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Sarah P. Wambier, Denny M. Garcia, Andre Messias, Antonio Augusto V. Cruz; Spontaneous Blink Kinematics in Paralytic Lagophthalmos After Upper Eyelid Cerclage With Autogenous Temporalis Fascia. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4873.
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To describe the effects of upper eyelid cerclage with autogenous temporalis fascia on spontaneous blink kinematics of patients with long-standing, unresolved unilateral facial nerve palsy.
Spontaneous blink of eight patients (5 males ranging in age from 27-69 years) with long-standing (median 120 months; range, 6 to 456 months) unresolved unilateral paralytic lagophthalmos were registered with magnetic search coil technique before and one month after upper eyelid cerclage with autogenous temporalis fascia. The etiology of the facial nerve palsy was removal of acoustic neuroma in 3 patients, Bell’s palsy in 2, congenital facial palsy in 1, radical mastoidectomy in 1, and radiotherapy after squamous cell carcinoma removal in 1 patient. During 5 minutes of video observation, two variables were measured: the blink rate of each patient, and the blink amplitude of normal and paralytic lid.
After surgery, the blink rate decreased from (median) 11.2 blinks/min to 10 blinks/min (p=0.0195; Wilcoxon Signed Rank). Blink amplitude increased in the paralytic lid from 1.65 degrees to 3.92 degrees (p=0.0236) (Figure 1). Furthermore, the ratio between the blink amplitude on the paralytic side and patients’ contralateral normal eyelid increased from 8.24% to 20.24% (p=0.0039).
Encircling the upper eyelid with autogenous fascia temporalis increased the eyelid blink amplitude substantially, and significantly decreased the spontaneous blink rate. The technique described in this research can be considered as an alternative for the prevention of severe corneal exposure frequently observed in facial palsy.
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