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Surgical Technique
May 2007

Rehabilitation of Long-standing Facial Nerve Paralysis With Percutaneous Suture–Based Slings

Author Affiliations
 

Author Affiliation: Section of Facial Aesthetic and Reconstructive Surgery, Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, Ohio.

Correspondence: Daniel Alam, MD, A71, Section of Facial Aesthetic and Reconstructive Surgery, Head and Neck Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195 (alamd@ccf.org).

Arch Facial Plast Surg. 2007;9(3):205-209. doi:10.1001/archfaci.9.3.205
Abstract

Long-standing facial paralysis creates significant functional and aesthetic problems for patients affected by this deficit. Traditional approaches to correct this problem have involved aggressive open procedures such as unilateral face-lifts and sling procedures using fascia and implantable materials. Unfortunately, our results with these techniques over the last 5 years have been suboptimal. The traditional face-lift techniques did not address the nasolabial fold to our satisfaction, and suture-based techniques alone, while offering excellent short-term results, failed to provide a long-term solution. This led to the development of a novel percutaneous technique combining the minimally invasive approach of suture-based lifts with the long-term efficacy of Gore-Tex–based slings. We report our results with this technique for static facial suspension in patients with long-standing facial nerve paralysis and our surgical outcomes in 13 patients. The procedure offers re-creation of the nasolabial crease and suspension of the oral commissure to its normal anatomic relationships. The recovery time is minimal, and the operation is performed as a short outpatient procedure. Long-term 2-year follow-up has shown effective preservation of the surgical results.

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