[Surgical therapy of blepharospasmus gravis]

Blepharospasm is a rather rare disease characterised by cramps of the orbicularis oculi muscle. The quality of life of patients suffering from this illness is often severely reduced. The therapeutic approaches reported in the literature have so far not been satisfactory in most cases. In the mid'-seventies a new operative technique has been introduced by Walser and modified by Behbehani. This procedure consists of the dissection of the zygomatico-temporal branch of the facial nerve. In the present paper the author reports on his own experience with this special method as well as the long-term results in 19 patients that have been followed up over a period of 3 months up to 14 years after operation. Surgery was carried out bilaterally in 19 cases, while 5 patients were operated on one side only. After resection of the nerve, blepharoplasty of the upper lid was performed. The therapeutic value of the technique is discussed and compared with the appropriate literature.