[Synthetical treatment for facial paralysis using static and dynamic techniques].
OBJECTIVE
To investigate a synthetical technique combining static and dynamic states for treating facial paralysis.


METHODS
From October 1993 to November 2005, 93 patients (26 males, 67 females; aged 9-69 years; illness course, 6 months to 24 years) with facial paralysis were admitted for treatment, of whom 48 were unknown in their pathological origins, 32 had a history of intracranial or ear operation, 13 had their facial paralysis related to trauma. We applied synthetical techniques for treating facial paralysis, including denerved muscle (extensor hallucis brevis and extensor digitorum brevis) free graft using an operating or chemical technique, temporal muscular flap suspending, treatment of eye closure by uplifting zygomo-malar tissues and temporal muscular flap suspending, brow lifting by the Buried Guiding Suture Appliance, Botox injection, and the nerve amputation of normal side for mandibular marginal ramus paralysis.


RESULTS
After the treatment for 82 patients with the method of the denerved muscle free graft combining femoral muscular flap suspending, 3 patients with the method of uplifting zygomo-malar tissues combining temporal muscular flap suspending for eye closure, 15 patients with the method of the Buried Guiding Suture for eyebrow lifting, 4 patients with the Botox injection and nerve amputation of normal side for the mandibular marginal ramus paralysis, 93 patients had a good therapeutic result. The follow-up for 3 months to 10 years in all the patients revealed that 75 patients were satisfied with their treatment results and 13 patients were almost satisfied according to the criteria for the facial symmetrical checking and the House-Brackmann grading system. The technique had advantages of a complete survival of the related small muscles, a hidden incision, less trauma for the Botox injection, and the denerved muscles for surrounding nerve inserting.


CONCLUSIONS
The synthetical technique combining static and dynamic states for treating facial paralysis is a good therapeutic method and the therapies for facial paralysis should vary with the different conditions of the paralysis. We advocate an individuation treatment for facial paralysis.
Wang
Hao
H
Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100041, PRChina.
Li
Senaki
S
Yang
Mingyong
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003131:Combined Modality Therapy; D005154:Facial Nerve / Q000601:surgery; D005158:Facial Paralysis / Q000601:surgery* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009121:Muscle Denervation; D018482:Muscle, Skeletal / Q000294:innervation / Q000637:transplantation*