Two Patients with Facial Paralysis Treated with Reconstruction Using the Tendon of the Long Palmar Muscle.

For reconstruction of facial paralysis, dynamic operative methods such as cross-face nerve transplantation and free muscle transplantation with neurovascular anastomosis are often performed. However, optimal reconstruction of the muscles of facial expression is very difficult. An appropriate operative method should be selected in each patient based on age, the underlying disease, the degree of paralysis, and the patient's desire to be treated.We performed palliative operations in 2 patients with complete facial paralysis. Patient 1 (81 years old) with Bell's palsy was treated by suspension of the lower eyelid, tarsectomy of the central area, and skin resection of the lateral area. Patient 2 (79 years old) after operation for parotid tumor (mucoepidermoid carcinoma) was treated by suspension of the lower eyelid and mouth angle, and skin resection of the upper area of the eyebrow and nasolabial groove and around the lips. The tendon of the long palmar muscle was used for suspension in both patients, and adequate results were obtained.The improvement achieved by palliative suspension is expected to be maintained for 5-10 years. If quality of life is a goal, this operation is appropriate for reconstruction of paralysis in aged patients. In our patients, adequate results could be obtained by using the tendon of the long palmar muscle.