Íñigo MF, Reyes-Amador M, Íñigo AF, Zendejas-Reyes L

Idioma: Español
Referencias bibliográficas: 26
Paginas: 80-84
Archivo PDF: 89.96 Kb.

RESUMEN

La exposición ocular, la irritación conjuntival y la queratitis corneal son secuelas del lagoftalmos secundario a una parálisis facial o a un exoftalmos. Muchas técnicas se han descrito para corregir esta condición. Presentamos un nuevo método para disminuir la apertura palpebral. Un injerto de cartílago auricular se interpone entre el músculo elevador del párpado y la placa tarsal. Con esta técnica fueron tratados 18 pacientes con parálisis del músculo orbicular corroborados por electromiografía y 8 pacientes con lagoftalmos secundario a exoftalmos. La apertura palpebral se disminuyó de 2 a 3 mm en todos los casos. Veintitrés pacientes mostraron una mejoría significativa de los síntomas oculares. Tres pacientes a los que no se pudo cerrar la fisura palpebral lo suficiente para proteger su globo ocular requirieron una elongación adicional del injerto de cartílago auricular de 4 mm y una tarsorrafia lateral.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Leatherbarrow B, Collin JR. Eyelid surgery in facial palsy. Eye 1991; 5: 585-90.

2. McLaughin CR. Surgical support in permanent facial paralysis. Plast Reconstr Surg 1953; 11: 302-14.

3. Jelks GW, Smith B, Bosniak S. The evaluation and management of the eye in facial palsy. Clin Plast Surg 1979; 6: 397-401.

4. Goren SB, Clemis JD. Care of the eye in facial paralysis. Arch Otolaryngol 1973; 97: 227-30.

5. Seiff SR, Chang J. Management of ophthalmic complications of facial nerve palsy. Otolaryngol Clin North Am 1992; 25: 669-73.

6. Edgerton MT, Wolfort FG. The dermal-flap canthal lift for lower eyelid support. Plast Reconstr Surg 1969; 43: 42-51.

7. Montandon DA. A modification of dermal-flap canthal lift for correction of the paralyzed lower lid. Plast Reconstr Surg 1978; 61: 555-60.

8. Tanenbaum M, Gossman MD, Bergin DJ, Friedman HI, Lett D, Haines P, Mc Cord MD. The tarsal pillar technique for narrowing and maintenance of the interpalpebral fissure. Ophthalmic Surg 1992; 23: 418-21.

9. Goudeau MJ, Durand PM. Lagophtalmie paralytique. Un procédé simple de chirurgie palliative utilisant un griffon veineux autologue. Ann Chir Plast Esthet 1985; 30: 359-62.

10. Jobe RE. A technique for lid loading in the management of lagophthalmos of facial palsy. Plast Reconstr Surg 1974; 53: 29-32.

11. May M, Hoffmann DF, Buerger GF, Jr, Soll DB. Management of the paralyzed lower eyelid by implanting auricular cartilage. Arch Otolaryngol Head Neck Surg 1990; 116: 786-89.

12. Mühlbauer WD, Segeth H, Viessmann A. Restoration of lid function in facial palsy with permanent magnets. Chir Plast (Berl) 1973; 1: 295-304.

13. Arion HG. Dynamic closure of the lids in paralysis of the orbicularis muscle. Int Surg 1972; 57: 48-52.

14. Wood-Smith D. Encircling Silastic band for paralysis of the orbicularis oculi muscle. Presented at the Society of Ophthalmic Plastic Surgeons. Dallas, Texas, September 1973. Cited. In: McCarthy JG, ed. Plastic Surgery. Philadelphia: Saunders 1990: 2319.

15. Guy CL. The palpebral spring for paralysis of the upper eyelid in facial nerve paralysis. Presented at the American Society of Plastic and Reconstructive Surgeons, St. Louis, 1969. Cited. In: McCarthy JG. Ed. Plastic Surgery. Philadelphia: Saunders 1990: 2317.

16. McNeill JI, Oh VH. An improved palpebral spring for the management of paralytic lagophthalmos. Ophthalmology 1991; 98: 715-19.

17. Morel-Fatio D, Lalardrie JP. Palliative surgical treatment of facial paralysis: the palpebral spring. Plast Reconstr Surg 1964; 33: 446-56.

18. Sheehan JE. Plastic surgery of the orbit. New York: Macmillan Company 1927.

19. Freeman BS. Review of long-term results in supportive treatment of facial paralysis. Plast Reconstr Surg 1979; 63: 214-18.

20. Muller-Jensen K, Muller-Jensen G. Zur operativen and Konservativen Behandiung des Lagophthalmus (Facialis parase). Ophthalmology 1993; 90: 27-31.

21. Pickford MA, Scamp T, Harrison DH. Morbidity after gold weight insertion into the upper eyelid in facial palsy. Br J Plast Surg 1992; 45: 460-4.

22. Seiff SR, Sullivan JH, Freeman LN, Ahn J. Pretarsal fixation of gold weights in facial nerve palsy. Ophthal Plast Reconstr Surg 1989; 5: 104-8.

23. Soll DB. New surgical approaches to the management of ocular exposure secondary to facial paralysis. Ophthal Plast Reconstr Surg 1988; 4: 215-18.

24. Mukherjee R, Dasgupta S, Ladi DS, Gandhi VH. Management of lagophthalmos by Gillies method (a case report). J Postgrad Med 1990; 36: 115-19.

25. Gupta AK, Jain S. Temporalis muscle sling revisited: a technique to restore ocular sphincter function. Ann Plast Surg 1994; 32: 496-9.

26. Iñigo F, Ysunza A, Rojo P, Trigos I. Recovery of facial palsy after crossed facial nerve grafts. Br J Plast Surg 1994; 47: 312-17.