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Edmund Fisher, MD; John L. Frodel, MD

Arch Facial Plast Surg. 1999;1:195-199.

Objective  To study the efficacy of acellular human dermal (AHD) allograft as a material for static slings used to treat ptosis of the oral commissure after facial paralysis.

Design  In the university facial plastic surgery practices (Baltimore, Md, and Albuquerque, NM) of the senior author (J.L.F.), 11 consecutive patients with facial paralysis were treated with AHD allograft slings. Follow-up was 4 to 14 months with 1 patient excluded for inadequate follow-up. Six of the remaining 10 patients received radiation therapy. Results were considered excellent and designated grade 1 when the affected oral commissure was at the same level as the normal commissure. Complete ptosis was designated grade 4. Grades 2 and 3 were designated between these extremes.

Results  All 10 patients showed improvement in the position of the oral commissure, in oral competence, and in cheek ptosis. Four patients were grade 1; 5, grade 2; and 1, grade 3. There were no implant extrusions or infections.

Conclusions  The increased biointegration of AHD allografts in comparison with alloplastic materials may account for the absence of infection reported in this study and the relatively high success rate, especially in patients receiving radiation therapy.

From the Section of Facial Plastic Surgery, Division of Otolaryngology, Plastic & Reconstructive Surgery, University of New Mexico Health Sciences Center, Albuquerque.

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