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Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
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Treating Nasal Valve Collapse in Facial Paralysis: What I Do Differently.
Jason D Pou1, Krishna G Patel2, Samuel L Oyer3
1Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Head and Neck Surgery, Ochsner Medical Center, 2820 Napoleon Avenue, Suite 820, New Orleans, LA 70115, USA.
Facial Plastic Surgery Clinics of North America
|July 4, 2021
Summary
Facial paralysis can cause nasal obstruction due to cheek drooping and loss of muscle tone, leading to nasal valve collapse. Standard rhinoplasty often fails to address this, necessitating specialized suspension techniques for effective treatment.
Area of Science:
- Plastic Surgery
- Otolaryngology
- Facial Nerve Disorders
Background:
- Facial paralysis significantly impacts patients' quality of life.
- Nasal airflow obstruction is a common but often overlooked consequence of facial paralysis.
- Flaccid paralysis leads to cheek ptosis and decreased alar/sidewall muscle tone, causing nasal valve narrowing.
Purpose of the Study:
- To highlight the underrecognized effects of facial paralysis on nasal airflow.
- To discuss the limitations of traditional rhinoplasty in correcting paralysis-induced nasal obstruction.
- To review surgical options for restoring nasal function in patients with facial paralysis.
Main Methods:
- Systematic zonal assessment of facial paralysis.
- Analysis of the biomechanical effects of flaccid paralysis on nasal structures.
- Review of surgical techniques, including suspension methods.
Main Results:
- Flaccid paralysis causes inferomedial displacement of the alar base.
- Cheek weight and loss of muscle tone contribute to nasal valve collapse.
- Traditional grafting techniques are often insufficient for correction.
Conclusions:
- Nasal obstruction due to facial paralysis requires specific attention to the nasal valve.
- Suspension techniques are crucial for addressing alar base displacement and nasal obstruction.
- Comprehensive surgical strategies are needed for optimal functional outcomes.
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