Tips and Pearls for Recovering Symmetry After Facial Palsy Using a Tendon Sling: Our 20-Year Experience.

Background

In facial palsy reconstruction, static techniques with the use of slings can improve the appearance and functionality of the paralyzed face and may be used in patients who cannot undergo complex surgeries or as an ancillary procedure to a dynamic reconstruction. The objective of this study was to assess the improvement in facial symmetry and quality of life among older patients with flaccid facial palsy with the use of a plantaris tendon sling.

Methods

A total of 46 patients who had undergone a static reconstruction with the plantaris tendon sling were studied. The surgical technique is detailed emphasizing the tips and pearls.

Results

The displacement of the oral commissure was assessed with the FACIAL CLIMA demonstrating a mean elevation of 1.5 ± 0.4 cm and an improvement of 97 ± 7% in the recovery of oral commissure symmetry 2 years after the surgery, whereas the Sunnybrook Facial Grading System showed an improvement of symmetry at rest (-15 ± 5) at 2 years. The Facial Disability Score indicated an improvement of the physical disability (+73.5 ± 14) as well as the social impairment (+21 ± 7) at 1 year postoperatively. Patients were followed for a median of 2 years (range 2-6 years).

Conclusions

The use of tendon slings for static facial paralysis reconstruction is a reliable technique with no functional sequelae and good long-term results.