Adjunctive techniques in facial paralysis

      Facial paralysis continues to represent a challenging clinical problem without a single solution or approach. Multiple areas of cosmetic and functional deficits complicate a paralyzed face, and each requires a targeted approach for optimal rehabilitation. When prioritizing care in patients with facial paralysis, ocular protection, and oral competence remain the primary areas of concern. However, other accompanying problems, such nasal obstruction, lower lip asymmetry, and facial drooping also prominently contribute to the morbidity of patients with facial paralysis. This article addresses these commonly overlooked problems in facial paralysis and focuses on the surgical management of incompetent nasal valve, depressor muscle asymmetry, and facial ptosis.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Operative Techniques in Otolaryngology-Head and Neck Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Friedman M.
        • Ibrahim H.
        • Syed Z.
        Nasal valve suspension: an improved, simplified technique for nasal valve collapse.
        Laryngoscope. 2003; 113: 381-385
        • Friedman M.
        • Ibrahim H.
        • Lee G.
        • et al.
        A simplified technique for airway correction at the nasal valve area.
        Otolaryngol Head Neck Surg. 2004; 131: 519-524
        • Lindsay R.W.
        • Edwards C.
        • Smitson C.
        • et al.
        A systematic algorithm for the management of lower lip asymmetry.
        Am J Otolaryngol. 2009; 32: 1-7
        • Hussain G.
        • Manktelow R.T.
        • Tomat L.R.
        Depressor labii inferioris resection: an effective treatment for marginal mandibular nerve paralysis.
        Br J Plast Surg. 2004; 57: 502-510
        • Hur M.S.
        • Hu K.S.
        • Cho J.Y.
        • et al.
        Topography and location of the depressor anguli oris muscle with a reference to the mental foramen.
        Surg Radiol Anat. 2008; 30: 403-407
        • Glasgold R.A.
        • Lam S.M.
        • Glasgold M.J.
        Facial fat grafting: the new paradigm.
        Arch Facial Plast Surg. 2008; 10: 417-418
        • Meier J.D.
        • Glasgold R.A.
        • Glasgold M.J.
        Autologous fat grafting: long-term evidence of its efficacy in midfacial rejuvenation.
        Arch Facial Plast Surg. 2009; 11: 24-28