Facial paralysis in oto-mandibular dysplasia. Clinical study and therapeutic implications] |
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Authors: | D Labbé H Bénateau |
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Institution: | Service de chirurgie maxillofaciale et chirurgie plastique, CHU de Caen, 14033 Caen, France. labbe-da@chu-caen.fr |
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Abstract: | The percentage of facial palsy in the otomandibular dysostosis is great. It varies from 12 to 50% in the literature. The OMENS classification embodies the muscular and facial nerve defects, and appears to represent the most inclusive classification. Few literature reviews have proposed a treatment of the facial palsy in the otomandibularis dysostosis. The authors proposed a treatment protocol depending on the patient's age. The patients before one year of age are treated with the I?igo's technique, which provide reinnervation to the affected muscles through a crossed facial nerve graft. After one-year old, the surgical approach is realised at five to seven years old to permit a physical therapy. The upper lip is reanimated by the lengthening temporalis myoplasty or by free muscle transplantation with nerve graft. The orbital area treatment of the paralyzed side can included a lengthening of the upper eyelid levator muscle, an asymmetric lateral tarsorraphy and a chondromucous graft. |
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