Partial lip resection with orbicularis oris transposition for lower lip correction in unilateral facial paralysis.
Malfunction of the marginal mandibular nerve, either in combination with a generalized facial palsy or in isolation, can cause an unpleasant and disturbing appearance around the mouth. In total palsy, a cross-facial nerve graft combined with a free vascularized muscle transplant will usually deal with this problem successfully; however, all older procedures used in this situation are unpredictable. For the isolated palsy, procedures such as digastric muscle transfer or sling suspension are not uniformly successful. A method using the contralateral, nonaffected lower lip orbicularis muscle is described. A wedge is removed from the paralyzed lower lip and the orbicularis is advanced to the modiolus to provide a functional orbicularis all the way across the lower lip up to the angle of the mouth. This is a simple outpatient procedure that has produced satisfactory results in most cases.
Yavuzer
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Institute for Craniofacial and Reconstructive Surgery, Providence Hospital, Southfield, Mich 48075, USA.
Jackson
I T
IT
D005158:Facial Paralysis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008046:Lip / Q000294:innervation / Q000601:surgery*; D008340:Mandibular Nerve / Q000503:physiopathology; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps