[New methods for the treatment of loss of eyelid closure in reversible facial paralysis]. / Neue Methoden zur Behandlung des fehlenden Lidschlusses bei reversibler Fazialisparese.

ABSTRACT

BACKGROUND: For prophylaxis or therapy of lagophthalmic keratopathy ointment application or hour glass dressing is indicated. The hour glass dressing has the disadvantage of a continuous visual impairment by steaming up of the moisture chamber. The main problem for the patients is the strong subjective feeling of physical handicap. A therapeutic alternative is the gravity dependent lidloading, which is known as gold implantation in cases of irreversible lagophthalmos. METHODS AND PATIENTS By lead weights of 0.8 to 2.0 g, which are fixed to the upper lid by a foil glueing on both sides (Tesafix) or in allergic patients by an adhesive layer, well tolerated by the skin (Combihesive), the lidclosure can become restored without impairment of lid-opening. In a controlled study the described method was first tested on 10 normal persons and than applied to 22 patients with lagophthalmos. Meanwhile the new method was applied to 32 further patients. RESULTS: The "liddynamic" procedure is effective and well tolerated; it is more accepted, especially during the day, because of better visual function and better cosmetics. The hour glass dressing, is still of importance in serious cases of keratopathy during the night. CONCLUSION: "lidloading" with lead weights, which are glued by an adhesive layer to the upper lid, can be recommended as a new method in cases of reversible lagophthalmos or as a preparing step before a gold implantation.