Facial nerve palsy

Left facial nerve palsy in a 59 year-old man. The pictures show left lower lid ectropion and upper lid retraction. The retraction is the result of unopposed levator function. The ocular discomfort results from the lower lid ectropion as well as upper lid retraction. The tip of a cotton bud is useful in demonstrating to the patient the position of the lids that can be achieved with surgery. In this case, a medial canthoplasty may be used to reduce the medial ectropion. The retraction may be reduced with levator disinsertion.
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