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.
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.
摘要：
背景：面瘫是一种可能由各种病因引起的改变生活的疾病，从创伤到恶性肿瘤。永久性面瘫可继发于面神经损伤或不可逆的面神经损伤。在这些特别具有破坏性的案例中,保护和维持眼睛的功能是至关重要的。对于这些患者有许多有效的眩光矫正外科手术。虽然眼睑重量的放置和眼睑收紧手术是眼睑康复的基石，关于永久性面瘫背景下眼睑干预的时机是否影响结果的信息有限，包括需要翻修手术。
方法：对2013年至2022年间使用上眼睑重量治疗的不可逆性面瘫患者进行了单中心回顾性图表回顾。获得电子健康记录以获取面瘫病因，相关临床特征，干预的类型，以及干预的时机。如果眼睑重量手术发生在初始面瘫的29天内，则将患者分类为立即，如果手术发生在初始表现后30天或更长时间，则将患者分类为延迟。根据翻修程序和手术并发症评估结果。
结果：共有70例患者，35名患者属于直接类别，35名患者属于延迟类别。最常见的病因与腮腺病理有关，58.6%的患者因癌症相关手术而出现面瘫。两组之间的翻修率（p<0.208）或手术类型（p=0.077）没有显着差异。两组之间的并发症发生率也没有显着差异；但是，延迟干预组仅有并发症.
结论：这些研究结果表明，两组之间的术后并发症没有差异，包括在比较有立即或延迟干预的组时需要进行翻修手术。因此，应根据患者和提供者的偏好定制治疗计划.
方法：对2013年至2022年间使用上眼睑重量治疗的不可逆性面瘫患者进行了单中心回顾性图表回顾。获得电子健康记录以获取面瘫病因，相关临床特征，干预的类型，以及干预的时机。如果眼睑重量手术发生在初始面瘫的29天内，则将患者分类为立即，如果手术发生在初始表现后30天或更长时间，则将患者分类为延迟。根据翻修程序和手术并发症评估结果。
结果：共有70例患者，35名患者属于直接类别，35名患者属于延迟类别。最常见的病因与腮腺病理有关，58.6%的患者因癌症相关手术而出现面瘫。两组之间的翻修率（p<0.208）或手术类型（p=0.077）没有显着差异。两组之间的并发症发生率也没有显着差异；但是，延迟干预组仅有并发症.
结论：这些研究结果表明，两组之间的术后并发症没有差异，包括在比较有立即或延迟干预的组时需要进行翻修手术。因此，应根据患者和提供者的偏好定制治疗计划.
