Dynamic smile reanimation in facial nerve palsy
Santha Krishnakumar Krishnan, Joseph Subin, Latheef Sameer, Narayanan Saju, Nair Santhy Mohanachandran, Babu Bibilash, Sivadasan Anand, Shet Srivatsa Manjunath, Pydi Rajesh Vardhan, Pati Ajit, Samantaray Srikant Aruna,
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( Santha Krishnakumar Krishnan ) - Aster MIMS Hospital Department of Plastic and Reconstructive Surgery
( Joseph Subin ) - Baby Memorial Hospital Department of Plastic, Reconstructive and Burns Surgery
( Latheef Sameer ) - Baby Memorial Hospital Department of Plastic, Reconstructive and Burns Surgery
( Narayanan Saju ) - Aster MIMS Hospital Department of Plastic and Reconstructive Surgery
( Nair Santhy Mohanachandran ) - Baby Memorial Hospital Department of Plastic, Reconstructive and Burns Surgery
( Babu Bibilash ) - Aster MIMS Hospital Department of Plastic and Reconstructive Surgery
( Sivadasan Anand ) - Baby Memorial Hospital Department of Plastic, Reconstructive and Burns Surgery
( Shet Srivatsa Manjunath ) - Baby Memorial Hospital Department of Plastic, Reconstructive and Burns Surgery
( Pydi Rajesh Vardhan ) - Baby Memorial Hospital Department of Plastic, Reconstructive and Burns Surgery
( Pati Ajit ) - Aster MIMS Hospital Department of Plastic and Reconstructive Surgery
( Samantaray Srikant Aruna ) - Baby Memorial Hospital Department of Plastic, Reconstructive and Burns Surgery
Abstract
Objectives: Long-term facial paralysis results in degeneration of the distal nerve segment and atrophy of the supplied muscles. Options for these patients include free muscle transfer, temporalis myoplasty, and botulinum toxin injections for smile reanimation. In this study we aimed to evaluate the subjective and objective outcomes of these procedures.
Materials and Methods: In our study, we retrospectively analyzed smile symmetry in patients with facial palsy (n=8) who underwent facial reanimation procedures.
Results: Subjective analysis showed high satisfaction in seven out of eight patients. Objective analysis showed statistically significant improvement postoperatively in both vertical and horizontal smile symmetry at rest and during maximum smile (P<0.001).
Conclusion: Choosing the ideal procedure for the patients is the most critical aspect for facial reanimation. Though free muscle transfer is considered gold standard procedure, temporalis myoplasty also gives satisfactory results. Residual synkinesis which can lead to disturbing aesthetic deformity can be effectively treated with botulinum toxin.
키워드
Facial nerve; Free tissue flaps; Smiling; Temporal muscle; Botulinum toxins
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