Facial nerve palsy (FNP) can come with a number of concerning side effects, including lagophthalmos (leading to dry eye symptoms) and aesthetic concerns that may affect a patient’s quality of life. Researchers have recently found eyelid full-thickness skin grafting may be a good option to tackle both issues at the same time.

Investigators in the United Kingdom studied 28 eyelids that underwent full-thickness skin grafting for FNP treatment, and recorded cornea, static asymmetry and dynamic and synkinesis (CADS) score facial nerve grading, lagophthalmos on blink, gentle and forced closure and marginal reflex distance. Two blinded assessors judged aesthetic outcomes using a mutually agreed grading scale. These functional and aesthetic outcomes were measured preoperatively, one to three, three to six and more than nine months post-op.

Results show an improvement in patients’ CADS scores and lagophthalmos and marginal reflex in both the early and late post-op follow-ups. The independent assessors agreed that the grafts “appeared to look natural in terms of color, surface contour and graft edge from the intermediate postoperative period and continued to improve significantly by the late postoperative period,” according to the study.

Periocular full-thickness skin grafts are “effective in improving lagophthalmos and periorbital symmetry in patients with FNP where skin contraction exists,” the researchers conclude. “They should be considered as an adjunct to other oculoplastic procedures for both functional and aesthetic rehabilitation.”

Maqsood SE, Cascone N, Grixti1 A, et al. Functional and aesthetic outcomes of eyelid skin grafting in facial nerve palsy. Br J Ophthalmol. June 26, 2018. [Epub ahead of print].