Experience with the gold weight and palpebral spring in the management of paralytic lagophthalmos.

Abstract:

BACKGROUND:The loss of the blink reflex and the ability to close the eye actively are disabling functional and aesthetic impairments common to patients with facial paralysis. Nonphysiologic (static) management techniques involve implantation of devices in the upper eyelid that mechanically aid eye closure. The most popular devices are the gold weight and the palpebral spring. The authors' experience with these devices is presented. METHODS:Thirty-nine patients treated for paralytic lagophthalmos by the senior author (J.K.T.) between 1987 and 2002 met the inclusion criteria. Eighteen patients received the gold weight and 21 received the palpebral spring. From standardized video records, preoperative and postoperative blink scores were calculated. RESULTS:Fifty-nine percent of the patients (23 of 39) were female, and the most common cause for facial paralysis [35.9 percent (14 of 39)] was extirpation of acoustic neuroma and other cerebellopontine lesions. Fifty percent of the gold weight cohort was younger than 20 years at the time of surgery, with almost 40 percent (seven of 18) younger than 10 years. In the palpebral spring group, 14.3 percent (three of 21) were younger than 20 years, with 4.8 percent (one of 21) younger than 10 years. The palpebral spring group obtained a larger postoperative mean blink score of 34.0 +/- 12.4 percent compared with the gain of 21.4 +/- 14.6 percent (p = 0.025) by the gold weight group. CONCLUSION:The gold weight and palpebral spring are both effective in restoring motion to the paretic upper eyelid, but the palpebral spring is more so despite the frequent need for revisions.

journal_name

Plast Reconstr Surg

authors

Terzis JK,Kyere SA

doi

10.1097/01.prs.0000299919.18076.b4

subject

Has Abstract

pub_date

2008-03-01 00:00:00

pages

806-815

issue

3

eissn

0032-1052

issn

1529-4242

pii

00006534-200803000-00013

journal_volume

121

pub_type

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