Blepharoptosis Following Surgery for Facial Paralysis

Abstract

Mehmet O. Yenidünya Uludağ Üniversitesi, Tıp Fakültesi, Plastik Rekonstrüktif ve Estetik Cerrahi Bölümü, Görükle, Bursa, Turkiye. e-mail: meogye@hotmail.com INTRODUCTION The two conditions called facial paralysis and blepharoptosis exist in medical literature due to two different neurumuscular pathologies. The first system includes facial nerve and related mimicking muscles. The second system includes oculomotor nerve and is related to only one muscle. There are 18 paired muscles of the face, including the orbicularis oris, which can be considered as a paired muscle, too. A detailed discussion of each of these muscles is available elsewhere. Since the eyelids are located close to the mimicking muscles of the face, there is a tendency among medical students and physicians to surmise that the eyelid opening is also under the effects of facial nerve as the other facial mimicking muscles. Contrary to this, the eyelids’ opening activity is mediated by another cranial nerve, and it is the third cranial nerve—, the oculomotory nerve. The intentional opening of the upper eyelid is under the effects of the levator palpebra superior muscle, and it is innervated by the oculomotory nerve. The unintentional eyelid movement of blinking is mediated by superior tarsal muscle’s action, and this muscle is innervated by the autonomous nerve system (1). Eyelids not able to close or open are nerve-related problems pertaining to the eyelids. In very rare situations, the two problems may coexist, and this would require more than one neural pathology. ABSTRACT