Subperiosteal Midface Lift: Its Role in Static Lower Eyelid Reconstruction after Chronic Facial Nerve Palsy

Abstract

Purpose: To describe the effect of subperiosteal midface lift on lower eyelid position of patients with chronic facial nerve palsy.Methods: In an observational prospective study nine patients underwent subperiosteal midface lift. Indications for surgery were lower eyelid paralytic retraction, lagophthalmos, ocular surface disruption, reactive tearing, midface ptosis, and facial asymmetry. Exclusion criteria were previous rehabilitative oculofacial surgery, and facial nerve palsy onset less than a year. Preoperative and postoperative assessment included evaluation of lower eyelid position, lagophthalmos, midfacial ptosis and facial asymmetry. Follow-up was at 1 week, 1 month, 3, and 12 months, postoperatively. Results: All patients referred improvement in their symptoms at 3 and 12 months, postoperatively: lower eyelid position (P=. 004), lagophthalmos (P=. 004), ocular surface symptoms, reactive tearing, and facial symmetry at rest.Conclusions: Subperiosteal midface lift has an effective role in the static lower eyelid malposition correction after chronic facial nerve palsy.