Man is endowed with the ability to show emotions and feeling through facial expressions. The permanent paralysis of 7th nerve, which is responsible for the bulk of the facial expressions, can not only lead to loss of facial expressions, but also the psychological trauma from this loss can be devastating. The goal of the plastic surgeon is then, to restore as much as possible the lossed function so that the patient can attempt to lead a normal social life.
The goals of therapy, because of its utmost importance should be reviewed. Maintaining an acceptable appearance while at rest should be the initial goal. Also it is important to remember that there must be symmetry with voluntary motion as well as retention of controlled emotions.
In achieving these goals, certain surgical precausion must be observed, e.g., there must be intact blood and nerve supply, adequate flap size, and avoidance of tension or angulation which could impair blood circulation.
Although there are numerous methods of surgical correction, none will result in complete recovery. And thus, the method must be carefully selected and tailored to suit each patient.
During the one year period between January through December of 1982, we encounted 4 patients who complained of wide palpebral fissure and/or deviation of mouth angle. They were diagnosed as having unilateral facial palsy and surgical correction using temporalis muscle or maseter muscle transfer was performed.
In all cases, satisfactory results were obtained.
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