Ocular outcomes after gold weight placement and facial nerve resection
AUTHOR CONTRIBUTIONS Ali Razfar, data collection, writing; Ahmed M. Afifi, data collection; Ernest K. Manders, data collection; Eugene N. Myers, data collection; Jonas T. Johnson, data collection; Robert L. Ferris, data collection; Frederic W.-B. Deleyiannis, data collection, writing.
FINANCIAL DISCLOSURE None.
Presented at the 2008 Annual Meeting of the American Academy of Otolaryngology–Head and Neck Surgery in Chicago, Illinois.
Abstract
OBJECTIVE
To assess the effectiveness of acute gold weight placement after facial nerve resection and to determine the role of concomitant lower eyelid procedures.
STUDY DESIGN
Retrospective review.
SUBJECTS AND METHODS
Twenty-two patients who received an upper eyelid gold weight at the time of parotidectomy and facial nerve resection were reviewed to assess ocular outcomes.
RESULTS
After gold weight placement, twelve patients (12 of 22, 54.5%) subsequently presented with symptomatic ectropion (n = 9) and/or lagophthalmos (n = 5). Nine patients received a lower eyelid procedure (7 tarsal strips only, 1 tarsal strip combined with a lateral tarsorrhaphy, and 1 lateral tarsorrhaphy only). Six patients, in addition to a gold weight, also underwent a static sling to the midface at the time of facial nerve resection. None of these 6 received a subsequent lower eyelid procedure. Two patients required gold weight upsizing. Two patients required weight removal.
CONCLUSIONS
Insertion of 1.2 gm upper eyelid weight with placement of midface sling is recommended at the time of facial nerve resection. Due to the need to tighten the lower eyelid in many of these patients, we now also consider performing a tarsal strip procedure at the time of facial nerve resection in any patient with pre-existing lower lid laxity.
