Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Ophthalmology, Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Middle East Afr J Ophthalmol. 2020 Oct 30;27(3):160-163. doi: 10.4103/meajo.MEAJO_152_19. eCollection 2020 Jul-Sep.
The purpose of this study is to introduce the results of a new surgical technique in patients with complete facial nerve palsy using the dynamic muscle transfer of orbicularis oculi muscle (OOM) flap from the contralateral side.
This case series presents a new surgical technique in three patients with complete facial palsy and lagophthalmos who were unresponsive to other modalities. In this technique, a rectangular flap of OOM was dissected from the upper lid of fellow eye and transferred to the affected eye through a subcutaneous tunnel over the nasal bridge. The flap was divided into two halves for upper and lower lids. Each half was incised longitudinally to increase the length of the flap and cover the lateral part of the affected eyelids.
Improvement in exposure keratitis, lagophthalmos, and other related symptoms was observed as soon as the 1 week after the surgery. Partial blinking recovered and the operation was uneventful.
Muscle flap transfer technique using contralateral OOM for complete facial palsy can be considered as a helpful alternative in patients who are still symptomatic despite conventional treatment modalities.
本研究旨在介绍一种新的手术技术,即使用对侧眼轮匝肌(OOM)瓣的动力肌肉转移来治疗完全性面神经麻痹患者。
本病例系列介绍了 3 例完全性面瘫和眼睑闭合不全患者的新手术技术,这些患者对其他治疗方法均无反应。在该技术中,从对侧上眼睑解剖出一个矩形的 OOM 瓣,并通过鼻桥上方的皮下隧道转移到受累眼。将皮瓣分为两半用于上、下眼睑。每一半都被纵向切开,以增加皮瓣的长度并覆盖受累眼睑的外侧部分。
术后 1 周即可观察到暴露性角膜炎、眼睑闭合不全和其他相关症状的改善。部分眨眼恢复,手术过程顺利。
对于即使经过传统治疗方法仍有症状的患者,使用对侧 OOM 的肌肉瓣转移技术可作为一种有帮助的替代方法。