Transnasal tendon suspension for the paralyzed lower eyelid

J Plast Reconstr Aesthet Surg. 2015 Aug;68(8):1072-8. doi: 10.1016/j.bjps.2015.04.008. Epub 2015 Apr 20.

Abstract

Background: Paralytic ectropion is a significantly functional and esthetic problem leading to problems with lacrimation, corneal exposure, and poor palpebral closure. Limitations with traditional corrective procedures include poor apposition of the lid to the globe, suboptimal medial canthal position, and high recurrence rates.

Objective: The objective of this study was to develop a technique of lower-lid suspension using transnasal wiring for the long-term maintenance of lid position.

Methods: Twenty-three consecutive patients with complete unilateral facial nerve paralysis underwent the procedure, and they were followed up for a median of 27 months (1-73 months).

Results: Fifteen of 18 patients maintained their intraoperative lower-lid position beyond the 12-month follow-up. Three patients had a minimal scleral show at 3 months. One of these patients also developed lid laxity seen on the snap test. No perioperative complications were experienced.

Conclusions: Transnasal wiring of the lower-lid tendon suspension provides consistent results that are maintained over time.

Keywords: Ectropion; Facial paralysis; Facial reanimation; Lower-lid suspension; Static reanimation; Transnasal wiring.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blepharoplasty
  • Ectropion / etiology
  • Ectropion / surgery*
  • Eyelids / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Ophthalmoplegia / complications
  • Ophthalmoplegia / surgery*
  • Tendons / transplantation*
  • Young Adult