Integrated Approaches for Reconstruction of Facial Paralysis

Shihheng Chen, Hung Chi Chen, Yueh Bih Tang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review


Background Facial paralysis can affect periorbital muscles, oral competence, and facial expressions with significant facial deformities, which could occur in either children or adults with variable severity, duration, and degree of recovery. Objective The present study was aimed to delineate treatment plans for facial paralysis with different clinical scenarios and to report the results of these patients. Methods Patients were grouped according to different presentations as follows: (1) facial paralysis with incomplete recovery; (2) young patients of facial paralysis without recovery; (3) senile patients of facial palsy without recovery; (4) combined facial palsy with mandibular deficiency, vascularized bone reconstruction for mandible with (a) subsequent muscle transfer or (b) simultaneous sling operation or (c) simultaneous facial nerve exploration and cross nerve grafting; (5) palsy of frontal branch of facial nerve; (6) palsy of zygomatic-buccal branch of facial nerve; (7) palsy of marginal mandibular branch of facial nerve; (8) partial recovery with dyskinesia; and (9) facial paralysis with dynamic asymmetry and muscle atrophy. According to clinical scenarios, different treatment plans were provided, and clinical outcomes were evaluated and presented. Results All patient groups achieved fair or satisfactory outcomes. Revisions using sling procedures, botulinum toxin injection, and filler or fat graft as supplement further refined the ultimate outcomes. Conclusions For reconstruction of facial paralysis, individualized integrated treatment plans are mandatory according to the presentation and condition of the patient. Comprehensive considerations and strategic solutions for the existing disabilities have been appreciated by the patients. The least numbers of operations with considerate correction of asymmetry were the major concerns of the patients.

Original languageEnglish
Pages (from-to)S165-S171
JournalAnnals of Plastic Surgery
Issue number5S Suppl 2
StatePublished - 01 05 2023

Bibliographical note

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  • facial paralysis
  • integrated
  • multimodal approaches
  • reconstruction
  • Bell Palsy/surgery
  • Humans
  • Facial Expression
  • Facial Paralysis/surgery
  • Facial Nerve/surgery
  • Plastic Surgery Procedures
  • Adult
  • Child
  • Facial Muscles/surgery


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