title: Smile Reanimation after Unilateral Facial Palsy by Lengthening Temporalis Myoplasty: Objective and Subjective Evaluation on 25 Cases.
abstract: BACKGROUND
  Comparison of functional results of lengthening temporalis myoplasty relies in current practice on subjective scales. The goal of this study was to define a simple, reproducible, objective scale validated through a comparison with a subjective scale for smile symmetrization results after temporal muscle myoplasty.
  
  
  METHODS
  A retrospective study was conducted on 25 patients having a unilateral facial palsy and rehabilitated with lengthening temporalis myoplasty. Evaluation consisted of objective measures: smile horizontal symmetry between left and right sides, vertical symmetry, and smile width on healthy and paretic sides on preoperative and postoperative photographs. Subjective scales were also used (i.e., a numeric scale and the Terzis and Noah scale) by a jury (four professionals and four nonprofessionals) and the patient himself or herself. Each evaluation was performed in three conditions: at rest, at intermediary smile, and at maximum smile.
  
  
  RESULTS
  Comparison of objective measures on the impaired side showed a postoperative improvement in the three conditions evaluation. Reproducibility of the numeric scale was weak for evaluation at rest and fair for maximum smile evaluation (intraclass correlation coefficient of 0.57). The Terzis and Noah scale was not reproducible from one observer to another. At maximum smile, a correlation between smile symmetry in the vertical plane, smile symmetry in the horizontal plane, and professional evaluation with the numeric scale on the one hand and global patient satisfaction on the other hand was observed.
  
  
  CONCLUSIONS
  Postoperative smile horizontal symmetry between left and right sides, and smile vertical symmetry, are good indicators with which to assess postoperative results of facial palsy rehabilitation.
authors.affiliation: Paris, France.|From the Otolaryngology Department, the Department of Biostatistics, Public Health and Medical Information, and the Federation of Clinical Neurophysiology, AP-HP, Pitié-Salpêtrière Hospital; the Pierre Louis Institute of Epidemiology and Public Health, Sorbonne University, University Pierre and Marie Curie; and Inserm, UMR S-1159.
authors.forename: Claire
authors.initials: C
authors.lastname: Foirest
authors.affiliation: Paris, France.|From the Otolaryngology Department, the Department of Biostatistics, Public Health and Medical Information, and the Federation of Clinical Neurophysiology, AP-HP, Pitié-Salpêtrière Hospital; the Pierre Louis Institute of Epidemiology and Public Health, Sorbonne University, University Pierre and Marie Curie; and Inserm, UMR S-1159.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Granger
authors.affiliation: Paris, France.|From the Otolaryngology Department, the Department of Biostatistics, Public Health and Medical Information, and the Federation of Clinical Neurophysiology, AP-HP, Pitié-Salpêtrière Hospital; the Pierre Louis Institute of Epidemiology and Public Health, Sorbonne University, University Pierre and Marie Curie; and Inserm, UMR S-1159.
authors.forename: Peggy
authors.initials: P
authors.lastname: Gatignol
authors.affiliation: Paris, France.|From the Otolaryngology Department, the Department of Biostatistics, Public Health and Medical Information, and the Federation of Clinical Neurophysiology, AP-HP, Pitié-Salpêtrière Hospital; the Pierre Louis Institute of Epidemiology and Public Health, Sorbonne University, University Pierre and Marie Curie; and Inserm, UMR S-1159.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Bernat
authors.affiliation: Paris, France.|From the Otolaryngology Department, the Department of Biostatistics, Public Health and Medical Information, and the Federation of Clinical Neurophysiology, AP-HP, Pitié-Salpêtrière Hospital; the Pierre Louis Institute of Epidemiology and Public Health, Sorbonne University, University Pierre and Marie Curie; and Inserm, UMR S-1159.
authors.forename: Yann
authors.initials: Y
authors.lastname: Nguyen
authors.affiliation: Paris, France.|From the Otolaryngology Department, the Department of Biostatistics, Public Health and Medical Information, and the Federation of Clinical Neurophysiology, AP-HP, Pitié-Salpêtrière Hospital; the Pierre Louis Institute of Epidemiology and Public Health, Sorbonne University, University Pierre and Marie Curie; and Inserm, UMR S-1159.
authors.forename: Georges
authors.initials: G
authors.lastname: Lamas
authors.affiliation: Paris, France.|From the Otolaryngology Department, the Department of Biostatistics, Public Health and Medical Information, and the Federation of Clinical Neurophysiology, AP-HP, Pitié-Salpêtrière Hospital; the Pierre Louis Institute of Epidemiology and Public Health, Sorbonne University, University Pierre and Marie Curie; and Inserm, UMR S-1159.
authors.forename: Frederic
authors.initials: F
authors.lastname: Tankere
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005158:Facial Paralysis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D012904:Smiling; D013703:Temporal Muscle / Q000601:surgery*; D055815:Young Adult