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'Adult' surgery helps children smile

Article-'Adult' surgery helps children smile

Boston — Children with facial paralysis that hinders their ability to smile can benefit — just as adults do — from free gracilis transfer, an operation in which part of the gracilis muscle in the thigh is transplanted into facial muscles, reports.

Researchers from the Massachusetts Eye and Ear Infirmary wanted to determine failure rates in children for this procedure, how much quality of life (QOL) improved after the operation and whether pediatric patients’ experiences differed from those of adults. To do so, investigators compared 17 children with facial paralysis who had had a total of 19 surgeries to 17 adults who also had had 19 surgeries.

The main measure of smile improvement was the extent of commissure excursion, or movement of the corners of the mouth. The average change in pediatric patients was 8.8 mm, similar to the change adults experienced. Investigators determined that the surgery failed in two of the pediatric patients (11 percent) and in four of the adults (21 percent). Thirteen children completed both a pre- and a postoperative Facial Clinimetric Evaluation, a QOL measurement tool that showed a statistically significant QOL improvement after the free gracilis transfer.

The authors concluded that “free gracilis for smile reanimation in children carries an acceptable failure rate, significantly improves smiling and seems to improve QOL with respect to facial function. Early facial reanimation provides the advantage of permitting children to express themselves nonverbally through smiling and may in fact lead to fewer negative social consequences as they interact with peers.”

The study appears in the May issue of Archives of Facial Plastic Surgery.

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