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Imaging the Postoperative Orbit

2

 

Daniel Thomas Ginat, Gul Moonis,

and Suzanne K. Freitag

2.1\ Eyelid Weights

2.1.1\ Discussion

Facial nerve deficits can lead to keratitis secondary to lagophthalmos and decreased lacrimal gland secretions. Implantable platinum and gold weights are available in various sizes and shapes, including thin profile. Eyelid weights are placed deep to the orbicularis oculi muscle and sutured

to the tarsus in the upper eyelid, enabling more complete eyelid closure (Fig. 2.1). The implants generally produce considerable metal streak artifact on CT. Gold and platinum eyelid weights are considered MRI compatible. Complications related to eyelid weight implantation include infection, allergic reaction, migration, and extrusion. Closure of the orbicularis oculi muscle over the implant reduces the risk of extrusion.

D.T. Ginat, M.D., M.S. (*)

Department of Radiology, University of Chicago, Pritzker School of Medicine, Chicago, IL, USA e-mail: dtg1@uchicago.edu

G. Moonis, M.D

Department of Radiology, Columbia Presbyterian, New York, NY, USA

S.K. Freitag, M.D.

Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA

© Springer International Publishing Switzerland 2017

31

D.T. Ginat, P.-L.A. Westesson (eds.), Atlas of Postsurgical Neuroradiology,

DOI 10.1007/978-3-319-52341-5_2

32

D.T. Ginat et al.

 

 

a

b

c

Fig. 2.1  Eyelid weight. The patient has a history of left cranial nerve VII palsy. Frontal radiograph (a) shows a left eyelid weight containing three suture holes (arrows). Sagittal CT image (b) shows a left upper eyelid weight

(arrows), which produces extensive streak artifact. Photograph of various sizes of gold eyelid weight implants (c) (Courtesy of Osmed)