Age-dependent outcomes of Gillies and McLaughlin's dynamic muscle support in irreversible facial paralysis with up to 25-year follow-up

Abstract

The purpose of this study was to analyse the long-term outcomes of Gillies and McLaughlin's dynamic muscle support in patients with irreversible facial paralysis with regard to age-dependent outcomes of three different age groups. A retrospective single-centre study of 154 patients with surgical correction of irreversible facial paralysis that underwent either Gillies procedure or McLaughlin or a combination of both techniques between 1994-2018 was conducted. Gillies and McLaughlin's combination was performed in 69 cases and was the most commonly used procedure in middle-aged and older patients. Operating duration and reoperation rates were highest in older patients. Comparison of middle-aged patients regarding the aspects patient satisfaction (p=1), complication rates (p=0.759) and reoperation rates (p=0.669) were all non-significant. Comparison of resting facial symmetry showed a trend towards significance at p=0.064 for patients aged 60 and above. Patient satisfaction was high at >77% for all three age groups and overall complication rates ranged from 0-14%. Facial reanimation of irreversible facial paralysis with Gillies or McLaughlin's dynamic muscle support or a combination of the two techniques should be considered for patients of all ages. A standardized outcome measurement is needed for comparability between reanimation techniques.

Keywords: Dynamic muscle support; Gillies technique; Irreversible facial paralysis; McLaughlin technique; Muscle transposition.