Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK.
Moran Eye Center, University of Utah, Salt Lake City, UT, USA.
Eye (Lond). 2024 Jan;38(1):205-209. doi: 10.1038/s41433-023-02661-2. Epub 2023 Jul 6.
BACKGROUND/OBJECTIVES: To determine whether horizontal lower eyelid margin length shortens following facial nerve palsy (FNP).
SUBJECTS/METHODS: A single-centre retrospective audit of lower eyelid margin horizontal length, measuring from the lower lacrimal punctum to lateral canthal angle with a straight plastic ruler, with the eyelid on gentle stretch ('punctum-to-canthus (PC) distance'), recorded in all FNP patients reviewed in July-September 2021. Affected and fellow eyes were compared using parametric testing.
Forty-one patients were reviewed. Seventeen were excluded due to previous surgery that would lengthen (e.g., periosteal flap) or shorten (e.g., lateral tarsal strip) the lower eyelid margin. Of the remaining 24, mean age was 52.5 years (range, 27-79) and 54% were female. Mean PC distance was significantly shorter in affected eyes (26.0 mm, range: 22-34 mm) compared to fellow eyes (27.5 mm, 24-35 mm) (paired t-test, T(23) = 6.06, p < 0.00001). Mean difference between both eyes' PC distance was 1.5 mm (0-4 mm). Only three patients were still in the 'paralytic phase' (i.e., <1 year since FNP onset), and difference in PC distance was 0 mm in all three. A reduction in lower eyelid PC distance was weakly associated with a reduction in upper eyelid lid-margin-to-brow distance (R = 0.4775, p = 0.0286).
The lower eyelid margin appears to shorten horizontally following FNP. This study provides proof-of-concept for the use of measuring PC distance in patients with FNP as an additional tool for the overall assessment of soft tissue contraction following FNP. It may help identify patients in whom further lower eyelid margin shortening should be avoided and in whom eyelid lengthening may be required.
背景/目的：确定面神经麻痹（FNP）后下眼睑缘长度是否缩短。
受试者/方法：对 2021 年 7 月至 9 月期间回顾性分析的所有 FNP 患者进行了一项单中心回顾性审计，使用直塑料尺测量下眼睑缘水平长度，从下泪点到外眦角（称为泪点至眦角（PC）距离），记录时眼睑处于轻微拉伸状态。使用参数检验比较患侧眼和对侧眼。
共回顾了 41 例患者。17 例患者因先前的手术而被排除在外，这些手术会延长（例如，骨膜瓣）或缩短（例如，外眦横韧带）下眼睑缘。在其余的 24 例中，平均年龄为 52.5 岁（范围，27-79 岁），54%为女性。患侧眼的平均 PC 距离（26.0 毫米，范围：22-34 毫米）明显短于对侧眼（27.5 毫米，范围：24-35 毫米）（配对 t 检验，T(23) = 6.06，p < 0.00001）。双眼 PC 距离的平均差异为 1.5 毫米（0-4 毫米）。仅有 3 例患者仍处于“麻痹期”（即 FNP 发病后<1 年），这 3 例患者的 PC 距离差异均为 0 毫米。下眼睑 PC 距离的减少与上眼睑缘至眉距的减少呈弱相关（R = 0.4775，p = 0.0286）。
FNP 后下眼睑缘似乎会水平缩短。本研究为 FNP 患者测量 PC 距离作为评估 FNP 后软组织收缩的额外工具提供了初步证据。它可以帮助识别那些需要避免进一步缩短下眼睑缘的患者，以及那些需要延长眼睑的患者。
