[Surgical treatment options for paralytic lagophthalmos]

Facial nerve palsy may result from a broad spectrum of causes, which is largely due to its topographic complexity. Different types of cross plastic surgery and nerve autografting and muscle transplantation and transposition are used to recover nerve function. Lagophthalmos is a most severe sequel of facial nerve palsy. Blephorrhaphy and tarsorrhaphy, operations for removal of lower eyelid ectropion, and different types of palpebral fissure narrowing are used widely to correct lagophthalmos and to prevent corneal complications. Various weight implants and special springs are employed to modify upper eyelid mobility. The lengthening of the upper eyelid levator and the administration of hyaluronic acid gel and botulotoxin type A are proposed for additional upper eyelid descent.