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Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
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[Facial palsy in children]

P Guerreschi1, P-E Gabert1, D Labbé2

  • 1Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, CHU de Lille, rue Émile-Laine, 59000 Lille, France.

Annales De Chirurgie Plastique Et Esthetique
|September 18, 2016
PubMed

Insights

Pediatric facial palsy (FP) management involves addressing congenital or acquired causes. Early corticosteroid therapy, ocular protection, and dynamic rehabilitation techniques like lengthening temporalis myoplasty (LTM) are recommended for improved outcomes.

Area of Science:

  • Pediatric Neurology
  • Craniofacial Surgery
  • Rehabilitation Medicine

Background:

  • Facial palsy (FP) in children presents as congenital or acquired, with congenital cases often linked to trauma and acquired cases requiring etiological investigation.
  • Idiopathic facial palsy, where no specific cause is identified, is common and necessitates prompt treatment strategies.
  • Understanding the etiology of pediatric facial palsy is crucial for determining prognosis and guiding treatment decisions.

Purpose of the Study:

  • To review the etiologies and management strategies for pediatric facial palsy.
  • To highlight the importance of dynamic facial rehabilitation, particularly for the lower third of the face.
  • To discuss surgical and non-surgical treatment options, including lengthening temporalis myoplasty (LTM) and botulinum toxin injections.

Main Methods:

  • Review of current literature on pediatric facial palsy.
  • Discussion of treatment protocols including corticosteroids, ocular protection, and surgical interventions.
  • Emphasis on dynamic rehabilitation principles and techniques.

Main Results:

  • Early oral corticosteroid therapy and ocular protection are standard treatments for idiopathic FP.
  • Lengthening temporalis myoplasty (LTM) is recommended for its reliable and harmonious smile outcomes.
  • Post-surgical rehabilitation focuses on voluntary movement control and leveraging brain plasticity for spontaneous smiles.

Conclusions:

  • Effective management of pediatric facial palsy requires a comprehensive approach, addressing both acute treatment and long-term functional and aesthetic rehabilitation.
  • Dynamic rehabilitation, especially targeting the lower facial third, is essential for optimizing outcomes.
  • Surgical techniques like LTM and adjunct therapies such as botulinum toxin offer valuable options for improving facial symmetry and function in children.

Keywords:
Botulinum toxinCongenital palsyFacial palsyLengthening temporalis myoplastyMuscle temporalMyoplastie d’allongement du temporalParalysie congénitaleParalysie facialeTemporal muscleToxine botulique

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