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At the recent meeting of the American Academy of Facial Plastic and Reconstructive Surgery in Washington, DC, Drs M. Sean Freeman and J. Regan Thomas, St Louis, Mo, addressed the question of orbital rehabilitation in the patient with facial paralysis. They focused primarily on the surgical treatment of lagophthalmos in the patient with facial paralysis present for at least 6 months, and without any expectation for return of function. The different forms of treatment currently available include (1) tarsorrhaphy, (2) palpebral spring, (3) Silastic sling, (4) temporalis muscle transfer, and (5) gold-weight implantation. They prefer to use the gold-weight form of treatment because of the ease of insertion, the high rate of success, and the ease of reversal. They point out, however, that the disadvantages of the gold-weight technique include the visible bulge through the eyelid and that it is gravity dependent. The size of gold weight used (0.6 to
CALHOUN KH. Orbital Rehabilitation in the Patient With Facial Paralysis. Arch Otolaryngol Head Neck Surg. 1989;115(5):555. doi:10.1001/archotol.1989.01860290013005
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