Twenty-Five-Year Outcomes of Treatment of Irreversible Facial Paralysis with Gillies and McLaughlin Techniques

Abstract

Introduction: Data on treatment outcomes of surgical correction of irreversible facial paralysis is rare and long-term outcomes are scarce in the literature, making treatment choices difficult for operating surgeons.

Objective: This study evaluated 25-year outcomes of treatment of irreversible facial paralysis with Gillies and McLaughlin techniques with a focus on general functional and age-related functional outcomes.

Methods: Data of all patients who underwent surgical correction of facial paralysis using either Gillies or McLaughlin procedure between 1994 and 2018 were included in the analysis of this retrospective, single-centre study (n = 154).

Results: Gillies surgery was performed on 12 and McLaughlin technique on 33 patients. Gillies and McLaughlin surgeries were associated with high patient satisfaction (75-86%), low complication rates (8-24%), and achievement of full or partial eyelid closure in 75% as well as smile reanimation in 97% of patients operated. Achievement of resting facial symmetry was low for both techniques and ranged from 27 to 46%. Age-related functional outcomes were generally superior in middle-aged patients (21-59 years) with fewer complications and reoperations compared to younger and older patients.

Conclusions: Surgical correction with Gillies or McLaughlin dynamic muscle support techniques yielded good clinical results with high patient satisfaction and should, therefore, be included as a treatment option for facial reanimation of irreversible facial paralysis. Patient age may play a role in treatment outcomes and reoperation and complication rates and should be taken into careful consideration during treatment planning.

Keywords: Extraoral McLaughlin technique; Gillies technique; Intraoral McLaughlin technique; Irreversible facial paralysis.