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Facial Nerve Paralysis

Facial Nerve Paralysis

A 38 yr old gentleman developed- Left BELL's Palsy (Facial Nerve Paralysis) about 3.5 yrs back spontaneously (no cause). Due to this he was unable to close eyelids. He also developed inability to lift Upper eyelid due to paralysis of muscles lifting eyelid (opp. action of Facial nerve action)- that is neither opening nor closure of upper eyelid.

There was NO significant recovery of the palsy of both actions over time. He was developing exposure of Cornea (eye) leading to- Keratitis during this time So he was seen and operated in another hospital by a Plastic Surgeon 1.5 yrs back by- GOLD weight (1.2 gms) implantation in (L)Upper eye lid, so that Eye lid closes passively by the weight of Gold- reducing chance of- Keratitis, which is the one of the recognized treatments for Bell's palsy.

Incidentally, patient recovered some function of closure of eyelid only, (which is unusal after 2 yrs)but he did not get recovery of elevation of eye lid. So his upper eyelid started drooping down due to un- opposed actions of both Gold weight and Facial nerve leading to complete closure of left eye lids with inability to open them.

PLAN- it was decided to remove Gold weight (to remove one source of closure of eyelid), so that the left upper eyelid opens up better and he can see clearly and it was executed under Local Anesthesia (LA). it was a day care procedure lasting just 1 hr and discharged in 2-3 hrs. He was relieved of the problem and able to see now.

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