Treatment of pseudoptosis secondary to aberrant regeneration of the facial nerve with botulinum toxin type A

Elaine R. McElhinny, Isaac Reich, Benjamin Burt, Ronald Mancini, Edward J. Wladis, Vikram D. Durairaj, Roman Shinder

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Purpose: To report on low-dose minimal injection treatment using botulinum toxin A for pseudoptosis secondary to aberrant facial nerve regeneration. Methods: A retrospective chart review was carried out on 16 consecutive patients with pseudoptosis secondary to aberrant facial nerve regeneration who received botulinum toxin A injections. Results: Study patients include 6 men and 10 women with median age of 65 years (range 34-78). Etiology of facial nerve palsy included Bell palsy (11), surgical injury (2), trauma (2), and Ramsay-Hunt syndrome (1). Mean duration of facial nerve palsy was 8.5 years (1.1-30). Mean duration of pseudoptosis was 6.8 years (0.5-29). Botulinum toxin A (Botox; Allergan) injections were given in the medial and lateral pretarsal upper eyelid orbicularis oculi with some patients also receiving a central and/or additional lateral injection. Mean number of injections was 2.6 (2-4). Mean total dose was 10.3 units (5-20). Subjective improvement of symptoms at follow up was noted in all cases. Margin reflex distance in all patients showed statistically significant (p < 0.001) mean improvement of 1.6 mm (0.5-2.5) during orbicularis oris contracture. No side effects were reported, and all patients desired repeat injections. Repeat injection was performed at 3- to 6-month intervals, with most patients (12) returning every 3 months. Mean follow up was 12.2 months (3-61). Conclusions: Using low doses of carefully injected botulinum toxin A into the upper eyelid can provide safe and successful treatment of pseudoptosis due to aberrant facial nerve regeneration.

Original languageEnglish (US)
Pages (from-to)175-178
Number of pages4
JournalOphthalmic Plastic and Reconstructive Surgery
Volume29
Issue number3
DOIs
StatePublished - May 2013

Fingerprint

Type A Botulinum Toxins
Facial Nerve
Regeneration
Injections
Nerve Regeneration
Facial Paralysis
Eyelids
Therapeutics
Bell Palsy
Intraoperative Complications
Contracture
Reflex
Wounds and Injuries

ASJC Scopus subject areas

  • Ophthalmology
  • Surgery

Cite this

Treatment of pseudoptosis secondary to aberrant regeneration of the facial nerve with botulinum toxin type A. / McElhinny, Elaine R.; Reich, Isaac; Burt, Benjamin; Mancini, Ronald; Wladis, Edward J.; Durairaj, Vikram D.; Shinder, Roman.

In: Ophthalmic Plastic and Reconstructive Surgery, Vol. 29, No. 3, 05.2013, p. 175-178.

Research output: Contribution to journalArticle

McElhinny, Elaine R. ; Reich, Isaac ; Burt, Benjamin ; Mancini, Ronald ; Wladis, Edward J. ; Durairaj, Vikram D. ; Shinder, Roman. / Treatment of pseudoptosis secondary to aberrant regeneration of the facial nerve with botulinum toxin type A. In: Ophthalmic Plastic and Reconstructive Surgery. 2013 ; Vol. 29, No. 3. pp. 175-178.
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