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Eye (2012) 26, 10951098& 2012 Macmillan Publishers Limited All rights reserved 0950-222X/12
http://www.nature.com/EYE
Web End =www.nature.com/eye
AH Alsuhaibani1, TM Bosley1, RA Goldberg2 and YH Al-Faky1
Entropion in children with isolated peripheral facial nerve paresis
CLINICALSTUDY
Abstract
Purpose Adults with facial nerve paresis (FNP) generally develop ectropion, but a recent report of children with syndromatic FNPs implies that entropion may be more common in this setting than ectropion. This study evaluates eyelid position and other periorbital changes in children with isolated, non-syndromatic FNP.
Methods Charts were reviewed of 10 sequential children who presented to a major national eye referral centre with isolated FNP of variable aetiology. Severity of FNP was assessed according to the House-Brackmann scale.
Results All 10 patients (4 males and6 females; mean age at presentation, 4 years) had unilateral, isolated FNP. Mild lower-eyelid entropion was present in four patients, and severe lower-eyelid entropion required surgical correction in three patients. All patients had lower eyelid retraction (mean2.3 mm) and lagophthalmos (mean 2.9 mm). None had enophthalmos, lower eyelid ectropion, or brow ptosis.
Conclusion Unlike adults, children with isolated FNP seem prone to develop entropion rather than ectropion. Entropion reported previously in ve syndromic children with FNP seems more likely related to patients age than to their congenital syndromes.
Eye (2012) 26, 10951098; doi:http://dx.doi.org/10.1038/eye.2012.102
Web End =10.1038/eye.2012.102 ; published online 25 May 2012
Keywords: entropion; ectropion; children; facial paresis; facial palsy
Introduction
Ectropion is common in adults with facial nerve paresis (FNP),1,2 but a recent report
described entropions in a small group of
children with syndromic FNP.3 Eyelid position has not yet been carefully evaluated in children with isolated FNP,2,410 so this study reports
eyelid and periorbital changes in 10 consecutive children presenting with isolated FNP.
Methods
Medical records were reviewed of 10 consecutive children who were presented to King Abdulaziz University Hospital, Riyadh, Saudi Arabia, with isolated lower motor neuron FNP between January 2007 and January 2011. Patients who had undergone previous ophthalmic surgery and patients with obvious craniofacial disorders were excluded. The information that was recorded included the cause of FNP, the complete ophthalmologic clinical examination, and ophthalmologic surgical procedures needed to manage the consequences of FNP.
Results
Table 1 summarizes the aetiology of FNP,age at onset and presentation, lower eyelid observations, and...