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The rational of forehead lifting in patients with chronic facial paralysis

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Abstract

Background

The incidence of permanent facial sequels in patients with Bell’s palsy is about 30 % and results in impaired mimic expression of both midface and forehead in varying degrees. Even at rest, most patients experience an imbalance of their facial features. In this article, static correction of brow imbalance was evaluated in patients with sequels after unilateral facial palsy.

Methods

Thirty-one patients with sequels of Bell’s palsy underwent surgery with endoscopic forehead lift. Brow position was geometrically assessed pre- and postoperatively. The validated self-assessment instrument for quality of life [Short Form 36(SF-36)] was completed prior to and after surgery. The follow-up period was 12 months.

Results

A notable improvement in the position of the brows was demonstrated over time with lasting results. All patients experienced an improvement in facial symmetry and balance at rest. However, no significant difference could be shown using SF-36 pre- and postoperatively.

Conclusion

Endoscopic forehead lift combined or as an isolated procedure is a valuable instrument to correct sequels of Bell’s palsy.

Level of Evidence: Level IV, therapeutic study.

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References

  1. Peitersen E (2002) Bell’s palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta Otolaryngol Suppl 549:4–30

    PubMed  Google Scholar 

  2. Chu EA, Byrne PJ (2008) Treatment considerations in facial paralysis. Facial Plast Surg: FPS 24(2):164–169. doi:10.1055/s-2008-1075831

    Article  PubMed  CAS  Google Scholar 

  3. Aaronson NK, Acquadro C, Alonso J, Apolone G, Bucquet D, Bullinger M, Bungay K, Fukuhara S, Gandek B, Keller S et al (1992) International Quality of Life Assessment (IQOLA) Project. Qual Life Res 1(5):349–351

    Article  PubMed  CAS  Google Scholar 

  4. Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–483

    Article  PubMed  Google Scholar 

  5. Sullivan M, Karlsson J, Ware JE Jr (1995) The Swedish SF-36 Health Survey—I. Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden. Soc Sci Med 41(10):1349–1358

    Article  PubMed  CAS  Google Scholar 

  6. Sullivan M, Karlsson J (1994) Swedish Manual and Intrepretation Guide (Svensk Manual och Tolkningsguide). International Quality of Life Assessment (IQOLA) Project. Göteborg University and Sahlgrenska Hospital, Göteborg

    Google Scholar 

  7. Keller GS, Mashkevich G (2009) Endoscopic forehead and brow lift. Facial Plast Surg: FPS 25(4):222–233. doi:10.1055/s-0029-1242034

    Article  PubMed  CAS  Google Scholar 

  8. Moody FP, Losken A, Bostwick J 3rd, Trinei FA, Eaves FF 3rd (2001) Endoscopic frontal branch neurectomy, corrugator myectomy, and brow lift for forehead asymmetry after facial nerve palsy. Plast Reconstr Surg 108(1):218–223

    Article  PubMed  CAS  Google Scholar 

  9. Troilius C (2004) Subperiosteal brow lifts without fixation. Plast Reconstr Surg 114(6):1595–1603, discussion 1604–1595

    PubMed  Google Scholar 

  10. Ducic Y, Adelson R (2005) Use of the endoscopic forehead-lift to improve brow position in persistent facial paralysis. Arch Facial Plast Surg 7(1):51–54. doi:10.1001/archfaci.7.1.51

    Article  PubMed  Google Scholar 

  11. Troilius C (1999) A comparison between subgaleal and subperiosteal brow lifts. Plast Reconstr Surg 104(4):1079–1090, discussion 1091–1072

    Article  PubMed  CAS  Google Scholar 

  12. Salles AG, Toledo PN, Ferreira MC (2009) Botulinum toxin injection in long-standing facial paralysis patients: improvement of facial symmetry observed up to 6 months. Aesthetic Plast Surg 33(4):582–590. doi:10.1007/s00266-009-9337-9

    Article  PubMed  Google Scholar 

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Correspondence to Åsa Edsander-Nord.

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Stark, B., Minberger, C., Edsander-Nord, Å. et al. The rational of forehead lifting in patients with chronic facial paralysis. Eur J Plast Surg 36, 83–86 (2013). https://doi.org/10.1007/s00238-012-0764-5

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  • DOI: https://doi.org/10.1007/s00238-012-0764-5

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