Mimetic surgery for the paralyzed face.

One hundred ten patients with facial nerve paralyses were treated by various surgical methods. Eighty-six patients had total facial nerve paralyses and 24 had segmental paralyses. In the total paralysis group, 62 patients had oncologic procedures or tumor induced paralysis. In the segmental paralysis group, 14 patients had malignancies. Two patients had idiopathic facial nerve paralysis. In the total paralysis group, 59 had neural reconstructions, 7 neuromuscular pedicles, and 20 muscle-fascia transpositions. The segmental paralysis group was divided into an upper facial palsy group (n = 11) and lower facial palsy group (n = 13). Five patients had neural transpositions, 5 had muscle-fascia transpositions, and 14 had plastic reconstructions. The results were analyzed by various methods and grading systems. The data indicate that neural repairs produce better results than muscle-fascia transpositions or plastic reconstructions. Within the repairs, the procedures are listed in an hierarchical order of cosmetic and functional results. The average follow-up for the entire group was 2.8 years. The average follow-up for the neural repair group was 3.2 years, and for the muscle fascia transpositions, 14.1 months.