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KMID : 0355620200460020143
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Journal of Korean Association of Oral and Maxillofacial Surgeons
2020 Volume.46 No. 2 p.143 ~ p.149
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Dynamic smile reanimation in facial nerve palsy
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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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Abstract
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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.
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KEYWORD
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Facial nerve, Free tissue flaps, Smiling, Temporal muscle, Botulinum toxins
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