOPHTHALMUS AFTER FACIAL PALSY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANGYang ¹ , CHENShaochun ⁴ , SUNTao ² ,  ZHANGFan ³

1. the First Affiliated Hospital of Kunming Medical University Department of Ophthalmology, Kunming Yunnan, 650032, P. R. China;
2. the First Affiliated Hospital of Kunming Medical University Department of Neurosurgery, Kunming Yunnan, 650032, P. R. China;
3. Department of Otolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P. R. China;
4. Department of Anatomy and Histoembryologye, Kunming Medical University;

Corresponding?author：

ZHANGFan, Email: sailzh@263.net

Keywords：

High porous polyethylene lower eyelid spacer; Lateral tarsal-strip procedure; Facial palsy; Lagophthalmus

DOI：

10.7507/1002-1892.20140050

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Objective To evaluate the effectivness of using high porous polyethylene lower eyelid spacers (Medpor LES) combined with the lateral tarsal-strip procedure for reconstruction of the eyelid closure function in paralytic lagophthalmus after facial palsy. Methods Between March 2008 and December 2012, 32 patients (32 eyelids) with hypophasis in facial palsy which all sorts of causes lead to were treated with Medpor LES combined with the lateral tarsal-strip procedure. Of 32 cases, 20 were male and 12 were female, aged from 20 to 72 years (mean, 46.8 years). The left eye was involved in 18 cases and the right eye in 14 cases with a disease duration of 1.5 months to 2 years (mean, 4.4 months). All the patients were shown as lower eyelid ectropion, lower eyelid retraction, exposure keratitis, and corneal ulcer, but no obvious upper eyelid retraction was observed. Results Primary healing of incision was obtained in all patients. The edema time of the eyelid was from 5 days to 3 weeks (mean, 2 weeks). Conjunctival edema appeared in 4 cases after 2 weeks of operation, which was cured after expectant treatment. The patients were followed up 5-8 months (mean, 6 months). At 1 week, 3 and 6 months after operation, the height of palpebral fissure was reduced, and the degree of lagophthalmus and low eyelid retraction were significantly corrected (P<0.05), but no significant difference among different time points after operation (P>0.05). Outer canthus displacement occurred in 3 cases at 1 month postoperatively, and was cured after the lateral tarsal strip procedure. No lower eyelid ectropion, corneal exposure, or Medpor LES displacement and exposure occurred during follow-up. Conclusion Medpor LES combined with the lateral tarsal-strip procedure has good effectiveness for reconstruction of eyelid closure function in most cases of paralytic lagophthalmus after facial palsy.

Citation： ZHANGYang, CHENShaochun, SUNTao, ZHANGFan. COMBINATION OF HIGH POROUS POLYETHYLENE LOWER EYELID SPACERS AND LATERAL TARSAL-STRIP PROCEDURE FOR RECONSTRUCTION OF EYELID CLOSURE FUNCTION IN PARALYTIC LAGOPHTHALMUS AFTER FACIAL PALSY. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(2): 233-236. doi: 10.7507/1002-1892.20140050 Copy

1.	Amer TA,El-Minawi HM,El-Shazly MI.Low-level versus high-level placement of gold plates in the upper eyelid in patient with facial palsy.Clin Ophthalmol,2011,5:891-895.
2.	Egemen O,Ozkaya O,Uscetin I,et al.Covering the gold weight with fascia lata graft in paralytic lagophthalmos patients.Br J Oral Maxillofac Surg,2012,50(4):369-372.
3.	Braun T,Batran H,Zengel P,et al.Surgical rehabilitation of paralytic lagophthalmus by platinum chain lid loading:focusing on patient benefit and health-related quality of life.Otol Neurotol,2012,33(9):1630-1634.
4.	Guillou-Jamard MR,Labbé D,Bardot J,et al.Paul Tessier's technique in the treatment of paralytic lagophthalmos by lengthening of the levator muscle:evaluation of 29 cases.Ann Plast Surg,2011,67(6):S31-S35.
5.	Chung JE,Yen MT.Midface lifting as an adjunct procedure in ectropion repair.Ann Plast Surg,2007,59(6):635-640.
6.	邢斌.麻痹性下瞼外翻的臨床治療.中外醫療,2013,5(15):78-80.
7.	Mavrikakis I,Francis N,Poitelea C,et al.Medpor lower eyelid spacer:does it biointegrate? Orbit,2009,28(1):58-62.
8.	Michaelidou M,Tzou CH,Gerber H,et al.The combination of muscle transpositions and static procedures for reconstruction in the paralyzed face of the patient with limited life expectancy or who is not a candidate for free muscle transfer.Plast Reconstr Surg,2009,123(1):121-129.
9.	Terzis JK,Karypidis D.Blink restoration in adult facial paralysis.Plast Reconstr Surg,2010,126(1):126-139.
10.	朱惠敏,孫英,徐乃江,等.高密度多孔聚乙烯下瞼植片在下瞼退縮中的應用.中國實用眼科雜志,2006,24(8):836-838.
11.	Graziani C,Panico C,Botti G,et al.Subperiosteal midface lift:its role in static lower eyelid reconstruction after chronic facial nerve palsy.Orbit,2011,30(3):140-144.
12.	Pirrello R,D'Arpa S,Moschella F.Static treatment of paralytic lagophthalmos with autogenous tissues.Aesthetic Plast Surg,2007,31(6):725-731.
13.	Schittkowski MP,Fichter N,Guthoff RF.Autogenous tarsus transplant as spacer for treatment of lower lid retraction in Grave's disease.Klin Monbl Augenheilkd,2008,225(8):708-712.
14.	陳濤,李冬梅,秦毅,等.自體硬腭黏膜移植治療下瞼退縮.眼科,2008,17(3):175-177.
15.	李雙,姜發綱,陳宏,等.Medpor下瞼插片與異體鞏膜植入治療下瞼退縮.國際眼科雜志,2012,12(7):1396-1398.
16.	Lee YJ,Khwarg SI.Polytetrafluoroethylene as a spacer graft for the correction of lower eyelid retraction.Korean J Ophthalmol,2005,19(4):247-251.
17.	李冬梅,陳濤,趙穎,等.Medpor下瞼插片植入治療下瞼退縮.眼科,2005,14(6):383-385.
18.	Altieri M.The advantages of lateral tarsal strip procedure.J Surg Tech Case Rep,2010,2(2):63.
19.	Razfar A,Afifi AM,Manders EK,et al.Ocular outcomes after gold weight placement and facial nerve resection.Otolaryngol Head Neck Surg,2009,140(1):82-85.

1. Amer TA,El-Minawi HM,El-Shazly MI.Low-level versus high-level placement of gold plates in the upper eyelid in patient with facial palsy.Clin Ophthalmol,2011,5:891-895.
2. Egemen O,Ozkaya O,Uscetin I,et al.Covering the gold weight with fascia lata graft in paralytic lagophthalmos patients.Br J Oral Maxillofac Surg,2012,50(4):369-372.
3. Braun T,Batran H,Zengel P,et al.Surgical rehabilitation of paralytic lagophthalmus by platinum chain lid loading:focusing on patient benefit and health-related quality of life.Otol Neurotol,2012,33(9):1630-1634.
4. Guillou-Jamard MR,Labbé D,Bardot J,et al.Paul Tessier's technique in the treatment of paralytic lagophthalmos by lengthening of the levator muscle:evaluation of 29 cases.Ann Plast Surg,2011,67(6):S31-S35.
5. Chung JE,Yen MT.Midface lifting as an adjunct procedure in ectropion repair.Ann Plast Surg,2007,59(6):635-640.
6. 邢斌.麻痹性下瞼外翻的臨床治療.中外醫療,2013,5(15):78-80.
7. Mavrikakis I,Francis N,Poitelea C,et al.Medpor lower eyelid spacer:does it biointegrate? Orbit,2009,28(1):58-62.
8. Michaelidou M,Tzou CH,Gerber H,et al.The combination of muscle transpositions and static procedures for reconstruction in the paralyzed face of the patient with limited life expectancy or who is not a candidate for free muscle transfer.Plast Reconstr Surg,2009,123(1):121-129.
9. Terzis JK,Karypidis D.Blink restoration in adult facial paralysis.Plast Reconstr Surg,2010,126(1):126-139.
10. 朱惠敏,孫英,徐乃江,等.高密度多孔聚乙烯下瞼植片在下瞼退縮中的應用.中國實用眼科雜志,2006,24(8):836-838.
11. Graziani C,Panico C,Botti G,et al.Subperiosteal midface lift:its role in static lower eyelid reconstruction after chronic facial nerve palsy.Orbit,2011,30(3):140-144.
12. Pirrello R,D'Arpa S,Moschella F.Static treatment of paralytic lagophthalmos with autogenous tissues.Aesthetic Plast Surg,2007,31(6):725-731.
13. Schittkowski MP,Fichter N,Guthoff RF.Autogenous tarsus transplant as spacer for treatment of lower lid retraction in Grave's disease.Klin Monbl Augenheilkd,2008,225(8):708-712.
14. 陳濤,李冬梅,秦毅,等.自體硬腭黏膜移植治療下瞼退縮.眼科,2008,17(3):175-177.
15. 李雙,姜發綱,陳宏,等.Medpor下瞼插片與異體鞏膜植入治療下瞼退縮.國際眼科雜志,2012,12(7):1396-1398.
16. Lee YJ,Khwarg SI.Polytetrafluoroethylene as a spacer graft for the correction of lower eyelid retraction.Korean J Ophthalmol,2005,19(4):247-251.
17. 李冬梅,陳濤,趙穎,等.Medpor下瞼插片植入治療下瞼退縮.眼科,2005,14(6):383-385.
18. Altieri M.The advantages of lateral tarsal strip procedure.J Surg Tech Case Rep,2010,2(2):63.
19. Razfar A,Afifi AM,Manders EK,et al.Ocular outcomes after gold weight placement and facial nerve resection.Otolaryngol Head Neck Surg,2009,140(1):82-85.

Chinese Journal of Reparative and Reconstructive Surgery

COMBINATION OF HIGH POROUS POLYETHYLENE LOWER EYELID SPACERS AND LATERAL TARSAL-STRIP PROCEDURE FOR RECONSTRUCTION OF EYELID CLOSURE FUNCTION IN PARALYTIC LAGOPHTHALMUS AFTER FACIAL PALSY

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