Certain types of brain tumors, and certain tumors involving the main motor nerve of the face (the facial nerve), can lead to problems with eye closure. Sometimes the problem is due to the tumor itself, but most often these nerves are cut during removal of the tumor. The end result is the same — the upper lid on the effected side doesn’t close, and the lower lid sags down because of cheek paralysis.
The upper lid can often be repaired using an implanted gold weight. The helps to lower the lid by gravity. It also helps to place the eyelid on stretch, which may help to improve whatever muscle function is still working. Sometimes, if there is at least some eyelid closure function, there is no need to do a gold weight, and in fact a tightening of the upper lid alone will suffice to improve closure. The lower lid laxity is a problem that usually requires a supporting tissue graft, to keep the lid from sagging down. An ear cartilage graft is usually chosen for this purpose.
The combination of these two surgeries can have a dramatic impact on a patients quality of life. Below are the sentiments from a recent patient who underwent surgery to improve his lid closure after he had a brain tumor removed:
In 2005 I had a very large brain tumor removed which left the right side of my face and eye paralyzed. Over the years I have undergone several reconstruction surgeries on my face and eye. Trying to take care of my eye was almost a full time job, everything from drying out so bad that the cornea would crack to having to put tape on it when I would go outside in cold weather. Then I was referred to Dr Walrath for a consultation, we talked about the surgery he could do on my eye and decided it was for me. After the surgery I would have to say it was more than a success, it was life changing. I no longer live with a bottle of eye drops in my hand and putting tape on my eye is a thing of the past. I would highly recommend Dr Waltath he is a remarkable man. I would like to publicly thank Dr Walrath for all he has done to give me my life back.