Dynamic Facial Reanimation for Facial Palsy: The Oman experience.

Objectives: The goal of facial reanimation for facial palsy is to restore resting facial symmetry and dynamic facial motion that mirrors the opposite side as closely as possible. This study aimed to evaluate the restoration of oral commissure symmetry at rest and during excursion among patients with facial paralysis treated with free gracilis muscle transfer.

Methods: This study included 9 patients who underwent facial reanimation with free gracilis muscle transfer at Khoula Hospital, Muscat, Oman, from 2019 to 2022. Children under 14 underwent a 2-stage surgery, while those above 14 underwent single-stage reconstruction.

Results: The average age among the cohorts was 24 years. Overall, 5 cases underwent a 2-stage facial animation, 4 underwent single-stage reconstruction and 1 patient had free flap loss following the free gracilis muscle transfer. The mean time for noticing recovery was 3 months postoperatively. Early recovery was noted in patients who underwent single-stage free gracilis muscle transfer with motor innervation from the ipsilateral nerve to the masseter compared to the cross-facial nerve transfer. Good patient satisfaction (88.9%) was observed following the procedure.

Conclusion: This study observed earlier recovery in patients who had undergone single-stage free gracilis muscle transfer with motor innervation from the ipsilateral nerve to the masseter compared to the cross-facial nerve transfer. The oral commissure symmetry at rest and during excursion among patients with facial paralysis treated with free gracilis muscle transfer in Oman was found to be near normal.