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NR. 4/2004
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Niedomykalność
szpary powiekowej w przebiegu porażenia nerwu VII po usunięciu
guza kąta mostowo-móżdżkowego – opis przypadku
Lagophtalmos as a complication of a facial nerve palsy after
removal of acoustic neurinoma – case report
Anna Otto, Aneta Paćkowska,
Mariusz Kęcik
Katedra i Klinika Okulistyki I Wydziału Lekarskiego Akademii
Medycznej
w Warszawie
Kierownik: prof. ndzw. dr hab. med. Dariusz Kęcik |
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| Summary: |
Treatment of the eye
complications of lagophtalmos as a corneal ulcers and
abrasions is very chronic, difficult and often requires
definitive surgical correction. Facial nerve paralysis (caused
mainly by acoustic neurinoma, some neurological diseases
or infections) is the most popular reason of the
lagophtalmos. Ophtalmological aim is the same despite
different reasons: it is to provide the best possible
condition of cornea. There are several methods in use
depending on a treatment centers possibilities:
tarsorrhapy (the oldest and the most rarely used one),
Botox injection of elevator parpebrae superioris which
causes temporarly, chemical muscle deinervation,
mechanical ballast of upper eyelid by gold or platinium
weights, anastomosis of facial nerve with hypoglossal or
glossopharyngeal nerves.
This presentation goal is to show different ways of
treatment and their efficiency based on a case of a
young patient having lagophtalmos after excising of
acoustic neurinoma. During long term teraphy the use of
soft contact lenses, lubrication and occlusion of lid
slit for the night time has been the most efficient
method especially when combined with gold eyelid weight
implantation which gave mechanical ballast to the eyelid.
Such way of treatment succeeded with a return to a
patient’s normal activity few months after acoustic
neurinoma excising, even if a facial nerve has been
still paralysed (EMG checks). It also made cornea’s
condition stable without any menace to an eye function. |
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| Key words: |
lagophtalmos, facial nerve
palsy, gold eyelid weight. |
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