A procedure involving only one small incision and no major modifications appears helpful in reanimating the lower face after paralysis, says a new study.
"The primary goal of all facial reanimation protocols is to restore facial movement that is controlled, symmetrical and spontaneous," the authors write.
Kofi D. Boahene and colleagues at the Johns Hopkins University School of Medicine, Baltimore, studied 17 patients with facial paralysis who underwent a minimally invasive temporalis tendon transposition procedure between 2006 and 2008.
"All the patients tolerated the procedure well, and none developed procedure-related complications. All the patients achieved improved symmetry at rest and voluntary motion of the oral commissure [corners of the mouth]," the authors wrote.
The patient first learns and practices a "Mona Lisa" smile, in which the corners of the mouth are elevated but not the upper or lower lip. They then learn to smile by contracting the temporal muscle without moving the jaw.
"Dynamic reanimation after facial paralysis remains challenging but can be achieved in selected patients using the minimally invasive temporalis tendon transposition (MIT3)," the authors conclude.
"Although the technique is straightforward and dynamic movement can be demonstrated with intraoperative muscle stimulation, acquisition of desired facial movement requires intensive physiotherapy and a motivated patient."
The study appears in the January/February issue of Archives of Facial Plastic Surgery.