J Korean Assoc Oral Maxillofac Surg.  2020 Apr;46(2):143-149. 10.5125/jkaoms.2020.46.2.143.

Dynamic smile reanimation in facial nerve palsy

• Santha KK
• Joseph S
• Latheef S
• Narayanan
• Nair SM
• Babu B
• Sivadasan
• Shet SM
• Pydi RV
• Pati A
• Samantaray SA

• KMID: 2500670
• DOI: http://doi.org/10.5125/jkaoms.2020.46.2.143

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.

Keyword

Facial nerve; Free tissue flaps; Smiling; Temporal muscle; Botulinum toxins