| Lengthening temporalis myoplasty versus hypoglossal-facial nerve coaptation in the surgical rehabilitation of facial palsy: evaluation by medical and nonmedical juries and patient-assessed quality of life. | |
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MedLine Citation:
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PMID: 19169134 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: To compare the results of 2 techniques of facial rehabilitation, lengthening temporalis myoplasty and 2 types of hypoglossal-facial (XII-VII) coaptation as evaluated by medical and nonmedical teams and patient self-assessment of quality of life (QOL). MATERIALS AND METHODS: Videos of 42 consecutive patients with complete facial palsy who underwent surgery from 1998 to 2005 were reviewed. Facial rehabilitation was by temporalis myoplasty (n = 10) or by XII-VII coaptation (n = 32) either end-to-end (n = 16) or end-to-side with a jump interpositional graft (n = 16). Evaluation was by (i) a medical jury using 4 facial nerve grading systems and 3 other measurements for the face at rest and during voluntary and emotional motions, (ii) a nonmedical jury using the 3 measures described above, and (iii) patient self-assessment of QOL by questionnaires. RESULTS: Whatever the grading systems used, the medical jury rated facial rehabilitation with XII-VII coaptation better than myoplasty. Scores did not differ between the 2 types of coaptation: synkinesis was severe with end-to-end and almost absent with end-to-side coaptation. However, muscle tone was stronger in the end-to-end than end-to-side coaptation. The nonmedical jury considered that XII-VII coaptation, whatever the type, led to better results than myoplasty. Patients in all groups considered their QOL improved by surgery, whatever the format, with no significant differences between the groups. CONCLUSION: This study revealed XII-VII coaptation with better results than myoplasty. End-to-end coaptation should be restricted to patients with a strong emotional expression or those with a long-standing facial palsy because it provides a strong muscle tone but significant synkinesis. |
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Authors:
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Gabriella Kecskes; Philippe Herman; Romain Kania; Didier Salvan; Wissame El Bakkouri; Patrice Tran Ba Huy; Elisabeth Sauvaget |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article |
Journal Detail:
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Title: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology Volume: 30 ISSN: 1537-4505 ISO Abbreviation: Otol. Neurotol. Publication Date: 2009 Feb |
Date Detail:
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Created Date: 2009-01-26 Completed Date: 2009-04-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100961504 Medline TA: Otol Neurotol Country: United States |
Other Details:
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Languages: eng Pagination: 217-22 Citation Subset: IM |
Affiliation:
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Department of Oto-Rhino-Laryngology, Lariboisiere Hospital, Paris, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Facial Nerve / surgery* Facial Paralysis / psychology*, surgery* Female Humans Hypoglossal Nerve / surgery* Male Middle Aged Neurosurgical Procedures* Otologic Surgical Procedures* Prognosis Quality of Life Temporal Bone / surgery* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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