New technique restores the smile to faces of those with facial paralysis

Jul 17 2007

Surgeons in the United States have used a new procedure to partially restore the muscle movement in the faces of patients with severe long-term facial paralysis.

The procedure involves the transfer of tendons within the face and it has been successfully tested on fifteen patients who have partially regained animation in their faces.

The surgeons believe the new technique could benefit stroke victims who often are affected by facial paralysis and lose the voluntary movement of muscles on one side of their face.

The team from Johns Hopkins University in Baltimore believe the technique marks significant progress in treating the condition and say it is simpler, more effective and the procedure is less traumatic than traditional methods.

Facial paralysis has a range of causes such as Bell's palsy, trauma caused by an accident and tumours and strokes, and the result is not only deformity, but also often severe speech problems.

If the condition is tackled early enough various operative techniques such as nerve grafts can now be used to restore movement.

The new technique however improves facial symmetry and also restores the ability to smile.

Current surgical procedures have been less successful on those with long-term paralysis, and it is in this area that surgeons at the John Hopkins University School of Medicine say they have made significant progress.

The new surgical technique, called temporalis tendon transfer involves a major muscle on the side of the head being severed at the point it joins the jawbone and then stretched across the head to attach to the mouth muscles, before a relating tendon is then also stretched and reconfigured.

Lead surgeon, Dr. Patrick J Byrne, says the results in the 15 patients who have so far undergone the procedure, have been good to excellent, with facial symmetry and speech immediately improved, with less recuperation time and better results than existing techniques.

Dr. Byrne says by tightening the muscle around the mouth and along the cheek, speech improves and patients have better control of their mouth and he says the results of surgery are easier to predict than with other methods used.

Dr. Byrne says though the procedure does not completely restore facial muscle function, patients are pleased with how much they are able to move these muscles.

Most patients with facial paralysis are concerned by the inability to smile says Dr. Byrne and some patients regained that ability within a week of the operation.

The research is published in the Archives of Facial Plastic Surgery.