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Background:Facial paralysis affecting the orbicularis oculi muscle results in an inability to close the eyelid(lagophthalmos) Due to the loss of orbicularis muscle tone, gravity pulls the atonic lower lid into a sagging position (ectropion) and also lower lid margin and lacrimal punctum are not in apposition with the globe, resulting in epiphora, dryness of the cornea and exposure keratitis leading to eventual blindness.These symptoms and signs are more aggravated with old age.A deep temporal fascia sling is known to be a very effective surgical method in the treatment of paralytic ectropion.Objective :Thes study was performed to evaluate the deep temporal fascia sling to correct paralytic ectropion.Methods:In 56 patients with lower lid ectropion due to facial nerve palsy as a leprosy sequelae, a strip of deep temporal fascia, 5.0§? long and 0.5§? wide was obtained from the scalp.The age distribution of the patients was shown from 55 year old to 80 years old.The technique is performed under local anesthesia.The one end of deep fascia is sutured to the medial canthal tendon and the other end of the tendon was threaded through the tunnel just under-neath the lower margin of the tarsus and secured to the periostemm of the lateral orbital rim near Whitnall's tubercle.Ancillary procedures are simultaneously performed with permanent medial tarsorrhaphy and lateral tarsal strip.Results:In one & half year follow-up period, post-operative improvement was achieved such as no eversion of the lower lid margin to the globe and symptom relief of conjunctival discomfort, compared with artificial tissue sling (Alloderm) results relapsed easily.Conclusion:The ocular complications of orbicularis oculi paralysis follow a progerive course.As much as possible, it is necessary to maintain the operative results more longer.The dynamic methods for the treatment of paralytic eye-lid is ideal, but it may be difficult for us practically to apply and find a operative procedure.The temporal fascia sling with lateral tarsal strip and permanent medial tarsorrhaphy is seemed esthetically & functionally to be an effective method for senile paralytic ectropion patients, even though it is a static method.