New procedure brings back smile

A new procedure called Temporalis Tendon Transfer is used to restore the ability to smile to patients with facial paralysis. This procedure is combined with intense physical therapy before and after surgery and could help similarly stricken patients right away. Through this procedure, surgeons detach, reroute, and reattach a muscle for chewing, thereby, allowing patients to bring back their smile.

Dr. Patrick Byrne, director of facial plastic and reconstructive surgery in the department of otolaryngology and head and neck surgery at The John Hopkins University School of Medicine in Baltimore, said that Temporalis Tendon Transfer is a very doable procedure and it is very applicable on a wide scale.

"Facial paralysis in general is really a complicated condition depending on the degree of facial paralysis, the areas involved and especially also on how long they've been paralyzed," Byrne said. "There are a lot of options, but, for patients with longstanding paralysis where we can't get the nerves to reawaken, then the options prior to this have been other forms of muscle transfers."

Before, surgeons were using a different portion of the same muscle to try to restore function. However, the procedure allowed the patient with some function but also left him with facial deformity.

This pitfall is avoided in Temporalis tendon transfer, which addresses one aspect of facial paralysis and that is the inability to smile, as well as an asymmetry in the lower half of the face.