title: Novel outpatient approach to lower lip reanimation using a palmaris longus tendon sling.
abstract: OBJECTIVE
  To report a new approach to lower lip reanimation, which can be performed in the outpatient clinic setting.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Tertiary and quaternary care academic hospital, Toronto.
  
  
  METHODS
  An evaluation of nine patients with marginal mandibular nerve injury, who underwent harvest of the palmaris longus tendon and static suspension of the lower lip, was performed in the outpatient setting. Outcome measures included subjective self-evaluation of the functional and aesthetic results using the Lip Reanimation Outcomes Questionnaire and postoperative photographic grading of symmetry at rest and during three smile poses. Medical records were reviewed for demographics and complications.
  
  
  RESULTS
  Seventy-eight percent of patients reported overall improvements in smiling, oral competence, and speech articulation following tendon transfer. Photographic grading by the judging panel found satisfactory smile symmetry postprocedure.
  
  
  CONCLUSIONS
  The palmaris longus tendon sling procedure provides an effective, additional option for reanimation of the paralyzed lower lip.
authors.affiliation: Department of Otolaryngology–Head and Neck Surgery, University Health Network, University of Toronto, Toronto, ON.
authors.forename: Ashlin J
authors.initials: AJ
authors.lastname: Alexander
authors.forename: John R
authors.initials: JR
authors.lastname: de Almeida
authors.forename: Mark G
authors.initials: MG
authors.lastname: Shrime
authors.forename: David P
authors.initials: DP
authors.lastname: Goldstein
authors.forename: Ralph W
authors.initials: RW
authors.lastname: Gilbert
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D001184:Articulation Disorders / Q000175:diagnosis / Q000601:surgery; D003430:Cross-Sectional Studies; D004954:Esthetics; D005146:Facial Asymmetry / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D008046:Lip / Q000294:innervation*; D008297:Male; D008340:Mandibular Nerve; D008875:Middle Aged; D010243:Paralysis / Q000601:surgery*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D012904:Smiling / Q000502:physiology; D013709:Tendon Transfer / Q000379:methods*; D061221:Trigeminal Nerve Injuries / Q000601:surgery*