Advertisement

Upper Eyelid Gold Weight Implantation for Facial Nerve Palsy—Short-Term and Long-Term Results

  • Hitesh Verma
  • Sandeep Puthiya Koiloorveetil
  • Veena Jain
  • Namrata Sharma
  • Alok ThakarEmail author
Original Article
  • 5 Downloads

Abstract

Lid loading with upper eyelid gold weight implants is one of the more accepted ways of treating facial paralysis-related lagophthalmos. This study evaluates the short- and long-term outcomes of the technique in terms of objective and subjective functional and aesthetic outcomes. Two groups of 10 patients in each group were included in the study for prospective and retrospective evaluation of outcome of upper eyelid gold weight implant in Indian ethnicity. Assessment of the weight and dimension of gold implant was done in both sexes along with an evaluation of patient satisfaction, medical observations and ophthalmological assessment for corneal integrity, symmetry and exposure. Chi-square test, Friedman’s test and Wilcoxon rank-sum (Mann–Whitney) test. The mean weight–length of the implant for appropriate correction was noted as 1.12 g (range 0.9–1.3 g) and 17.8 mm (range 16–20 mm). Initial postsurgical congestion and eyelid oedema was near universal. Comparing the short-term and long-term assessments, palpebral fissure height reduction and eye closure was noted as stable and all subjective parameters were relatively consistent. Nineteen of 20 patients reported satisfaction with the cosmetic and functional results. Upper eyelid loading by gold weight implantation results in consistent and sustained improvement for eye closure in patients with facial paralysis.

Keywords

Lagophthalmos Gold weight implant Facial nerve Lid loading 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Tower RN, Dailey RA (2004) Gold weight implantation: a better way. Ophthal Plast Reconstr Surg 20(3):202–206CrossRefGoogle Scholar
  2. 2.
    Dalkiz M, Gokce HS, Aydin A, Beydemir B (2007) Gold weight implantation for rehabilitation of the paralysed eyelid. Int J Oral Maxillofac Surg 36(6):522–526CrossRefGoogle Scholar
  3. 3.
    Lavy JA, East CA, Bamber A, Andrews PJ (2004) Gold weight implants in the management of lagophthalmos in facial palsy. Clin Otolaryngol Allied Sci 29(3):279–283CrossRefGoogle Scholar
  4. 4.
    Yu Y, Sun J, Chen L, Liu L (2011) Lid loading for treatment of paralytic lagophthalmos. Aesthet Plast Surg 35(6):1165–1171CrossRefGoogle Scholar
  5. 5.
    Abenavoli FM, De Gregorio A, Corelli R (2006) Upper eye lid loading with autologous cartilage in paralytic lagophthalmos. Plast Reconstr Surg 117(7):2511–2512CrossRefGoogle Scholar
  6. 6.
    Harrisberg BP, Singh RP, Croxson GR, Taylor RF, McCluskey PJ (2001) Long-term outcome of gold eyelid weights in patients with facial nerve palsy. Otol Neurotol 22(3):397–400CrossRefGoogle Scholar
  7. 7.
    Razfar A, Afifi AM, Manders EK, Myers EN, Johnson JT, Ferris RL, Deleyiannis FWB (2009) Ocular outcomes after gold weight placement and facial nerve resection. Otolaryngol Head Neck Surg 140(1):82–85CrossRefGoogle Scholar
  8. 8.
    Doyle E, Mavrikakis I, Lee EJ, Emerson R, Rainey AJ, Brittain GP (2005) Type IV hypersensitivity reactions to upper lid gold weight implants-is patch testing necessary. Orbit 24(3):205–210CrossRefGoogle Scholar
  9. 9.
    Bair RL, Harris GJ, Lyon DB, Komorowski RA (1995) Noninfectious inflammatory response to gold weight eyelid implants. Ophthal Plast Reconstr Surg 11(3):209–214CrossRefGoogle Scholar
  10. 10.
    Kao C-H, Moe KS (2004) Retrograde weight implantation for correction of lagophthalmos. Laryngoscope 114(9):1570–1575CrossRefGoogle Scholar
  11. 11.
    Kim DW, Ali MJ (2007) Modified retrograde approach to upper eyelid static loading. Laryngoscope 117(12):2110–2114CrossRefGoogle Scholar
  12. 12.
    Terng SC, Rijnders W, Kon M, Werker PM (2000) Custom-made gold plate prosthesis in the upper eyelid in patients with facial paralysis: improved eyelid closure with less effects on other eye complaints. Ned Tijdschr Geneeskd 144(17):800–804PubMedGoogle Scholar
  13. 13.
    Rofagha S, Seiff SR (2010) Long-term results for the use of gold eyelid load weights in the management of facial paralysis. Plast Reconstr Surg 125(1):142–149CrossRefGoogle Scholar
  14. 14.
    Terzis JK, Kyere SA (2008) Experience with the gold weight and palpebral spring in the management of paralytic lagophthalmos. Plast Reconstr Surg 121(3):806–815CrossRefGoogle Scholar
  15. 15.
    Jayashankar N, Morwani KP, Shaan MJ, Bhatia SR, Patil KT (2008) Customized gold weight eyelid implantation in paralytic lagophthalmos. J Laryngol Otol 122(10):1088–1091CrossRefGoogle Scholar
  16. 16.
    Schrom T, Buchal A, Ganswindt S, Knipping S, Knippping S (2009) Patient satisfaction after lid loading in facial palsy. Eur Arch Otorhinolaryngol 266(11):1727–1731CrossRefGoogle Scholar
  17. 17.
    73.Schrom T, Wernecke K, Thelen A, Knipping S (2007) Results after lidloading with rigid gold weights. A meta-analysis. Laryngorhinootologie 86(2):117–123CrossRefGoogle Scholar
  18. 18.
    Marra S, Leonetti JP, Konior RJ, Raslan W (1995) Effect of magnetic resonance imaging on implantable eyelid weights. Ann Otol Rhinol Laryngol 104(6):448–452CrossRefGoogle Scholar
  19. 19.
    Schrom T, Thelen A, Asbach P, Bauknecht H-C (2006) Effect of 7.0 Tesla MRI on upper eyelid implants. Ophthal Plast Reconstr Surg 22(6):480–482CrossRefGoogle Scholar
  20. 20.
    Canady JW, Meine J, Thompson SA, Yuh WT (1993) Effects of magnetic resonance imaging fields on gold eyelid loads. Ann Plast Surg 31(1):76–77CrossRefGoogle Scholar
  21. 21.
    Saleh GM, Mavrikakis I, de Sousa J-L, Xing W, Malhotra R (2007) Corneal astigmatism with upper eyelid gold weight implantation using the combined high pretarsal and levator fixation technique. Ophthal Plast Reconstr Surg 23(5):381–383CrossRefGoogle Scholar
  22. 22.
    Pausch N, Sterker I, Hemprich A, Frerich B (2006) Restoration of lid function in peripheral facial palsy by implanting gold weights. Mund Kiefer Gesichtschir 10(3):135–140CrossRefGoogle Scholar
  23. 23.
    Mavrikakis I, Beckingsale P, Lee E, Riaz Y, Brittain P (2006) Changes in corneal topography with upper eyelid gold weight implants. Ophthal Plast Reconstr Surg 22(5):331–334CrossRefGoogle Scholar
  24. 24.
    Goldhahn A, Schrom T, Berghaus A, Krause A, Duncker G (1999) Corneal astigmatism as a special complication after lid-loading in patients with lagophthalmos. Ophthalmologe 96(8):494–497CrossRefGoogle Scholar
  25. 25.
    Maurer J, Madani M, Mann W (1997) Experiences with upper eyelid gold implantation in facial paralysis. Laryngorhinootologie 76(2):106–109CrossRefGoogle Scholar
  26. 26.
    Linder TE, Pike VE, Linstrom CJ (1996) Early eyelid rehabilitation in facial nerve paralysis. Laryngoscope 106(9 Pt 1):1115–1118CrossRefGoogle Scholar
  27. 27.
    Neuman AR, Weinberg A, Sela M, Peled IJ, Wexler MR (1989) The correction of seventh nerve palsy lagophthalmos with gold lid load (16 years experience). Ann Plast Surg 22(2):142–145CrossRefGoogle Scholar
  28. 28.
    Foster JA, Perry JD, Cahill KV, Holck DEE, Kugler L (2004) Processed human pericardium barrier for gold weight implantation. Ophthal Plast Reconstr Surg 20(2):107–109CrossRefGoogle Scholar
  29. 29.
    Lessa S, Nanci M, Sebastiá R, Flores E (2009) Treatment of paralytic lagophthalmos with gold weight implants covered by levator aponeurosis. Ophthal Plast Reconstr Surg 25(3):189–193CrossRefGoogle Scholar

Copyright information

© Association of Surgeons of India 2019

Authors and Affiliations

  • Hitesh Verma
    • 1
  • Sandeep Puthiya Koiloorveetil
    • 2
  • Veena Jain
    • 3
  • Namrata Sharma
    • 4
  • Alok Thakar
    • 5
    Email author
  1. 1.Department of Otolaryngology, Head and Neck SurgeryAll India Institutes of Medical SciencesNew DelhiIndia
  2. 2.Department of ENTHear & Speak Habilitation Centre for the Hearing ImpairedCalicutIndia
  3. 3.Department of ProsthodonticsAll India Institutes of Medical SciencesNew DelhiIndia
  4. 4.Department of OphthalmologyAll India Institutes of Medical SciencesNew DelhiIndia
  5. 5.Department of Otolaryngology & Head-Neck SurgeryAll India Institutes of Medical SciencesNew DelhiIndia

Personalised recommendations