Examining timing of periorbital interventions in patients with upper division facial paralysis.

IF 2.3 3区 医学 Q1 OTORHINOLARYNGOLOGY
Samuel Doty, Amanda Goslawski, Claudia I Cabrera, Eve Tranchito, Nicole Fowler, Shawn Li, Jason E Thuener, Theodoros N Teknos, Rod P Rezaee, Cyrus C Rabbani, Akina Tamaki
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引用次数: 0

Abstract

Background: Facial paralysis is a life-altering condition that may arise from various etiologies, ranging from trauma to malignancy. Permanent facial paralysis may occur secondary to facial nerve sacrifice or irreversible damage to the nerve. In these particularly devastating cases, protection and maintaining function of the eye is paramount. There are many effective lagophthalmos corrective surgical procedures available for these patients. While placement of eyelid weights and lid tightening surgeries are the cornerstone of eyelid rehabilitation, limited information exists on whether the timing of eyelid interventions in the setting of permanent facial paralysis impact outcomes, including need for revision surgery.

Methods: A single-center retrospective chart review was performed for patients with irreversible facial paralysis treated with an upper eyelid weight between 2013 to 2022. Electronic health records were acquired to obtain facial paralysis etiology, associated clinical characteristics, the type of intervention, and the timing of intervention. Patients were classified as immediate if the eyelid weight operation occurred within 29 days of the initial facial paralysis and delayed if the surgery occurred 30 days or more after initial presentation. Outcomes were assessed in terms of revision procedures and surgical complications.

Results: There were 70 patients in total, with 35 patients in the immediate category and 35 patients in the delayed category. The most common etiology related to parotid gland pathology, and 58.6% of patients had facial paralysis from cancer-related surgeries. There were no significant differences in revision rates (p < 0.208) or in the types of procedures (p = 0.077) between the two groups. The complication rates also did not differ significantly between groups; however, there were only complications in the delayed intervention group.

Conclusions: These findings suggest there is no difference in postoperative complications between groups, including the need for revision surgeries when comparing groups with immediate or delayed intervention. Thus, treatment plans should be customized based on patient and provider preferences.

研究对上部面瘫患者进行眶周干预的时机。
背景:从外伤到恶性肿瘤,各种病因都可能导致面瘫。永久性面瘫可能继发于面神经牺牲或面神经不可逆转的损伤。在这些极具破坏性的病例中,保护和维持眼睛的功能至关重要。对于这些患者,有许多有效的眼睑下垂矫正手术可供选择。虽然放置眼睑重物和眼睑收紧手术是眼睑康复的基石,但在永久性面瘫的情况下,眼睑干预的时机是否会影响治疗效果,包括是否需要进行翻修手术,这方面的信息十分有限:对2013年至2022年期间接受上眼睑重物治疗的不可逆面瘫患者进行了单中心回顾性病历审查。通过获取电子病历来了解面瘫病因、相关临床特征、干预类型和干预时机。如果患者在初次面瘫后29天内进行了眼睑负重手术,则被归类为即时手术;如果手术在初次面瘫后30天或更长时间内进行,则被归类为延迟手术。结果根据翻修手术和手术并发症进行评估:共有70例患者,其中35例为即刻手术,35例为延迟手术。最常见的病因与腮腺病变有关,58.6%的患者因癌症相关手术导致面瘫。翻修率没有明显差异(P这些研究结果表明,在比较立即干预组和延迟干预组时,术后并发症(包括翻修手术需求)在各组之间没有差异。因此,治疗方案应根据患者和医疗服务提供者的偏好进行定制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.00
自引率
6.90%
发文量
278
审稿时长
1.6 months
期刊介绍: Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.
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