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Peter D. Costantino, MD; David H. Hiltzik, MD; Jason Moche, BS; Aviva Preminger, BS

Arch Facial Plast Surg. 2003;5:171-174.

Objective  To report a new technique for unilateral brow suspension for facial paralysis that is minimally invasive, limits supraciliary scar formation, does not require specialized endoscopic equipment or expertise, and has proved to be equal to direct brow suspension in durability and symmetry.

Design  Retrospective survey of a case series of 23 patients between January 1997 and December 2000.

Setting  Metropolitan tertiary care center.

Patients  Patients with head and neck tumors and brow ptosis caused by facial nerve paralysis.

Main Outcome Measure  The results of the procedure were determined using the following 3-tier rating system: outstanding (excellent elevation and symmetry); acceptable (good elevation and fair symmetry); and unacceptable (loss of elevation).

Results  The results were considered outstanding in 12 patients, acceptable in 9 patients, and unacceptable in only 1 patient. One patient developed a hematoma, and 1 patient required a secondary adjustment.

Conclusions  The technique has proved to be superior to standard brow suspension procedures with regard to scar formation and equal with respect to facial symmetry and suspension. These results have caused us to abandon direct brow suspension and to use this minimally invasive method in all cases of brow ptosis due to facial paralysis.

From the Departments of Otolaryngology–Head and Neck Surgery, Columbia University College of Physicians and Surgeons (Drs Costantino and Hiltzik), Mount Sinai School of Medicine (Mr Moche), and Weil Medical College, Cornell Medical School (Ms Preminger), New York, NY.

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