Abstract
Paralytic lagophthalmos is treated by pretarsal implantation of eyelid weights consisting either of rigid gold weights or flexible platinum chains. Functional results being good, subjective patient satisfaction has been examined only by a small number of studies. The aim of our study, conducted by means of a questionnaire, was to assess subjective patient satisfaction after implantation of different eyelid implants. Questionnaires were sent to 42 patients treated by pretarsal implantation of a gold weight (group 1) and 51 patients with a pretarsally fixed platinum chain (group 2). In total, 46 response sheets were evaluated (16 × gold weight, 30 × platinum chain) and the results were compared. In group 1, 75% of patients were very satisfied to satisfied with the overall result. In group 2, 100% of patients were very satisfied to satisfied with the overall result. In group 1, an infection occurred in 6.5% of patients, an extrusion in 6.5%, and a change of vision in 31%. In group 2, inflammation occurred in 13%, extrusion in 0%, and a change of vision occurred in 13% of patients. On a visual analogous scale from 1 to 10 (1, very good; 10, very poor), group 1 assessed the cosmetic result with an average grade of 3.8 and the functional result with an average grade of 3.1. Group 2 assessed the cosmetic result with the grade 2.9 and the functional result with grade 3.0. The implantation of an eyelid weight for treatment of paralytic lagophthalmos was assessed as positive by a majority of patients. When compared with conventional gold implants, patients who have been treated with a flexible platinum chain are overall more satisfied and have a more favorable subjective view of the cosmetic results.
Similar content being viewed by others
References
Bair R, Harris G, Lyon D, Komorowski R (1995) Noninfectious inflammatory response to gold weight eyelid implants. Ophthal Plast Reconstr Surg 11:209–214. doi:10.1097/00002341-199509000-00008
Berghaus A, Neumann K, Schrom T (2003) The platinum chain: a new upper-lid implant for facial palsy. Arch Facial Plast Surg 5(2):166–170. doi:10.1001/archfaci.5.2.166
Chepeha D, Yoo J, Birt C, Gilbert R, Chen J (2001) Prospective evaluation of eyelid function with gold weight implant and lower eyelid shortening for facial paralysis. Arch Otolaryngol Head Neck Surg 127(3):299–303
Cies W (1993) Modified gold weights for reanimation of the upper lid in facial nerve paralysis. Ophthal Plast Reconstr Surg 9(3):214–217. doi:10.1097/00002341-199309000-00009
Goldhahn A, Schrom T, Berghaus A, Krause A, Duncker G (1999) Goldimplantation bei Lagophthalmus—Hornhautastigmatismus als besondere Komplikation. Ophthalmologe 96:494–497. doi:10.1007/s003470050443
Grisius M, Hof R (1993) Treatment of lagophthalmos of the eye with a custom prothesis. J Prosthet Dent 70:333–335. doi:10.1016/0022-3913(93)90218-D
Illig K (1958) Eine neue Operationsmethode gegen Lagophthalmus. Klin Monatsbl Augenheilkd 32:410–411
Javaid M, Cormack G (2001) A precise method of gold-weight contour shaping for upper-eyelid loading in facial palsy. Br J Plast Surg 54(7):653. doi:10.1054/bjps.2001.3678
Jayashankar N, Morwani K, Shaan M, Bhatia S, Patil K (2008) Customized gold weight eyelid implantation in paralytic lagophthalmos. J Laryngol Otol 122(10):1088–1091. doi:10.1017/S0022215108001886
Kelly S, Sharpe D (1992) Gold eyelid weights in patients with facial palsy: a patient review. Plast Reconstr Surg 89:436–440. doi:10.1097/00006534-199203000-00006
Kuntheseth S (1999) Reanimation of the lagophthalmos using stainless steel weight implantation; a new approach and prospective evaluation. Int J Lepr Other Mycobact Dis 67(2):129–132
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):331–334. doi:10.1097/01.iop.0000231774.70194.3f
Mohr A (1997) Prätarsale Platin–Iridium–Implantate Zur Therapie Des Lagophthalmus Bei Fazialisparese—Vorläufige Ergebnisse. Ophthalmologe 94:600–602. doi:10.1007/s003470050167
Pickford M, Scamp T, Harrison D (1992) Morbidity after gold weight insertion into the upper eyelid in facial palsy. Br J Plast Surg 45:460–464. doi:10.1016/0007-1226(92)90210-O
Schrom T, Bloching M, Wernecke K, Scherer H (2005) Measurement of upper eyelid implants curvature by ultrasound. Laryngoscope 115(5):884–888. doi:10.1097/01.MLG.0000160489.30701.74
Schrom T, Habermann A, Wernecke K, Scherer H (2005) Implantation von Lidgewichten zur Therapie des Lagophthalmus. Ophthalmologe 102(12):1186–1192. doi:10.1007/s00347-005-1228-0
Schrom T, Wernecke K, Thelen A, Knipping S (2007) Ergebnisse nach Lidgewichtimplantation mit starren Goldgewichten—eine Metaanalyse. Laryngorhinootol 86:117–123. doi:10.1055/s-2006-944748
Sheehan J (1950) Progress in correction of facial palsy with tantalum wire and mesh. Surgery 27:122–125
Sönmez A, Oztürk N, Durmuş N, Bayramiçli M, Numanoğlu A (2008) Patients’ perspectives on the ocular symptoms of facial paralysis after gold weight implantation. J Plast Reconstr Aesthet Surg 61(9):1065–1068. doi:10.1016/j.bjps.2007.06.019
Conflict of interest statement
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Additional information
An erratum to this article can be found at http://dx.doi.org/10.1007/s00405-010-1267-2
Rights and permissions
About this article
Cite this article
Schrom, T., Buchal, A., Ganswindt, S. et al. Patient satisfaction after lid loading in facial palsy. Eur Arch Otorhinolaryngol 266, 1727–1731 (2009). https://doi.org/10.1007/s00405-009-0981-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-009-0981-0