title: Reanimation of facial palsy following tumor extirpation in pediatric patients: our experience with 16 patients.
abstract: The aim of this study was to present our experience with reanimation of facial palsy (FP) following tumor extirpation in pediatric patients and to analyze the functional outcomes based on different types of procedures performed considering demographic and electrophysiological data of the patients. Sixteen patients with FP post-tumor extirpation who underwent facial reanimation were reviewed. Three independent assessors evaluated the preoperative and postoperative videos using the Terzis' grading scale for eye closure, smile, depressor and overall esthetic and functional outcomes. Preoperative and postoperative electromyographic interpretations and the effect of demographic variables were also evaluated. There was significant improvement in all the patients regarding overall esthetic and functional outcomes (p < 0.0001). Good and excellent overall esthetic and functional outcomes were observed in 62.50% of the patients (n = 10). The difference between preoperative and postoperative EMG results was of statistical significance (p < 0.0001 for each target re-innervated). Better results were observed in younger patients (≤10 years) (p = 0.014) and in early cases (denervation time ≤2 years) (p = 0.033). Functional results were significantly better if surgery was performed within 2 years and the patient was younger than 10 years. Augmentation of the paretic facial musculature in pediatric patients with post-tumor FP was feasible with the use of dynamic and/or static procedures. Advanced microsurgical techniques, such as the use of free muscle transfers, should be kept in mind in late cases (denervation time over 2 years).
authors.affiliation: Department of Plastic Surgery, New York University Medical Center, 307 East 33rd Street, New York, NY 10016, USA. jktmd1@aol.com
authors.forename: Julia K
authors.initials: JK
authors.lastname: Terzis
authors.forename: Petros
authors.initials: P
authors.lastname: Konofaos
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004576:Electromyography / Q000379:methods; D004954:Esthetics; D005149:Facial Expression; D005158:Facial Paralysis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D009369:Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery; D016067:Nerve Transfer / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012904:Smiling; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
keywords: Extracranial tumors; Facial reanimation following tumor extirpation; Intracranial tumors; Pediatric facial paralysis