Tarsal strip and suspension of the nasolabial fold, patients with facial paralysis, Ophthalmology Unit, Hospital de Especialidades Carlos Andrade Marín (in Spanish)

Abstract

INTRODUCTION. Facial paralysis and secondary paralytic ectropion are conditions that predispose to exposure keratopathy and ocular complications. The management of this pathology can be conservative or surgical. Surgical options include tarsorrhaphy, canthopexy, weight placement, etc. OBJECTIVE. To evaluate the efficacy of the surgical technique: tarsal strip and suspension of the nasolabial fold, for the reduction and resolution of ocular symptoms and ophthalmological complications in patients with paralytic ectropion secondary to facial paralysis. MATERIAL AND METHODS. Retrospective observational study with a population and a known sample of 8 participants, at the Carlos Andrade Marin Specialties Hospital in the period between January 2016 and December 2018. Inclusion criteria were patients with facial paralysis and paralytic ectropion, the information was taken from the medical records documented in the AS400 system. The data was analyzed using the statistical software International Business Machines Statistical Package for the Social Sciences, Version 25.0. RESULTS. The most common etiology was tumorous in 62.5% (5; 8). In the postoperative follow-up up to 6 months, we observed the resolution of the lagophthalmos, lacrimation, ocular burning and keratitis in 87.5% (7; 8); ectropion resolved in all patients and an improvement in hemifacial ptosis was achieved. Visual acuity improved with a gain of one or two lines in 75% (6; 8) of the patients. DISCUSSION: The technique allows to correct eyelid deformations with an improvement of the aesthetic appearance and facial symmetry, but our approach is towards the reduction of ocular symptoms and signs. CONCLUSIONS. The surgical technique of tarsal strip and suspension of the nasolabial fold was new and effective, applicable for the resolution of ocular symptoms and complications in patients with paralytic ectropion secondary to facial paralysis.