Choe W J, Kim H D, Han B H, Kim J
Department of Anaesthesiology and Pain Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Gyeonggi-do, Korea (Republic of).
Department of Otorhinolaryngology, Head & Neck Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Gyeonggi-do, Korea (Republic of).
HNO. 2017 Nov;65(11):910-915. doi: 10.1007/s00106-017-0367-3.
Chronic facial paralysis induces degenerative facial muscle changes on the involved side, thus, making the individual seem as older than their actual age. Furthermore, contralateral facial hypertrophy aggravates facial asymmetry. A thread-lifting procedure has been used widely for correction of a drooping or wrinkled face due to the aging process. In addition, botulinum toxin injection can be used to reduce facial hypertrophy. The aim of study was to evaluate the effectiveness of thread lifting with botulinum toxin injection for chronic facial paralysis.
A total 34 of patients with chronic facial paralysis were enrolled from March to October 2014. Thread lifting for elevating loose facial muscles on the ipsilateral side and botulinum toxin A for controlling the facial muscle hypertrophy on the contralateral side were conducted. Facial function was evaluated using the Sunnybrook grading system and dynamic facial asymmetry ratios 1 year after treatment.
All 34 patients displayed improved facial symmetry and showed improvement in Sunnybrook scores (37.4 vs. 83.3) and dynamic facial asymmetry ratios (0.58 vs 0.92). Of the 34 patients, 28 (82.4%) reported being satisfied with treatment.
The application of subdermal suspension with a reabsorbable thread in conjunction with botulinum toxin A to optimize facial rejuvenation of the contralateral side constitutes an effective and safe procedure for face lifting and rejuvenation of a drooping face as a result of long-lasting facial paralysis.
慢性面瘫会导致患侧面部肌肉发生退行性变化，从而使患者看起来比实际年龄更大。此外，对侧面部肥大加剧了面部不对称。线雕手术已被广泛用于矫正因衰老过程导致的面部下垂或皱纹。此外，肉毒杆菌毒素注射可用于减轻面部肥大。本研究的目的是评估线雕联合肉毒杆菌毒素注射治疗慢性面瘫的有效性。
2014年3月至10月共纳入34例慢性面瘫患者。对患侧进行线雕以提升松弛的面部肌肉，对侧注射A型肉毒杆菌毒素以控制面部肌肉肥大。治疗1年后，使用桑尼布鲁克分级系统和动态面部不对称率评估面部功能。
所有34例患者面部对称性均有改善，桑尼布鲁克评分（37.4对83.3）和动态面部不对称率（0.58对0.92）均有所改善。34例患者中，28例（82.4%）表示对治疗满意。
应用可吸收线进行皮下悬吊联合A型肉毒杆菌毒素，以优化对侧面部年轻化，是一种有效且安全的方法，可用于因长期面瘫导致的面部下垂的提拉和年轻化。
