Summary
To obtain symmetric appearance in facial palsy patients, it is important to retain
any remaining potential of the compromised facial mimetic muscles. The purpose of
the present study was to introduce surgical rehabilitation based on neural signal
augmentation/neural supercharge concept for the treatment of reversible facial palsy
patients. With construction of facial–hypoglossal network system using end-to-side
neurorrhaphy technique, both facial and hypoglossal motor signals are provided to
the compromised facial mimetic muscles. It is hypothesised that the remaining potential
of incompletely or completely paralysed muscles without atrophy is activated by a
neural ‘supercharge’ effect. To date, nine patients presented with reversible facial
palsy have been treated by surgical rehabilitation with facial–hypoglossal network
system in our institutes. Facial mimetic muscle function evaluated by the House–Brackmann
grading system was improved from grade IV–VI to II–III in this series. The postoperative
ENMG findings showed double innervation of the mimetic muscles supplied by the facial
and hypoglossal donor motor sources. Hemiglossal dysfunction and mimetic muscle synkinesis
associated with tongue motion were never seen with an average follow-up period of
21 months after surgery. This reconstructive concept offers a significant advantage
for the treatment of the facial palsy patients with persistent incomplete type and
reversible complete type without distinct mimetic muscle atrophy.
Keywords
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Article info
Publication history
Published online: August 10, 2006
Accepted:
May 31,
2006
Received:
February 15,
2006
Identification
Copyright
© 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
