Combination Treatment with Depressor Anguli Oris Myectomy and Pedicled Buccal Fat Pad Flap for Sequelae of Facial Paralysis: Case Reports

Facial paralysis sequelae result in functional and cosmetic deficits. Myectomy for facial contractures has been reported, and recently, selective myectomy of the smile antagonists (depressor anguli oris [DAO]) for perioral synkinesis has gained attention. Although less invasive, this approach can le...

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Main Authors: Ko Nakao, Eri Matoba, Hisashi Sakuma
Format: Article
Language:English
Published: Thieme Medical Publishers, Inc.
Series:Archives of Plastic Surgery
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/a-2631-4203
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author Ko Nakao
Eri Matoba
Hisashi Sakuma
author_facet Ko Nakao
Eri Matoba
Hisashi Sakuma
author_sort Ko Nakao
collection DOAJ
description Facial paralysis sequelae result in functional and cosmetic deficits. Myectomy for facial contractures has been reported, and recently, selective myectomy of the smile antagonists (depressor anguli oris [DAO]) for perioral synkinesis has gained attention. Although less invasive, this approach can lead to postoperative depressed deformities of myectomy site. We report two cases of facial nerve paralysis. In one case, DAO myectomy was performed for synkinesis with upper lip levator muscles. In the other, the DAO and depressor labii inferioris were myectomized for facial contractures centered on the lower lip. A pedicled buccal fat pad flap was elevated to cover the myectomy defect, preventing postoperative depressed deformity. One year postoperatively, no depressed deformities were observed; lower lip symmetry and oral commissure movement improved, achieving a natural smile. As the procedure involves transfer of vascularized blood-rich buccal fat, the risk of postoperative induration and contracture is lower than that with fat injections.
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institution Kabale University
issn 2234-6163
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publisher Thieme Medical Publishers, Inc.
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series Archives of Plastic Surgery
spelling doaj-art-4bfa33ebeec44e15a260852937ad73d82025-08-20T03:46:09ZengThieme Medical Publishers, Inc.Archives of Plastic Surgery2234-61632234-617110.1055/a-2631-4203Combination Treatment with Depressor Anguli Oris Myectomy and Pedicled Buccal Fat Pad Flap for Sequelae of Facial Paralysis: Case ReportsKo Nakao0Eri Matoba1Hisashi Sakuma2Department of Plastic and Reconstructive Surgery, Tokyo Dental College Ichikawa General Hospital, Ichikawa, JapanDepartment of Plastic and Reconstructive Surgery, Tokyo Dental College Ichikawa General Hospital, Ichikawa, JapanPlastic and Reconstructive Surgery, Tokyo Dental College Ichikawa General HospitalFacial paralysis sequelae result in functional and cosmetic deficits. Myectomy for facial contractures has been reported, and recently, selective myectomy of the smile antagonists (depressor anguli oris [DAO]) for perioral synkinesis has gained attention. Although less invasive, this approach can lead to postoperative depressed deformities of myectomy site. We report two cases of facial nerve paralysis. In one case, DAO myectomy was performed for synkinesis with upper lip levator muscles. In the other, the DAO and depressor labii inferioris were myectomized for facial contractures centered on the lower lip. A pedicled buccal fat pad flap was elevated to cover the myectomy defect, preventing postoperative depressed deformity. One year postoperatively, no depressed deformities were observed; lower lip symmetry and oral commissure movement improved, achieving a natural smile. As the procedure involves transfer of vascularized blood-rich buccal fat, the risk of postoperative induration and contracture is lower than that with fat injections.http://www.thieme-connect.de/DOI/DOI?10.1055/a-2631-4203
spellingShingle Ko Nakao
Eri Matoba
Hisashi Sakuma
Combination Treatment with Depressor Anguli Oris Myectomy and Pedicled Buccal Fat Pad Flap for Sequelae of Facial Paralysis: Case Reports
Archives of Plastic Surgery
title Combination Treatment with Depressor Anguli Oris Myectomy and Pedicled Buccal Fat Pad Flap for Sequelae of Facial Paralysis: Case Reports
title_full Combination Treatment with Depressor Anguli Oris Myectomy and Pedicled Buccal Fat Pad Flap for Sequelae of Facial Paralysis: Case Reports
title_fullStr Combination Treatment with Depressor Anguli Oris Myectomy and Pedicled Buccal Fat Pad Flap for Sequelae of Facial Paralysis: Case Reports
title_full_unstemmed Combination Treatment with Depressor Anguli Oris Myectomy and Pedicled Buccal Fat Pad Flap for Sequelae of Facial Paralysis: Case Reports
title_short Combination Treatment with Depressor Anguli Oris Myectomy and Pedicled Buccal Fat Pad Flap for Sequelae of Facial Paralysis: Case Reports
title_sort combination treatment with depressor anguli oris myectomy and pedicled buccal fat pad flap for sequelae of facial paralysis case reports
url http://www.thieme-connect.de/DOI/DOI?10.1055/a-2631-4203
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