Acceptance and willingness of patients with chronic facial nerve palsy for an implantable device that assists with eye closure

Paul Rozenbroek; Annie Waugh; Gillian Heller; Raymond Hayler; Jacinta Cleary; Shaheen Hasmat; Nigel H Lovell; Gregg Suaning; Jonathan R Clark; Tsu-Hui Hubert Low

doi:10.1016/j.bjps.2024.09.028

Acceptance and willingness of patients with chronic facial nerve palsy for an implantable device that assists with eye closure

J Plast Reconstr Aesthet Surg. 2024 Sep 25:S1748-6815(24)00583-7. doi: 10.1016/j.bjps.2024.09.028. Online ahead of print.

Authors

Affiliations

¹ Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, Sydney, NSW, Australia; Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Sydney, NSW, Australia. Electronic address: paul.rozenbroek@health.nsw.gov.au.
² Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Sydney, NSW, Australia.
³ NHMRC Clinical Trials Centre, University of Sydney, Camperdown, Australia.
⁴ Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Sydney, NSW, Australia; Sydney Facial Nerve Clinic, The Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia.
⁵ Graduate School of Biomedical Engineering, Tyree Institute of Health Engineering (IHealthE) UNSW, Sydney, Australia.
⁶ Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Sydney, NSW, Australia; Graduate School of Biomedical Engineering, Tyree Institute of Health Engineering (IHealthE) UNSW, Sydney, Australia.
⁷ School of Biomedical Engineering, University of Sydney, Sydney, Australia; Freiburg Institute for Advanced Studies, Albert-Ludwigs-Universität, Freiburg, Germany.
⁸ Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, Sydney, NSW, Australia; Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Sydney, NSW, Australia; Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Sydney, Australia.
⁹ Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, Sydney, NSW, Australia; Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Sydney, NSW, Australia; Sydney Facial Nerve Clinic, The Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia; Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW 2109, Australia.

PMID: 39379217
DOI: 10.1016/j.bjps.2024.09.028

Abstract

Background: Patients with facial nerve palsy often experience lagophthalmos (incomplete eye closure), which can lead to exposure keratitis. The Bionic Lid Implant for Natural Eye Closure (BLINC) is a medical device designed to mimic the more natural blink kinetics than traditional lid loading techniques.

Aims: This study aimed to evaluate potential factors that might influence the design of the BLINC device and willingness of participant to undergo the implant placement surgery.

Methods: Patients attending a multidisciplinary facial nerve clinic were invited to complete a survey addressing patient acceptance of the BLINC device implantation.

Results: Seventy-two patients were mailed the survey, of which 50 returned completed surveys (69%). The most important factor identified by participants was the device function (81% ranked as very important) and the least important factor was cost (16% ranked as very important). Median acceptable device function time was 5 years (range 1-10 years). Ten participants (20%) indicated willingness to be the first to trial BLINC. Women were more likely to rate visual appearance as important (OR 3.32, CI 1.14-9.62, p = 0.028), and less likely to rate user friendliness as important (OR 0.16, CI 0.04-0.52, p = 0.0021). Older participants were more likely to rate the length of recovery period as important (OR 1.04, CI 1.01-1.08, p = 0.006). Participants with complete eye closure were less likely to be willing to trial the implant (OR 0.08, CI 0.00-0.53, p = 0.006, whilst patients with eye irritation were more willing to trial the implant (OR 7.20, CI 1.12-142, p = 0.036).

Conclusion: Certain patient demographics impact patient aesthetic and functional preferences and the willingness to trial the BLINC device.

Keywords: Bionic Implant; Facial paralysis; Lagophthalmos; Prosthesis; Surgery.