Long-term enhancement of botulinum toxin injections by upper-eyelid surgery in 14 patients with facial dyskinesias.

Abstract

OBJECTIVES:

To determine the effects of upper-eyelid surgery (limited myectomy, blepharoplasty, and levator aponeurotic advancement) on patients who demonstrated a suboptimal response or residual heaviness of the upper eyelids after botulinum toxin eyelid injections for facial dyskinesia.

DESIGN:

Retrospective study.

SUBJECTS:

Charts of 358 patients with a diagnosis of benign essential blepharospasm, Meige syndrome (with eyelid involvement), and hemifacial spasm were reviewed.

METHODS:

Data were retrospectively analyzed and included subjective and objective responses about botulinum toxin injections (number and duration of effect of injections before and after eyelid surgery).

RESULTS:

Of 358 patients with facial dyskinesias, 14 (3.91%) underwent upper-eyelid limited myectomy with or without upper-lid blepharoplasty (n = 5), upper-lid blepharoplasty alone (n = 6), or levator advancement with or without blepharoplasty (n = 3). Mean subjective improvement was 68.75% after limited myectomy combined with blepharoplasty and 58.33% after levator and/or blepharoplasty surgery. Average duration of effect of injections increased from 122.1 days in the patients prior to undergoing eyelid surgery to 210.5 days after surgery.

CONCLUSIONS:

Upper-eyelid surgery, including limited myectomy, enhanced the effect of the botulinum toxin in this small group of patients. Patients with a suboptimal response to injections in terms or moderate to marked dermatochalasis with subjective heaviness of the eyelids, upper-eyelid blepharoplasty, and/or limited myectomy should be considered.

• Authors: J A Mauriello Jr, R Keswani, M Franklin
• Journal: Archives of otolaryngology--head & neck surgery (Arch Otolaryngol Head Neck Surg) Vol. 125 Issue 6 Pg. 627-31 (Jun 1999) ISSN: 0886-4470 [Print] United States
• PMID: 10367918 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Dyskinesia Agents
• Botulinum Toxins

Topics

• Aged
• Anti-Dyskinesia Agents (administration & dosage)
• Blepharoplasty (methods)
• Blepharospasm (drug therapy, surgery)
• Botulinum Toxins (administration & dosage)
• Combined Modality Therapy
• Eyelids (surgery)
• Female
• Follow-Up Studies
• Hemifacial Spasm (drug therapy, surgery)
• Humans
• Male
• Meige Syndrome (drug therapy, surgery)
• Middle Aged
• Retrospective Studies
• Time Factors