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Children With Facial Paralysis Learn to Smile, Thanks to Plastic Surgeons (PR Newswire) ...It can also be acquired via head trauma, removal of facial or brain tumors, or laceration of a facial nerve.... - Nov 06 9:30 AM ET

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Posted on: 11/06/2001

"Yahoo - Children With Facial Paralysis Learn to Smile, Thanks to Plastic Surgeons"
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Tuesday November 6, 9:31 am Eastern Time

Press Release

SOURCE: American Society of Plastic Surgeons

Children With Facial Paralysis Learn to Smile, Thanks to Plastic Surgeons

ORLANDO, Fla., Nov. 6 /PRNewswire/ -- Children with partial facial paralysis can obtain a more even smile through a microsurgical procedure developed and improved by plastic surgeons, according to a study presented today at the 70th Annual Scientific Meeting of the American Society of Plastic Surgeons (ASPS) in Orlando, Fla.

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    "A smile is a basic human expression many of us never think about, it just happens," explained Ronald M. Zuker, MD, head, division of plastic surgery, The Hospital for Sick Children, Toronto, Ontario, Canada. "For children with partial facial paralysis, they can only smile on the functional side of their face, really it's half of a smile. This study looks at 65 children who underwent surgery to give them the ability to smile on the paralyzed side of their face -- allowing a more even, symmetric smile the majority of us enjoy."

    According to Dr. Zuker, about 1 in 50,000 children may be born or acquire unilateral (one-sided) facial paralysis. The congenital form can be caused by pressure on the facial nerve while the infant is in the uterus or being delivered. It can also be acquired via head trauma, removal of facial or brain tumors, or laceration of a facial nerve. As the child ages, gravity can take its toll on the paralyzed side of the face causing it to droop.

    The procedure used by Dr. Zuker and his associates consists of two operations. The first procedure explores the functional side of the face to find the nerve responsible for the child's smile. The precise branch required for smile is then divided.

    A nerve graft is then taken from the child's leg and connected to this branch. This graft is then tunneled across the child's face, underneath the nose and extended to the paralyzed side of the face. This grafted nerve is then "banked" for 9 to 12 months to re-establish its circulation and functional potential. A year later, the second procedure takes a muscle (gracilis) from the thigh and transplants it into the paralyzed side of the face where it is appropriately positioned, secured, revascularized by the grafted nerve.

    "The surgeries' successes have been overwhelmingly positive," said Dr. Zuker. "The smiles aren't perfect, but the surgery helps to make the children's smile more even. This procedure helps support the lower lip, so children don't drool, and it helps children with speech development. Perhaps most significantly there has been enormous benefit for these children in terms of interpersonal communication, self esteem and acceptance by their peers."

    The surgery is successful when the brain sends an impulse to the nerve responsible for smiling on the functional side of the face. This impulse is then passed across the child's face along the nerve graft to the newly transplanted gracilis muscle on the paralyzed side of the face.

    "Most of these children are delighted with the surgery's outcome," said Dr. Zuker. "There is significant improvement in the child's ability to smile more evenly, which can only help these children feel better about themselves and may help them feel more comfortable as they grow and become more social."

    ASPS, founded in 1931, represents physicians certified by the American Board of Plastic Surgery (ABPS) or the Royal College of Physicians and Surgeons of Canada. To find ABPS-certified plastic surgeons in your area or to learn more about cosmetic and reconstructive surgery, call the Plastic Surgery Information Service at (888) 4-PLASTIC (475-2784) or visit .

    EDITOR'S NOTE: This presentation is scheduled for Tuesday, November 6 at 4:06 p.m., Orange County Convention Center, Orlando, Fla.

    SOURCE: American Society of Plastic Surgeons

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