Effectiveness of plastic procedures managed with anatomic sub-unit zone on advanced facial paralysis

Objective To investigate the surgical efficacy of the anatomic subunit zone and affiliated procedures on long-standing facial palsy. Methods A total of 533 long-standing facial palsy cases were treated from Mar. 2003 to Dec. 2013 according to the anatomic division into the subunit: eyebrow, upper eyelid and lower eyelid, upper lip and lower lip, and chin. The surgical procedures were done to prevent complications: skin resection for eyebrow plasty, heavy implant for upper eyelid plasty, temporal muscle transfer for lower eyelid plasty, and mini muscle transplantation for lip and chin. We evaluated the surgical effects by Douglas Harrison standard and the paralysis appearance by Stennert international score system. Results Of the above 533 cases evaluated by Douglas Harrison methods, 475 (89%) were good, 48 (9%) were satisfactory, and 6 (1%) were not obviously improved. The paralysis appearance evaluated by Stennert score system showed that 533 (100%) cases were less than 1 of static state score (full score was 4), 475 (89.1%) cases were less than 2 of dynamic state score (full score of 6). Conclusions The proper procedures combined with the deformity location and symptoms with subunit anatomy in facial palsy cases seem to be safe and effective, which not only improve the successful rate of surgery, but also prevent the complications. Key words: Long-standing facial paralysis; Synthetic plasty; Complication; Prevention