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Combined corneal and facial nerve neurotization technique in the treatment of iatrogenic paralysis of the facial nerve and neurotrophic keratitis: 2 year follow-up of a case report

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Session Details

Session Title: Presented Poster Session: Cornea: Surgical

Venue: Poster Village: Pod 3

First Author: : S.Bagaglia ITALY

Co Author(s): :    G. Gabriele   C. Menicacci   P. Gennaro                 

Abstract Details


a double trigeminal microsurgical procedure was performed. facial reanimation was obtained adopting masseteric facial neurorraphy and corneal sensibility was re-established using a novel technique with infraorbitary nerve in a 79 years old female, who previously underwent VIII nerve neurinoma exeresis, reporting Iatrogenic facial paralysis and lesion of ophthalmic branch of the trigeminal, nerve, and consequent corneal neurotrophic keratitis


University of Siena, dep. of Ophthalmology. University of Siena, dept of Maxillofacial Surgery


Complete eye examination, Cochet Bonnet Kertoestesiometry and in vivo confocal microscopy was perfomed, pre surgery, at 6 months, 1 year, 18 and 24 months after surgery. Neurorraphy trough facial and masseternin nerve was performed, and fascicles of infraorbital nerve conduced under the conjunctiva were sutured in limbar area.


IVCM showed a reduced number corneal nerve fibers ,of Superficial epithelial layer cells and a high number of basal epithelial cells, comparing to controlatheral eye Cochet Bonnet Keratoestesiometry showed a mild progression during 2 years follow up. IVCM showed a progressive reduction of basal epithelial cells and an augmented number of superficial epithelial cells, similar to the non affected eye.


Conreal Neurotization may be a novel technique helpful in selected cases to perform coreal reanimation leading to a progressive mild healing on neurotrophic keratitis.

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