A surgical algorithm for lower eyelid resuspension in facial nerve paralysis

      The authors discuss the ophthalmologic manifestations of facial nerve paralysis and propose a surgical algorithm for their managment. Surgical techniques for canthoplasty, tarsorrhaphy, and suborbicularlis oculi fat pad lift (SOOF lift) are discussed.


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        • Elner V.M.
        • Mauffray R.O.
        • Fante R.G.
        • et al.
        Comprehensive midfacial elevation for ocular complications of facial nerve palsy.
        Arch Facial Plast Surg. 2003; 5: 427-433
        • Bergeron C.M.
        • Moe K.S.
        The evaluation and treatment of lower eyelid paralysis.
        Facial Plast Surg. 2008; 24: 231-241
        • Jobe R.P.
        A technique for lid loading in the management of the lagophthalmos of facial palsy.
        Plast Reconstr Surg. 1974; 53: 29-32
        • Chepeha D.B.
        • Yoo J.
        • Birt C.
        • et al.
        Prospective evaluation of eyelid function with gold weight implant and lower eyelid shortening for facial paralysis.
        Arch Otolaryngol Head Neck Surg. 2001; 127: 299-303
        • Krastinova D.
        • Franchi G.
        • Kelly M.B.
        • et al.
        Rehabilitation of the paralysed or lax lower eyelid using a graft of conchal cartilage.
        Br J Plast Surg. 2012; 55: 12-19
        • Chang L.
        • Olver J.
        A useful augmented lateral tarsal strip tarsorrhaphy for paralytic ectropion.
        Ophthalmology. 2006; 113: 84-91
        • Terzis J.K.
        • Kyere S.A.
        Minitendon graft transfer for suspension of the paralyzed lower eyelid: our experience.
        Plast Reconstr Surg. 2008; 121: 1206-1216
        • Zide B.M.
        • Jelks G.W.
        Surgical anatomy of the orbit.
        Plast Reconstr Surg. 1984; 74: 301-305
        • Kakizaki H.
        • Malhotra R.
        • Madge S.N.
        • et al.
        Lower eyelid anatomy: an update.
        Ann Plast Surg. 2009; 63: 344-351
        • Lowe J.B.
        • Cohen M.
        • Hunter D.A.
        • et al.
        Analysis of the nerve branches to the orbicularis oculi muscle of the lower eyelid in fresh cadavers.
        Plast Reconstr Surg. 2005; 116 (discussion 1750): 1743-1749
        • Freeman M.S.
        Transconjunctival sub-orbicularis oculi fat (SOOF) pad lift blepharoplasty: a new technique for the effacement of nasojugal deformity.
        Arch Facial Plast Surg. 2000; 2: 16-21
        • Krastinova D.
        • Franchi G.
        • Kelly M.B.
        • et al.
        Rehabilitation of the paralysed or lax lower eyelid using a graft of conchal cartilage.
        Br J Plast Surg. 2002; 55: 12-19
        • Ridgway E.B.
        • Chen C.
        • Colakoglu S.
        • et al.
        The incidence of lower eyelid malposition after facial fracture repair: a retrospective study and meta-analysis comparing subtarsal, subciliary, and transconjunctival incisions.
        Plast Reconstr Surg. 2009; 124: 1578-1586