title: Paralysis of the marginal mandibular branch of the facial nerve: treatment options.
abstract: Isolated paralysis of the marginal mandibular branch of the facial nerve results in an asymmetrical smile with elevation of the lower lip on the affected side. We discuss the surgical options for its correction and present a series of 26 patients who underwent either botulinum toxin injection, anterior belly of digastric transfer or free extensor digitorum brevis transfer as treatment. Botulinum toxin injection provided satisfactory results although these were temporary. Anterior belly of digastric transfer was the surgical procedure of choice. It yielded superior cosmetic results, less donor-site morbidity and required a shorter operating time. In more complex congenital facial hypoplastic syndromes, or following extensive surgery in the digastric triangle, the anterior belly of the digastric muscle may be absent or damaged. Extensor digitorum brevis transfer is the preferred option in these cases.
authors.affiliation: Raft Institute of Plastic Surgery, Mount Vernon Hospital, Northwood, Middlesex, UK.
authors.forename: P
authors.initials: P
authors.lastname: Tulley
authors.forename: A
authors.initials: A
authors.lastname: Webb
authors.forename: J S
authors.initials: JS
authors.lastname: Chana
authors.forename: S T
authors.initials: ST
authors.lastname: Tan
authors.forename: D
authors.initials: D
authors.lastname: Hudson
authors.forename: A O
authors.initials: AO
authors.lastname: Grobbelaar
authors.forename: D H
authors.initials: DH
authors.lastname: Harrison
mesh_terms: D000293:Adolescent; D000328:Adult; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005158:Facial Paralysis / Q000209:etiology / Q000628:therapy*; D019066:Facies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps; D016896:Treatment Outcome
chemical_list: D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins