A patient with complete unilateral facial paralysis (House-Brackmann Grade VI) following temporal bone fracture is unable to close the eye. What is the most appropriate immediate management to prevent corneal complications?
- A Observation with artificial tears only
- B Tarsorrhaphy (surgical closure of the eyelids)
- C Lubricating eye drops, ointment, and taping the eye shut at night ✓
- D Gold weight upper lid implantation
Correct answer: C. Lubricating eye drops, ointment, and taping the eye shut at night
Explanation
In acute facial paralysis with inability to close the eye, the immediate priority is corneal protection using frequent lubricating eye drops during the day, ophthalmic ointment, and taping or patching the eye closed at night to prevent exposure keratitis. Tarsorrhaphy and gold weight implantation are considered only if recovery does not occur. Observation alone without protection risks corneal ulceration and permanent vision loss.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.