Complications of gold weight eyelid implants for treatment of fifth and seventh nerve paralysis

Elizabeth A. Dinces, Joseph A. Mauriello, Jed A. Kwartler, Mark Franklin

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Complications occurred in six patients after gold weights were implanted into the upper eyelid tissues for fifth and seventh nerve palsies. These complications included implant infection without extrusion (in one patient); entropion with trichiasis and presumed inflammatory reaction to the gold weight material (in one patient); upper eyelid distortion and poor eyelid contour with corneal ulceration and scarring (in one patient); significant residual lagophthalmos with exposure keratitis (in one patient); and blepharoptosis obscuring the pupillary access (in two patients). Resolution of the complications required 1. implant removal in four of six patients without reinsertion of a second weight, 2. recession of the retractors of the upper eyelids with medial and lateral canthoplasty (in four patients), and 3. permanent tarsorrhaphy (in one patient). The authors conclude that complications may be minimized by careful preoperative determination of the optimum implant size, weight, and placement within the eyelid as well as meticulous attention to the surgical technique of implantation. The use of other eyelid protective procedures is often necessary to augment corneal protection especially in patients with combined fifth and seventh cranial nerve palsies. Endogenous implant infection without extrusion of the gold weight may be distinguished from presumed inflammation due to gold allergy by clinical response to antibiotics in the former and requirements of steroids or removal of the implant in the latter.

Original languageEnglish (US)
Pages (from-to)1617-1622
Number of pages6
JournalLaryngoscope
Volume107
Issue number12 I
StatePublished - Dec 1997
Externally publishedYes

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Eyelids
Paralysis
Gold
Weights and Measures
Therapeutics
Trichiasis
Entropion
Blepharoptosis
Cranial Nerve Diseases
Trigeminal Nerve
Keratitis
Facial Nerve
Infection
Cicatrix
Hypersensitivity
Steroids
Anti-Bacterial Agents
Inflammation

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Dinces, E. A., Mauriello, J. A., Kwartler, J. A., & Franklin, M. (1997). Complications of gold weight eyelid implants for treatment of fifth and seventh nerve paralysis. Laryngoscope, 107(12 I), 1617-1622.

Complications of gold weight eyelid implants for treatment of fifth and seventh nerve paralysis. / Dinces, Elizabeth A.; Mauriello, Joseph A.; Kwartler, Jed A.; Franklin, Mark.

In: Laryngoscope, Vol. 107, No. 12 I, 12.1997, p. 1617-1622.

Research output: Contribution to journalArticle

Dinces, EA, Mauriello, JA, Kwartler, JA & Franklin, M 1997, 'Complications of gold weight eyelid implants for treatment of fifth and seventh nerve paralysis', Laryngoscope, vol. 107, no. 12 I, pp. 1617-1622.
Dinces, Elizabeth A. ; Mauriello, Joseph A. ; Kwartler, Jed A. ; Franklin, Mark. / Complications of gold weight eyelid implants for treatment of fifth and seventh nerve paralysis. In: Laryngoscope. 1997 ; Vol. 107, No. 12 I. pp. 1617-1622.
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