Facial paralysis: Moderation of non-paralysed muscles

Niklison, J

doi:10.1016/s0007-1226(65)80066-2

Cited by 23 publications

(3 citation statements)

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“…Techniques to achieve selective weakening of the unaffected side include chemodenervation with botulinum toxin, [8][9][10] selective neurectomy of the marginal mandibular nerve, 11 and selective myectomy. 8,10,[12][13][14] An injection of local anesthetic into the DLI both functionally and aesthetically simulates the expected results of selective weakening and may be used as a therapeutic trial prior to chemodenervation. 8,15 If the response is as desired, then chemodenervation with botulinum toxin may be pursued.…”

Section: Discussionmentioning

confidence: 99%

“…11 Selective myectomy is accomplished through an intraoral incision with resection of at least 1 cm of muscle to prevent recurrence under local or general anesthesia. 8,[12][13][14] Other surgical options can be pursued to improve tension and strength of the affected side. Bidirectional fascial grafts have been described by 2 different institutions with successful aesthetic results in 7 patients with CULLP.…”

Section: Discussionmentioning

confidence: 99%

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Neuromodulator for the Treatment of Congenital Unilateral Lower Lip Palsy

Krane

Markey

Loyo

2018

Ann Otol Rhinol Laryngol

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Introduction: Congenital unilateral lower lip palsy is an infrequently encountered condition that manifests as lower lip asymmetry during smiling, laughing, and crying. Treatment options are not well characterized. Methods: The authors present the case of a 51-year-old woman who was referred for surgical intervention for facial paralysis. Physical examination demonstrated a symmetric face at rest that became asymmetric when smiling. The asymmetry, evident by inappropriate inferior displacement of the lower lip, was secondary to unilateral contraction and presence of the depressor labii inferioris. The depressor anguli oris was symmetric bilaterally. Her presentation was consistent with congenital unilateral lower lip palsy. Results: Lidocaine was injected into the depressor labii inferioris on the side of the face that demonstrated unilateral presence and contraction. This resulted in symmetry of the smile and lower lip without untoward effect. Onabotulinum toxin A was thereafter injected into the depressor labii inferioris. In-office treatment with botulinum toxin injection resulted in a 4-month improvement in smile symmetry. Conclusion: Chemodenervation is a safe and minimally invasive method to improve smile symmetry and lower lip position in cases of congenital unilateral lower lip palsy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Neuromodulator for the Treatment of Congenital Unilateral Lower Lip Palsy

Krane

Markey

Loyo

2018

Ann Otol Rhinol Laryngol

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“…Dans le cas particulier de la co-contraction du DAO et des zygomatiques (signe du DAO), lorsque la toxine botulique ne montre pas d'efficacité suffisante ou lorsque les récidives des co-contractions sont trop précoces, on peut être amené à réaliser des résections musculaires du DAO par voie endobuccale selon Le Louarn et al [7] (résection d'au moins 7 mm de muscle selon Niklison [8] afin d'éviter les récidives) associées au traitement par toxine. Ceci est expliqué par la puissance du DAO par rapport aux autres muscles de la face (Fig.…”

Section: Traitement Des Co-contractionsunclassified