Rehabilitation of long-standing facial nerve paralysis with percutaneous suture-based slings.
Long-standing facial paralysis creates significant functional and aesthetic problems for patients affected by this deficit. Traditional approaches to correct this problem have involved aggressive open procedures such as unilateral face-lifts and sling procedures using fascia and implantable materials. Unfortunately, our results with these techniques over the last 5 years have been suboptimal. The traditional face-lift techniques did not address the nasolabial fold to our satisfaction, and suture-based techniques alone, while offering excellent short-term results, failed to provide a long-term solution. This led to the development of a novel percutaneous technique combining the minimally invasive approach of suture-based lifts with the long-term efficacy of Gore-Tex-based slings. We report our results with this technique for static facial suspension in patients with long-standing facial nerve paralysis and our surgical outcomes in 13 patients. The procedure offers re-creation of the nasolabial crease and suspension of the oral commissure to its normal anatomic relationships. The recovery time is minimal, and the operation is performed as a short outpatient procedure. Long-term 2-year follow-up has shown effective preservation of the surgical results.
Alam
Daniel
D
Section of Facial Aesthetic and Reconstructive Surgery, Head and Neck Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195, USA. alamd@ccf.org
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005158:Facial Paralysis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome