Lower lip depressor reanimation using anterior belly of digastric muscle transfer improves psychological wellbeing in facial palsy patients

Abstract Background The authors previously published positive peer-reviewed (21 raters using the Terzis scale) and photogrammetric (Emotrics) outcomes in patients who had undergone two-stage lower lip reanimations up to 2018. Other series have published surgeon and peer-rated results but only two series (n=12) assessed patient’s views using patient satisfaction surveys. Aims This paper presents patient-rated outcomes (PROMS) in an 11-year series of both single- and two-stage ABDM lower lip reanimations. Methods Demographics, paralysis characteristics, operative details and complications were recorded. Patients were telephoned and requested to complete the Glasgow Benefit Inventory (GBI) to assess patient-rated outcomes. Results Thirty-two patients were eligible (mean age 36.4 years). Twenty-one patients (63.6%) completed the GBI (mean score +33.3). More patients reported benefit than did detriment (95.2% vs.4.8%). Complications were infrequent and included three superficial infections, and one dermatitis. Four patients (12.5%) underwent minor revisions, mostly lipofilling of lip notches. The median duration of follow up was 2.8 years (0.3 – 8.5). Conclusions Anterior belly of digastric transfer for lower lip reanimation is a safe, low morbidity procedure which enhances the psychological wellbeing of patients with facial palsy.