title: Secondary surgery in paediatric facial paralysis reanimation.
abstract: Ninety-two children, the entire series of paediatric facial reanimation by a single surgeon over thirty years, are presented. The objective is to analyse the incidence and value of secondary revisions for functional and aesthetic refinements following the two main stages of reanimation. The reconstructive strategy varied according to the denervation time, the aetiology, and whether the paralysis was uni- or bilateral, complete or partial. Irrespective of these variables, 89% of the patients required secondary surgery. Post-operative videos were available in seventy-two cases. Four independent observers graded patients' videos using a scale from poor to excellent. The effect of diverse secondary procedures was measured computing a mean-percent-gain score. Statistical differences between treatment groups means were tested by the t-test and one-way ANOVA. Two-thirds of the corrective and ancillary techniques utilized granted significantly higher mean-scores post-secondary surgery. A comparison of pre- and post-operative data found valuable improvements in all three facial zones after secondary surgery. In conclusion, inherent to dynamic procedures is the need for secondary revisions. Secondary surgery builds in the potential of reanimation surgery, effectively augmenting functional faculties and aesthesis.
authors.affiliation: Department of Surgery, Plastic and Division of Reconstructive Surgery, Eastern Virginia Medical School, 700 Olney Road, LH 2055, Norfolk, Virginia 23507, USA. mrc@jkterzis.com
authors.forename: Julia K
authors.initials: JK
authors.lastname: Terzis
authors.forename: Fatima S
authors.initials: FS
authors.lastname: Olivares
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005145:Face / Q000502:physiology*; D005158:Facial Paralysis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function / Q000502:physiology*; D012086:Reoperation / Q000379:methods*; D016896:Treatment Outcome