Cerclage sling technique using temporalis muscle fascia to manage paralytic lagophthalmos: A preliminary study.

PURPOSE: Despite various existing surgical techniques, treatment of facial nerve palsy remains difficult. The purpose of this report is to present the cerclage sling technique using temporalis fascia to manage paralytic lagophthalmos. METHODS: A series of six patients underwent a cerclage sling technique using temporalis muscle fascia to treat paralytic lagophthalmos. The technique is presented in detail. Symptoms, palpebral fissures, and lagophthalmos were assessed pre- and postoperatively. Data were submitted for statistical analysis. RESULTS: After surgery, all patients achieved a reduction in clinical symptoms. The upper eyelids had lowered, and the inferior eyelids had elevated, reducing ocular exposure even if mild residual lagophthalmos was present. CONCLUSION: Cerclage using the temporalis muscle fascia sling technique is a safe and effective procedure to treat facial nerve paralytic lagophthalmos. A reduction in ocular exposure and lagophthalmos provides improvement in clinical symptoms and eyelid function.

Comparison of two techniques for surgical eyebrow suspension.

PURPOSE: Brow ptosis can interfere with blepharoplasty results and can be corrected using several techniques. The present study was performed to compare two techniques for brow suspension, both with concomitant upper eyelid blepharoplasty. METHOD: A prospective, interventional, randomized study involving 27 female patients was performed to compare the effects of two different techniques of brow suspension: eyebrow suspension with nylon thread (ESN) and internal browpexy fixation (IBF), both combined with upper lid blepharoplasty. Qualitative assessment was carried out using a questionnaire, and quantitative angular measurement analysis of the brow position was performed using digital photographs taken with a Vectra H1 camera before, 60, and 120 days after surgery. The data were transferred to an Excel table and statistically analyzed. RESULTS: ESN was performed in 14 patients and IBF in 13 patients. Both groups were homogeneous in terms of age. The main preoperative complaints were excess skin on the upper eyelid (81.4%) and reduced visual field (59.2%) in both groups. Most of the patients expected aesthetic improvement, and the surgical results were considered satisfactory for all of them. There was no significant difference between ESN and IBF in the quantitative evaluation of eyebrow position. CONCLUSION: Both ESN and IBF resulted in a high degree of patient satisfaction. Both techniques provided similar brow suspension, emphasizing that IBF is technically easier to perform and produces less scarring.