ABSTRACT
Botulinum Toxin is used for weakening of the levator complex in the management of upper lid retraction following Facial nerve palsy. Prospective non comparative interventional case series study. Twenty seven consecutive patients with VII nerve palsy, upper lid retraction and symptomatic lagophthalmos (3–8 mm) were included. Botulinum Toxin (37,5 – 75 IU) was administered with a 26 G needle deep into the upper lid sulcus, above the levator muscle. Follow up ranged from 6 to 8 months. Lid position improved within ten days from treatment. Upper lid retraction and lagophthalmos was corrected with lid position above the visual axis. No ocular motility defects observed. Facial nerve function improved spontaneously in eight teen cases, the remaining nine required retreatment in three months time. Botulinum Toxin weakening of levator muscle is an effective management of upper lid retraction following facial nerve palsy especially in temporary nerve palsy.
