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Septal chondromucosal grafts in paralytic lagophthalmos
- Source :
- Journal of Plastic, Reconstructive & Aesthetic Surgery. 71:1352-1361
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Objective The risk of sight-threatening complications related to facial paralysis makes palpebral fissure management a priority. Surgery must take account of and adapt to the clinical signs of paralytic lagophthalmos. This therefore presupposes that a sufficient therapeutic arsenal is available. In this report, we propose a technique for palpebral lengthening (lower and/or upper), reconstructing the posterior lamella using a chondromucosal graft harvested from the nasal septum, combined with anterior lamellar repositioning. Patients and Method A 5-year single center retrospective study was conducted, including sixteen patients for a total of nineteen septal chondromucosal grafts. The only inclusion criterion was paralytic lagophthalmos. Functional ophthalmic deficits were recorded (main outcome measure), first preoperatively, then postoperatively. Additionally, the degree of lagophthalmos was measured in order to infer palpebral fissure elongation gain. Surgical consequences and complications were recorded. Results A rapid regression in functional ophthalmic deficits was observed in 87% of patients, improving in stability over time (mean follow-up interval of 34 months). Mean palpebral fissure elongation gain was 3 mm. 53% of patients suffered from complete occlusion of the palpebral fissure. Surgical consequences were uncomplicated. 38% of patients eventually underwent revision surgery. Conclusion Palpebral fissure lengthening using septal chondromucosal grafts serves as an alternative to existing treatment methods for paralytic lagophthalmos. Robust functional and cosmetic results, combined with very low morbidity, make this a simple and efficient technique whose indications may be extended.
- Subjects :
- Adult
Blepharoplasty
Male
medicine.medical_specialty
Time Factors
Lagophthalmos
Facial Paralysis
030230 surgery
Single Center
03 medical and health sciences
0302 clinical medicine
Complete occlusion
medicine
Nasal septum
Humans
Paralytic lagophthalmos
030223 otorhinolaryngology
Aged
Nasal Septum
Retrospective Studies
Aged, 80 and over
business.industry
Eyelids
Retrospective cohort study
Middle Aged
medicine.disease
Facial paralysis
Surgery
Nasal Mucosa
Treatment Outcome
Palpebral fissure
medicine.anatomical_structure
Eyelid Diseases
Female
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 17486815
- Volume :
- 71
- Database :
- OpenAIRE
- Journal :
- Journal of Plastic, Reconstructive & Aesthetic Surgery
- Accession number :
- edsair.doi.dedup.....bcd85aa0c19d3b02c7fb52eb6f34ba5f