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Answers: 2010 Series : February 2, 2010
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To see views enlarged, click on the individual pictures...
| This young man is shown at rest, during attempted eyelid closure, and during attempted brow elevation. |
| 1. |
These findings are explained by: |
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b -- facial nerve palsy
This patient has a right facial nerve palsy giving laophthalmos from decreased innervation of the orbicularis oculi, and impaired brow elevation from decreased innervation of the frontalis muscle.
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| 2. |
Potential etiologies for tearing in a patient with this condition include: |
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e -- (a), (b), and (c)
Impaired lacrimal pump mechanism, paralytic ectropion, and exposure keratpathy with reflex tear hypersecretion are all reasons why patients with facial palsy may have tearing. These patients have no increased risk for obstruction of the nasolacrimal outflow system.
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| 3. |
Possible treatment options may include all except: |
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b -- levator advancement
Levator advancement is warranted to surgically correct blepharoptosis and would be contraindicated in a patient with facial palsy and lagophthalmos.
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