Aesthetic plastic surgery · 2026
Functional and Aesthetic Outcomes of Trans-Mastoid Decompression for Facial Paralysis After Retroauricular Hyaluronic Acid Injection.
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Qu Siwei, Shen Sile, Li Hongwen, Wang Chengyuan
Аннотация
BACKGROUND: Retroauricular hyaluronic acid (HA) injection for aesthetic enhancement can precipitate immediate-onset facial nerve palsy. The underlying mechanism remains unclear, and no consensus exists on the next step when prolonged conservative therapy fails.
OBJECTIVE: To investigate the pathogenesis of persistent facial paralysis following retroauricular HA injection and to evaluate the functional and aesthetic outcomes of trans-mastoid facial nerve decompression in affected patients.
METHODS: We retrospectively reviewed 17 patients (16 females, 1 male; mean age 33.65±7.91 years) who developed immediate-onset unilateral facial paralysis after retroauricular HA injection and showed no improvement after 4 weeks of conservative therapy. All patients underwent trans-mastoid facial nerve decompression. Functional outcomes were assessed pre- and 3 months post-operatively using the eFACE scale, Emotrics software, Facial Disability Index (FDI), and CSQ-3 satisfaction questionnaire.
RESULTS: Post-operative eFACE scores revealed significant improvement in all static and dynamic parameters except static palpebral fissure height (P<0.001), with dynamic indices showing the most marked recovery. Emotrics measurements demonstrated significant reductions in inter-side differences for eyebrow elevation, oral commissure height, and dental show on smiling (all P<0.001). FDI scores rose significantly for both physical function and social/well-being function (P<0.001). Patient satisfaction was uniformly high.
CONCLUSION: Trans-mastoid facial nerve decompression is safe and effective for persistent facial paralysis secondary to retroauricular HA injection, yielding significant functional improvement and high patient satisfaction.
LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
OBJECTIVE: To investigate the pathogenesis of persistent facial paralysis following retroauricular HA injection and to evaluate the functional and aesthetic outcomes of trans-mastoid facial nerve decompression in affected patients.
METHODS: We retrospectively reviewed 17 patients (16 females, 1 male; mean age 33.65±7.91 years) who developed immediate-onset unilateral facial paralysis after retroauricular HA injection and showed no improvement after 4 weeks of conservative therapy. All patients underwent trans-mastoid facial nerve decompression. Functional outcomes were assessed pre- and 3 months post-operatively using the eFACE scale, Emotrics software, Facial Disability Index (FDI), and CSQ-3 satisfaction questionnaire.
RESULTS: Post-operative eFACE scores revealed significant improvement in all static and dynamic parameters except static palpebral fissure height (P<0.001), with dynamic indices showing the most marked recovery. Emotrics measurements demonstrated significant reductions in inter-side differences for eyebrow elevation, oral commissure height, and dental show on smiling (all P<0.001). FDI scores rose significantly for both physical function and social/well-being function (P<0.001). Patient satisfaction was uniformly high.
CONCLUSION: Trans-mastoid facial nerve decompression is safe and effective for persistent facial paralysis secondary to retroauricular HA injection, yielding significant functional improvement and high patient satisfaction.
LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .