Using a double-layered palmaris longus tendon for suspension of facial paralysis.

INTRODUCTION Facial palsy is a debilitating condition entailing both cosmetic and functional limitations. Static suspension procedures can be performed when more advanced dynamic techniques are not indicated. Since 2006, we have used a double-layered palmaris longus tendon graft through an ovular skin excision in the nasolabial fold for access. The aim of this paper is to present our surgical technique and case series. METHODS This study was a retrospective case series in a university hospital setting. All patients who had this procedure performed were included before August 2013. Data from electronic patient records were retrieved, patients were invited for a follow-up visit and results were measured using the Lip Reanimation Outcomes Questionnaire. Furthermore, standardised photographs were taken and evaluated by multiple surgeons. RESULTS A total of 13 patients were included with a mean follow-up of 49 months (range: 3-89 months). 93% noted an improvement of their facial appearance at follow-up. Seven out of 11 patients with preoperative problems with speech noted an improvement at follow-up. Eight out of 12 patients with preoperative problems with oral competence noted an improvement at follow-up. Photographic evaluation revealed an acceptable symmetry at rest with an increasing asymmetry with increasing smile intensity. No post-operative complications or donor site morbidity was noted in any of our patients. CONCLUSION Our technique is easy to perform with no noteworthy complications, and it improves the quality of life of patients with facial palsy. It is an acceptable alternative when more advanced procedures are not indicated. FUNDING not relevant. TRIAL REGISTRATION not relevant.