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June 1989

Improved Gold-Weight Implantation for Facial Paralysis

Author Affiliations

Cleveland, Ohio

Arch Otolaryngol Head Neck Surg. 1989;115(6):661-663. doi:10.1001/archotol.1989.01860300015004

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At the recent meeting of the American Academy of Otolaryngology–Head and Neck Surgery in Washington, DC, Jack M. Kartush, MD, and colleagues, University of Michigan, Ann Arbor, reported that gold-weight implantation for the rehabilitation of the paralyzed eye resulted in excellent eyelid closure, protection, and cosmesis. They placed 38 implants in 37 patients at the Michigan Ear Institute, Detroit, and, over a follow-up period of 1 through 17 months, found excellent results with no infections, extrusions, or "breakthrough keratitis." Twenty-four-karat gold bars, ranging in weight from 0.6 to 1.6 g, were used, after determining proper size and weight by taping the bar to the patient's eyelid.

Average eye exposure (lagophthalmos) was 5.4 mm preoperatively and 0.1 mm postoperatively. Clinical ptosis (lid drooping at least 2.0 mm from the upper corneal limbus) was observed in only 16% of patients. When indicated, the procedure of choice for eyelid rehabilitation

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