Temporalis muscle sling revisited: a technique to restore ocular sphincter function.

Five patients with unilateral facial palsy with moderate to severe lagophthalmos (less than 70% eyelid closure) and duration of palsy expected to last more than 2 years were selected for the study. In all patients, a temporalis muscle-fascia sling was used to restore ocular sphincter function. A few modifications in the original technique as described by Gillies have been recommended: namely, harvesting of a narrow strip of temporalis muscle to avoid a bulge in the temporal region, submuscular passage of temporalis fascial strip in the eyelid to avoid eversion of the lid margins, and tenorrhaphy of fascial strips at the medial aspect of the lower eyelid to avoid webbing of the medial canthus. Average duration of follow-up was 3 years. All patients showed excellent eyelid closure. Advantages of the temporalis muscle sling, which is a dynamic procedure using autogenous tissue, are discussed.