Smile Restoration for Permanent Facial Paralysis

LEARNING OBJECTIVES

After reviewing this article on facial paralysis, the reader should be able to do the following:

1. 1) Review the epidemiology and causes of facial paralysis;

2. 2) Describe the assessment of a patient;

3. 3) Describe the treatment in adults and children; and

4. 4) Understand the outcomes of facial reanimation surgery.

Publication History

Received: 25 January 2013

Accepted: 15 March 2013

Article published online:
01 May 2022

• References

• 1 Bradbury ET, Simons W, Sanders R. Psychological and social factors in reconstructive surgery for hemi-facial palsy. J Plast Reconstr Aesthet Surg 2006; 59: 272-278
• 2 Bonnet RM. Causes of facial palsies. In: Beurskens CH. The facial palsies: complementary approaches. Utrecht: Lemma publishers; 2005
• 3 Tzafetta K, Terzis JK. Essays on the facial nerve: Part I. Microanatomy. Plast Reconstr Surg 2010; 125: 879-889
• 4 Falco NA, Eriksson E. Facial nerve palsy in the newborn: incidence and outcome. Plast Reconstr Surg 1990; 85: 1-4
• 5 Gilden DH. Clinical practice. Bell's Palsy. N Engl J Med 2004; 351: 1323-1331
• 6 Harii K, Ohmori K, Torii S. Free gracilis muscle transplantation, with microneurovascular anastomoses for the treatment of facial paralysis. A preliminary report. Plast Reconstr Surg 1976; 57: 133-143
• 7 Fattah A, Borschel GH, Manktelow RT. et al. Facial palsy and reconstruction. Plast Reconstr Surg 2012; 129: 340e-352e
• 8 Harrison DH. Pectoralis minor for facial palsy. Plast Reconstr Surg 1985; 76: 656-657
• 9 Terzis JK, Olivares FS. Long-term outcomes of free-muscle transfer for smile restoration in adults. Plast Reconstr Surg 2009; 123: 877-888
• 10 Terzis JK, Olivares FS. Long-term outcomes of free muscle transfer for smile restoration in children. Plast Reconstr Surg 2009; 123: 543-555
• 11 Manktelow RT, Tomat LR, Zuker RM. et al. Smile reconstruction in adults with free muscle transfer innervated by the masseter motor nerve: effectiveness and cerebral adaptation. Plast Reconstr Surg 2006; 118: 885-899
• 12 Terzis JK, Noah EM. Dynamic restoration in Mobius and Mobius-like patients. Plast Reconstr Surg 2003; 111: 40-55
• 13 Woollard AC, Harrison DH, Grobbelaar AO. An approach to bilateral facial paralysis. J Plast Reconstr Aesthet Surg 2010; 63: 1557-1560
• 14 Takushima A, Harii K, Asato H. et al. Fifteen-year survey of one-stage latissimus dorsi muscle transfer for treatment of longstanding facial paralysis. J Plast Reconstr Aesthet Surg 2013; 66: 29-36
• 15 Guelinckx PJ, Sinsel NK. Muscle transplantation for reconstruction of a smile after facial paralysis past, present, and future. Microsurgery 1996; 17: 391-401
• 16 Zuker RM, Coombs C, Borschel G. et al. Panel discussion. Instructional Course for Facial Palsy Reconstruction; 2011 Oct 25-26; Taiwan. Linkou Chang Gung Mayo Clinic Symposium in Reconstructive Surgery 2011
• 17 Ibrahim AM, Rabie AN, Kim PS. et al. Static treatment modalities in facial paralysis: a review. J Reconstr Microsurg 2013; 29: 223-232
• 18 Labbe D, Huault M. Lengthening temporalis myoplasty and lip reanimation. Plast Reconstr Surg 2000; 105: 1289-1297
• 19 Labbe D, Bussu F, Iodice A. A comprehensive approach to long-standing facial paralysis based on lengthening temporalis myoplasty. Acta Otorhinolaryngol Ital 2012; 32: 145-153
• 20 Michaelidou M, Tzou CH, Gerber H. et al. The combination of muscle transpositions and static procedures for reconstruction in the paralyzed face of the patient with limited life expectancy or who is not a candidate for free muscle transfer. Plast Reconstr Surg 2009; 123: 121-129
• 21 Nduka C, Hallam MJ, Labbe D. Refinements in smile reanimation: 10-year experience with the lengthening Temporalis Myoplasty. J Plast Reconstr Aesthet Surg 2012; 65: 851-856
• 22 Bulstrode NW, Harrison DH. The phenomenon of the late recovered Bell's palsy: treatment options to improve facial symmetry. Plast Reconstr Surg 2005; 115: 1466-1471
• 23 Conley J, Baker DC, Selfe RW. Paralysis of the mandibular branch of the facial nerve. Plast Reconstr Surg 1982; 70: 569-577
• 24 Tulley P, Webb A, Chana JS. et al. Paralysis of the marginal mandibular branch of the facial nerve: treatment options. Br J Plast Surg 2000; 53: 378-385
• 25 Terzis JK, Kalantarian B. Microsurgical strategies in 74 patients for restoration of dynamic depressor muscle mechanism: a neglected target in facial reanimation. Plast Reconstr Surg 2000; 105: 1917-1931
• 26 Horlock N, Sanders R, Harrison DH. The SOOF lift: its role in correcting midfacial and lower facial asymmetry in patients with partial facial palsy. Plast Reconstr Surg 2002; 109: 839-849
• 27 Olver JM. Raising the suborbicularis oculi fat (SOOF): its role in chronic facial palsy. Br J Ophthalmol 2000; 84: 1401-1406
• 28 Terzis JK, Tzafetta K. The "babysitter" procedure: minihypoglossal to facial nerve transfer and cross-facial nerve grafting. Plast Reconstr Surg 2009; 123: 865-876
• 29 Frey M, Giovanoli P, Gerber H. et al. Three-dimensional video analysis of facial movements: a new method to assess the quantity and quality of the smile. Plast Reconstr Surg 1999; 104: 2032-2039
• 30 Terzis JK, Noah ME. Analysis of 100 cases of free-muscle transplantation for facial paralysis. Plast Reconstr Surg 1997; 99: 1905-1921
• 31 Harrison DH, Grobbelaar AO. Pectoralis minor muscle transfer for unilateral facial palsy reanimation: an experience of 35 years and 637 cases. J Plast Reconstr Aesthet Surg 2012; 65: 845-850
• 32 O'Brien BM, Pederson WC, Khazanchi RK. et al. Results of management of facial palsy with microvascular free-muscle transfer. Plast Reconstr Surg 1990; 86: 12-22
• 33 Romeo M, O'Reilly B, Robertson BF. et al. Validation of the Glasgow Facial Palsy Scale for the assessment of smile reanimation surgery in facial paralysis. Clin Otolaryngol 2012; 37: 181-187
• 34 Ho AL, Scott AM, Klassen AF. et al. Measuring quality of life and patient satisfaction in facial paralysis patients: a systematic review of patient-reported outcome measures. Plast Reconstr Surg 2012; 130: 91-99
• 35 Takushima A, Harii K, Asato H. et al. Revisional operations improve results of neurovascular free muscle transfer for treatment of facial paralysis. Plast Reconstr Surg 2005; 116: 371-380
• 36 Frey M, Giovanoli P. The three-stage concept to optimize the results of microsurgical reanimation of the paralyzed face. Clin Plast Surg 2002; 29: 461-482
• 37 Terzis JK, Olivares FS. Secondary surgery in adult facial paralysis reanimation. Plast Reconstr Surg 2009; 124: 1916-1931
• 38 Biglioli F, Colombo V, Tarabbia F. et al. Recovery of emotional smiling function in free-flap facial reanimation. J Oral Maxillofac Surg 2012; 70: 2413-2418