A modified temporalis transfer technique for facial paralysis in elderly patients

Introduction: In patients with chronic facial palsy where the treatment by conservative means or only nerve grafting is no longer an option, reconstruction by dynamic procedures such as pedicled and/or free muscle transfer is required. Patients and methods: Five patients with chronic facial palsy were treaded by temporalis muscle transfer to the eye and mouth simultaneously. In four of them, the combined Gillies-McLaughlin technique was used, but for the fifth one, a modified technique was applied. Results: In all patients, immediate and late postoperative clinical outcomes were satisfactory and improved their everyday quality of life. Discussion: Depending on the duration of the disease, there are different techniques that can be used. For the chronic facial palsy in elderly patients, the muscle transfer has better results, and a self-developed algorithm give us the opportunity to choose the best possible treatment for each one of our patients. The modified technique was found to be better with less surgical time, and recovery period for the patients. Conclusion: All the patients were satisfied with the results. For the fifth patient that the modified technique applied, the healing process was faster, and the aesthetic and functional reanimation achieved easiest, with no donor-site morbidity, comparatively with the rest patients where the standard Gillies-McLaughlin technique was used. (C) 2020 Elsevier Ltd. All rights reserved.