Combined corneal and facial nerve neurotization technique in the treatment of iatrogenic paralysis of the facial nerve and neurotrophic keratitis: 2 year follow-up of a case report

Session Details

Session Title: Presented Poster Session: Cornea: Surgical

Venue: Poster Village: Pod 3

First Author: : S.Bagaglia ITALY

Co Author(s): :    G. Gabriele   C. Menicacci   P. Gennaro                 

Abstract Details

Purpose:

a double trigeminal microsurgical procedure was performed. facial reanimation was obtained adopting masseteric facial neurorraphy and corneal sensibility was re-established using a novel technique with infraorbitary nerve in a 79 years old female, who previously underwent VIII nerve neurinoma exeresis, reporting Iatrogenic facial paralysis and lesion of ophthalmic branch of the trigeminal, nerve, and consequent corneal neurotrophic keratitis

Setting:

University of Siena, dep. of Ophthalmology. University of Siena, dept of Maxillofacial Surgery

Methods:

Complete eye examination, Cochet Bonnet Kertoestesiometry and in vivo confocal microscopy was perfomed, pre surgery, at 6 months, 1 year, 18 and 24 months after surgery. Neurorraphy trough facial and masseternin nerve was performed, and fascicles of infraorbital nerve conduced under the conjunctiva were sutured in limbar area.

Results:

IVCM showed a reduced number corneal nerve fibers ,of Superficial epithelial layer cells and a high number of basal epithelial cells, comparing to controlatheral eye Cochet Bonnet Keratoestesiometry showed a mild progression during 2 years follow up. IVCM showed a progressive reduction of basal epithelial cells and an augmented number of superficial epithelial cells, similar to the non affected eye.

Conclusions:

Conreal Neurotization may be a novel technique helpful in selected cases to perform coreal reanimation leading to a progressive mild healing on neurotrophic keratitis.

Financial Disclosure:

None