An approach to bilateral facial paralysis

Area of Science:

• Neurology
• Plastic Surgery
• Pediatric Surgery

Background:

• Möbius syndrome involves congenital paralysis of the Facial and Abducens nerves.
• Functional free muscle transfers are the primary treatment for Möbius syndrome.
• This study presents the largest published series of Möbius reanimation to date.

Purpose of the Study:

• To evaluate the outcomes of functional free muscle transfers in 20 patients with Möbius syndrome.
• To describe the evolution of surgical technique for Möbius reanimation.
• To assess the impact of age on smile reanimation outcomes.

Main Methods:

• A retrospective review of 20 consecutive cases of Möbius reanimation.
• Surgical technique involves a single-stage bilateral procedure using segmental Latissimus dorsi muscles.
• Muscles are innervated by the masseteric branch of the Trigeminal nerve.
• Outcomes were assessed by the senior surgeon and an independent panel.

Main Results:

• All 20 cases demonstrated significant improvement in facial animation.
• The preferred surgical approach evolved to a single-stage bilateral Latissimus dorsi transfer.
• A more spontaneous smile was observed in patients under ten years of age.

Conclusions:

• Functional free muscle transfer is an effective treatment for Möbius syndrome.
• Single-stage bilateral Latissimus dorsi reanimation provides significant functional improvement.
• Age is a factor influencing the quality of the achieved smile in pediatric patients.