Abstract: Comparison of Muscle Activity and Facial Symmetry in Lengthening Temporalis Myoplasty Vs. Two-Stage Free Gracilis Muscle Transfer in Children

RESULTS: Fourteen patients met inclusion criteria. Six patients had congenital facial palsy and 8 patients had acquired. The average age at time of surgery was 10.3 ± 4.4 years for congenital and 14.0 ± 5.7 years for acquired etiology (p=0.20) Causes of congenital disease included idiopathic (5) and birth trauma (1). Causes for acquired facial palsy were tumor resection (5), meningitis (1), and trauma (2). On univariate analysis, surface EMG scores averaged 55.36 for congenital patients and 33.63 for acquired patients (p=0.01). Using a mixed regression model that controlled for sex, age and time after surgery, there was no significant difference between congenital and acquired subjects in surface EMG measurements, open smile Sunnybrook scores, or total Sunnybrook scores (p=0.23, 0.88, and 0.52; respectively). However, a mixed regression model was used to analyze data from FACE-gram. Patients with acquired facial palsy, relative to congenital, had an average difference of 7.08 +/2.99 mm in overall commissure displacement when comparing paralyzed to unaffected side over time. (p=0.018).