Mediterr J Otol 2006:2(1): 9-13

Medial canthoplasty and platinum weight implant: strategy for prevention of ocular complications following facial palsy.

Roberto Filipo, Elio De Seta, Rocco Plateroti, Giorgio Balsamo, Annarita Vestri, Gian Antonio Bertoli

Department of Otolaryngology University of Rome, La Sapienza, Italy.  roberto.filipo@uniroma1.it

Objective: To evaluate medial canthoplasty and platinum-weight implant, intraoperatively or in an early postoperative period, when a negative prognosis in terms of facial function recovery is seen, to avoid serious ocular complications as a sequelae of neuro-otological surgery.

Materials and methods: Ninety-eight patients underwent surgery for otologic and neuro-otologic pathologies; 25 patients had persistent facial palsy and underwent medial canthoplasty and/or platinum-weight implant. The reliability of such techniques was evaluated via the measure of lagophthalmos through the area of scleral exposure before and after the operations.

Results: All patients showed a statistically significant reduction of scleral exposure after surgery, both with open and closed eyes. All patients reported subjective improved comfort after the oculoplastic procedures.

Conclusions: Intraoperative facial nerve function and an immediate postoperative clinical observation can predict the necessity of some oculoplastic procedures to prevent ocular complications caused by paretic lagophthalmos. Medial canthoplasty and platinum-weight implant are effective procedures for preventing ocular damage in facial palsy.