gms | German Medical Science

Objectives: The aim of the study was to evaluate and compare different surgical techniques for the facial rehabilitation, by using 4 grading systems and the quality of life (QOL) questionnaire.

Material and methods: This retrospective study reviewed 96 consecutive patients who underwent facial rehabilitation between 1998 and 2006. Facial palsy was severe, mostly secondary to skull base, middle ear or parotid surgery. Facial rehabilitation was either hypoglossal-facial anastomosis (classical n=34, jump n=22, modified n=7) or lengthening temporalis myoplasty (n=33). Evaluation was done according to different facial nerve grading systems and QOL estimated by a questionnaire with physical and socio-professional questions.

Results: Population was classified in 4 groups according to the surgery. Mean duration of facial palsy was 1 year in the anastomosis, more than 7 years in the myoplasty group. Grading systems could be done on 41; QOL was evaluated on 39 patients. Evaluation according to grading systems showed better scores in anastomosis than in myoplasty group. Difference between the 3 anastomosis groups was the higher synkinesis in the classical anastomosis. QOL evaluation showed better results in the myoplasty group.

Conclusion: The study highlights that the partial XII-VII (jump or modified) anastomosis has given best results than the classical one. The better QOL in the myoplasty group – which has showed the worst results in the grading systems – could be explained by the longer duration of the facial palsy, which led to a greater satisfaction after the facial rehabilitation