Lateral tarsal strip for facial nerve palsy This 78 year-old man had had right facial nerve palsy since the age three. For the past few years, he suffered from recurrent epiphora and ocular discomfort.  Examination revealed right sided facial muscle weakness and marked right lower lid ectropion.  A right tarsal strip procedure was performed by attaching the lateral tarsus to the periosteum 3 mm above the medial canthus. Post-operatively, there was a marked upward slanting of the right lateral corner. This contour is essential for successful outcome as the lateral tarsal strip tend to sack with time. A lower attachment of the lateral strip would have led to a lateral canthus which is lower than the medial canthus and possible recurrence of epiphora.

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