An effect of Masseter muscle transfer in recurred cases following temporalis transfer for lower lip paralysis / 나학회지

BACKGROUND: Facial nerve palsy in patients with leprosy brings a variety of discomfort functionally and cosmetically. Although the distortion of the lips is less frequent than that of the eyes, when it occurs, it happens either unilaterally or bilaterally and shows a different dynamic from that in eyes. The lower lip droop causes saliva to flow out of the mouth when eating and exposes the gum and teeth. MATERIALS AND METHODS: All patients were previously treated using the TMT procedure yet symptoms recurred within an unacceptable timeframe. Therefore, we retreated patients using the masseter muscle plication. We performed the masseter muscle plication to the lateral portion of the lower lip muscle to give it power without dividing the anterior segment of masster muscle from mandibular border. RESULTS: Complete closure of the mouth was observed in 6 patients with a moderate degree of lower lip droop. One patient that presented with severe lower lip droop bilaterally showed only partial closure. CONCLUSIONS: Without dividing anterior half segment of masseter muscle from mandibular border, the direct plication of the anterior border of masseter muscle and lower lip muscles was very effective method to correct the lower lip droop and to close the mouth in recurrent patients after temporal muscle transfer.

Comparison of static and dynamic methods in paralytic lagophthalmos treatment / 나학회지

Changes in the eye resulting from leprosy include lagophthalmos, ectropion and the eyelid retraction. In lagophthalmos, an interpalpebral gap(lid gap) of 2mm or less, which is most preferred after correction, does not have any adverse effect on the vision. However, a gap of 3mm or greater can cause or make the eye susceptible to the dryness of the cornea or other vision problems. Bell's phenomenon will adequately prevent eye damages, especially corneal damage when the lid gap is less than 3mm. Although static methods such as autogenous canthal sling, lateral tarsal strip, medial tarsorrhaphy and gold implant had a positive cosmetic effect when used in combination, the lid gap could hardly reduce to less than 3mm. Frequent recurrence of lagophthalmos and ectropion after static methods required further definite surgical treatment. We applied a dynamic method of modified Gillies to correct lagophthalmos and it was successful in reducing the lid gap to less than 2mm in most cases.