Nerve Compressive Stitches: A New Surgical Technique for the Treatment of Blepharospasm

Viterbo F, Magnani LV and Neto BFM

Department of Surgery and Orthopedics, School of Medicine of Botucatu, São Paulo State University, Brazil

^*Correspondance to: Fausto Viterbo 

 PDF  Full Text DOI: 10.25107/2474-1647.3653

Abstract

Introduction: Blepharospasm (BSP) is a debilitating condition characterized by hyperactivity of the periorbicular muscles. It results in functional blindness, which affects accomplishment of daily tasks. In addition, BSP can cause serious emotional repercussions because of the difficulty that the spasms impose. Treatment is not currently available, but botulinum toxin applications and surgical procedures are good options. However, the application of botulinum toxin has caused temporary and variable results. In many cases, the improvement does not last for more than one week. The current surgical option is total orbicularis oculi myectomy, which offers good results in some cases but may also cause unsightly and variable results with bad aesthetic sequela. Methods: We performed a pre-auricular incision and carefully isolated the branches of the facial nerve. Next, we applied nerve compressive stitches in the zygomatic nerve, varying the amount according to the level of spasms in each patient. Results: Three patients underwent surgery and had good outcomes, with total cessation of spasms in two of them. In one case, few spasms remained, which can be resolved with the reapplication of more nerve compressive stitches. Discussion: Based on the case reports presented here, we can conclude that nerve compressive stitches are revolutionary for the treatment of blepharospasms, presenting a great alternative to the current treatments for the disease. The main advantages of the technique presented here are adjustable, by increasing or decreasing the stitch quantity, the possibility of reapplication in a short period of time with local anesthesia, and presenting immediate results. Conclusion: The application of botulinum toxin continues to be the primary treatment for blepharospasms. However, for refractory patients or in severe cases, the application of nerve compressive stitches is highly recommended. Synopsis: This article presents a revolutionary new approach for treating blepharospasm, using the technique of nerve compressive stitches, presenting a great alternative to the current treatments for the disease.

Keywords

Blepharospasms; Benign essential blepharospasm; Nerve compressive stitches; New surgical technique

Cite the article

Viterbo F, Magnani LV, Neto BFM. Nerve Compressive Stitches: A New Surgical Technique for the Treatment of Blepharospasm. Clin Surg. 2023; 8: 3653..