T Schrom1, C Taege, G Wolf, A Reinhardt, H Scherer. 1. Klinik für Hals-, Nasen-, Ohrenkrankheiten, Universitätsmedizin Berlin - Charité Campus Mitte. thomas.schrom@gmx.de
Abstract
BACKGROUND: Various implants are used to treat lagophthalmos in facial paralysis. The implantation of gold or platinum eyelid weights (lid loading) is being used increasingly. Histological changes have not yet been systematically examined in the implant capsule during explantation of the eyelid weight. MATERIAL AND METHODS: Of 26 explanted implants, 18 implants in 17 patients were followed-up using light microscopy from 1997 to 2004. We semi-quantitatively evaluated the density of the inflammatory infiltrate and recorded the occurrence of foreign bodies in the tissue. The inflammatory infiltrate was also immunohistochemically examined to characterize cellular composition. RESULTS: In the semi-quantitative examination of inflammatory infiltration density, 60% of the gold implants showed a moderately dense or dense inflammatory infiltrate, while there was moderately dense infiltration in only 12.5% of the platinum implants. The immunohistochemical examination revealed a mixed lymphocytic inflammatory infiltrate which tended to a preponderance of B lymphocytes (humoral response). This is typical of unspecific chronic inflammation. CONCLUSIONS: Both gold and platinum are suitable for treating lagophthalmos, however, platinum has a higher density and better biocompatibility than gold.
BACKGROUND: Various implants are used to treat lagophthalmos in facial paralysis. The implantation of gold or platinum eyelid weights (lid loading) is being used increasingly. Histological changes have not yet been systematically examined in the implant capsule during explantation of the eyelid weight. MATERIAL AND METHODS: Of 26 explanted implants, 18 implants in 17 patients were followed-up using light microscopy from 1997 to 2004. We semi-quantitatively evaluated the density of the inflammatory infiltrate and recorded the occurrence of foreign bodies in the tissue. The inflammatory infiltrate was also immunohistochemically examined to characterize cellular composition. RESULTS: In the semi-quantitative examination of inflammatory infiltration density, 60% of the gold implants showed a moderately dense or dense inflammatory infiltrate, while there was moderately dense infiltration in only 12.5% of the platinum implants. The immunohistochemical examination revealed a mixed lymphocytic inflammatory infiltrate which tended to a preponderance of B lymphocytes (humoral response). This is typical of unspecific chronic inflammation. CONCLUSIONS: Both gold and platinum are suitable for treating lagophthalmos, however, platinum has a higher density and better biocompatibility than gold.
Authors: Jill A Foster; Julian D Perry; Kenneth V Cahill; David E E Holck; Lance Kugler Journal: Ophthalmic Plast Reconstr Surg Date: 2004-03 Impact factor: 1.746