title: Minimally invasive brow suspension for facial paralysis.
abstract: OBJECTIVE
  To report a new technique for unilateral brow suspension for facial paralysis that is minimally invasive, limits supraciliary scar formation, does not require specialized endoscopic equipment or expertise, and has proved to be equal to direct brow suspension in durability and symmetry.
  
  
  METHODS
  Retrospective survey of a case series of 23 patients between January 1997 and December 2000.
  
  
  METHODS
  Metropolitan tertiary care center.
  
  
  METHODS
  Patients with head and neck tumors and brow ptosis caused by facial nerve paralysis.
  
  
  METHODS
  The results of the procedure were determined using the following 3-tier rating system: outstanding (excellent elevation and symmetry); acceptable (good elevation and fair symmetry); and unacceptable (loss of elevation).
  
  
  RESULTS
  The results were considered outstanding in 12 patients, acceptable in 9 patients, and unacceptable in only 1 patient. One patient developed a hematoma, and 1 patient required a secondary adjustment.
  
  
  CONCLUSIONS
  The technique has proved to be superior to standard brow suspension procedures with regard to scar formation and equal with respect to facial symmetry and suspension. These results have caused us to abandon direct brow suspension and to use this minimally invasive method in all cases of brow ptosis due to facial paralysis.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Columbia University College of Physicians and Surgeons, Mount Sinai School of Medicine, New York, NY 10019, USA. Costantino@FacialSurgeon.com
authors.forename: Peter D
authors.initials: PD
authors.lastname: Costantino
authors.forename: David H
authors.initials: DH
authors.lastname: Hiltzik
authors.forename: Jason
authors.initials: J
authors.lastname: Moche
authors.forename: Aviva
authors.initials: A
authors.lastname: Preminger
mesh_terms: D005158:Facial Paralysis / Q000601:surgery*; D005500:Follow-Up Studies; D005546:Forehead; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D018482:Muscle, Skeletal / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome