July 17, 2007 (Insidermedicine) People with facial paralysis may be helped using a surgical technique known as temporalis tendon transfer, in conjunction with intense physical therapy before and after surgery, say researchers in a report published in the Archives of Facial Plastic Surgery.

Treating patients with facial paralysis is one of the greatest challenges faced by reconstructive surgeons. Since every case of facial paralysis is different in terms of the cause of paralysis, its degree and location, and the resulting condition, each case presents unique challenges. As a result, surgeons treating it must be able to perform multiple types of procedures and understand the underlying neurologic disorder.

The available surgical options are determined by the cause and duration of paralysis. The transfer of muscle, called temporal tendon transfer, is an excellent alternative for patients for whom the options of primary nerve repair, grafting, and nerve transfer are not an option. It involves an incision beginning at the ear and ending three to four centimeters into the hairline. The temporalis muscle on the side of the head is cut where it connects to the jawbone, stretched, and reconnected to the intersection where the muscles of the mouth join together. Physical therapy to retrain facial muscles begins before surgery and continues starting one week after the procedure.

In a review of seven patients with facial paralysis, this procedure resulted in “very high” patient satisfaction four months after surgery. The majority of patients were satisfied with their appearance, and ability to eat, talk and smile.

The procedure is considered to be relatively easy to perform and has distinct advantages compared with other options. These include the elimination of facial asymmetry associated with other procedures, immediate results, and predictability of outcomes.

Reporting for Insidermedicine, I’m Dr. Susan Sharma.