American Association of Plastic Surgeons

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The Outcomes Of Free-functional Platysma Transfer For Reanimation Of The Eye In Unilateral Facial Paralysis: A Case Series Of 23 Sequential Patients
Jonathan Leckenby, MD1, Adriaan Grobbelaar, MD2.
1URMC, Rochester, NY, USA, 2Great Ormond Street Hospital for Children, London, United Kingdom.

PURPOSE:
Facial palsy patients suffer an array of problems ranging from functional to psychological issues. With regard to the eye, lacrimation, lagophthalmos and the inability to spontaneously blink are the main symptoms and if left untreated can compromise the cornea and vision. This paper reports the outcomes of 23 free functional vascularized platysma transfers used for reanimation of the eye in unilateral facial paralysis.
METHODS:
Data was collected prospectively for all patients undergoing reanimation of the paralysed eye using free functional platysma transfer. The only exclusion criteria was that a minimum of a two-year follow up was required. Patients were assessed pre- and post-operatively and scored using the eFACE tool focusing on eye-symmetry with documentation of blink reflex.
RESULTS:
A total of 26 free functional platysma transfer were completed between 2011 and 2018; three patients were excluded due to inadequate follow up. The mean age was 10 years (SD 7.5) and a ratio of 12 males to 11 females. Pre-operatively no patients had evidence of a blink reflex in comparison to 22 patients at two-year follow up. There was a statistically significant improvement in palpebral fissure (p < 0.001) and full eye closure (p < 0.001) scores at two-year follow up however, there was no statistically significant difference in gentle eye closure (p = 0.15).
CONCLUSION:
This is the first report of free functional platysma outcomes in eye reanimation. The results demonstrate that successful restoration of the blink reflex can be achieved and full eye closure is obtainable following surgery.


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