Injerto libre de platisma neurotizado en un solo tiempo quirúrgico para el tratamiento del lagoftalmos posterior a una parálisis facial
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Fecha
2025
Autores
Lacouture Armenta, Carlos José
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
Introducción: El lagoftalmos es una complicación frecuente de la parálisis facial que puede derivar en úlceras corneales y ceguera si no se trata de manera adecuada. Los tratamientos estáticos actuales, como la pesa de oro, no restauran la dinámica natural del parpadeo, lo que limita su efectividad funcional y estética.
Objetivo: Describir y evaluar una técnica quirúrgica novedosa utilizando un injerto libre de músculo platisma neurotizado en un solo tiempo quirúrgico para restaurar la función palpebral en pacientes con lagoftalmos.
Metodología: Se realizó un estudio retrospectivo, observacional y descriptivo tipo serie de casos, en tres pacientes con parálisis facial y lagoftalmos de larga evolución. La técnica quirúrgica incluyó el injerto libre de músculo platisma con un nervio injertado, seguido de un año de seguimiento clínico y electromiográfico.
Resultados: Todos los pacientes presentaron recuperación funcional satisfactoria, con cierre palpebral adecuado y mejoras estéticas significativas. El tiempo promedio para el inicio de la contracción muscular fue de 7.6 meses. No se reportaron complicaciones durante el seguimiento.
Conclusión: La técnica quirúrgica propuesta demuestra ser una alternativa eficaz y segura para el manejo del lagoftalmos, ofreciendo ventajas funcionales y estéticas. Se recomienda realizar estudios adicionales con muestras más amplias para confirmar estos hallazgos.
Introduction: Lagophthalmos is a common complication of facial paralysis that can lead to corneal ulcers and blindness if untreated. Current static treatments, such as gold weights, fail to restore the natural dynamics of blinking, limiting their functional and aesthetic effectiveness. Objective: To describe and evaluate a novel surgical technique using a free neurotized platysma muscle graft in a single surgical stage to restore palpebral function in patients with lagophthalmos. Methodology: A retrospective, observational, descriptive case series study was conducted involving three patients with long-standing facial paralysis and lagophthalmos. The surgical technique included a free platysma muscle graft with a nerve transfer and one-year follow-up with clinical and electromyographic evaluations. Results: All patients achieved satisfactory functional recovery, with proper eyelid closure and significant aesthetic improvements. The average time to initial muscle contraction was 7.6 months. No complications were reported during follow-up. Conclusion: The proposed surgical technique proves to be an effective and safe alternative for managing lagophthalmos, offering functional and aesthetic advantages. Further studies with larger samples are recommended to validate these findings.
Introduction: Lagophthalmos is a common complication of facial paralysis that can lead to corneal ulcers and blindness if untreated. Current static treatments, such as gold weights, fail to restore the natural dynamics of blinking, limiting their functional and aesthetic effectiveness. Objective: To describe and evaluate a novel surgical technique using a free neurotized platysma muscle graft in a single surgical stage to restore palpebral function in patients with lagophthalmos. Methodology: A retrospective, observational, descriptive case series study was conducted involving three patients with long-standing facial paralysis and lagophthalmos. The surgical technique included a free platysma muscle graft with a nerve transfer and one-year follow-up with clinical and electromyographic evaluations. Results: All patients achieved satisfactory functional recovery, with proper eyelid closure and significant aesthetic improvements. The average time to initial muscle contraction was 7.6 months. No complications were reported during follow-up. Conclusion: The proposed surgical technique proves to be an effective and safe alternative for managing lagophthalmos, offering functional and aesthetic advantages. Further studies with larger samples are recommended to validate these findings.
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Palabras clave
Parálisis facial, Injerto libre de platisma, Reanimación facial, Lagoftalmos
