CONTEMPORARY CONCEPTS AND SURGICAL TECHNIQUES IN FACIAL REANIMATION: A SCOPING REVIEW

Area of Science:

• Plastic Surgery
• Neurology
• Ophthalmology

Background:

• Facial nerve paralysis causes severe functional, social, and cosmetic issues, impairing eye protection, oral competence, and communication.
• The resulting disfigurement and loss of mimic function lead to social isolation, depression, and significantly reduced quality of life.
• Facial reanimation's primary goals are restoring resting tone, mimic function, and symmetry.

Purpose of the Study:

• To review current facial reanimation techniques for paralysis.
• To categorize reanimation methods based on the affected facial third (upper vs. lower).
• To highlight the importance of timely and appropriate surgical intervention.

Main Methods:

• Facial reanimation is divided into static (e.g., eyelid tightening, eyebrow lift) and dynamic procedures.
• Upper facial reanimation often employs static oculoplastic techniques.
• Lower facial reanimation prioritizes dynamic methods, including nerve repair, grafts (cross-facial nerve graft), and muscle flaps (temporalis tendon transfer, gracilis free flap).

Main Results:

• Direct nerve repair yields optimal outcomes when feasible.
• For long-term paralysis (>2 years), muscle flaps are necessary.
• Technique selection depends on nerve condition, duration of paralysis, and patient goals.

Conclusions:

• Facial reanimation is crucial for functional recovery and improved quality of life.
• Both static and dynamic approaches are vital components of comprehensive facial reanimation.
• Timely intervention and tailored surgical strategies are key to successful outcomes.