EP574 - Outcomes of temporalis muscle based facial reanimation surgery: A systematic review and meta-analysis

Abstract

Abstract Aims Despite encouraging findings of temporalis based facial reanimation surgery without the need for nerve grafting, there remains a need for a comprehensive evaluation of the impact of temporalis based facial reanimation surgery on key outcome measures. Methods Comprehensive search in MEDLINE and Embase databases were done up to 25th February 2023. The inclusion criteria for this study focused on articles that examined facial reanimation surgery utilising the temporalis muscle. Postoperative changes in smile excursion and angle of mouth while smiling were pooled using the DerSimonian and Laird random effects model. Narrative synthesis was conducted for other outcomes including assessments of spontaneous smile, subjective evaluation of facial symmetry using validated rating tools, functional outcomes, aesthetic outcomes, and patient-reported outcomes owing to heterogeneity in reporting of outcomes. Results 24 studies were included in the analysis. Conflicting evidence was demonstrated regarding emotional smile outcomes and its definition. The pooled changes in smile excursion post-surgery was 7.06mm (95 CI 3.73-10.40, P<0.001; I2= 0%) and in angle of mouth while was 11.76 degree (95 CI 8.80-14.71, P<0.001; I2= 0%). Significant improvement was reported across validated rating scales of symmetry, functional outcomes, aesthetic outcomes, and patient-reported outcomes while superiority compared to other procedures remain inconclusive. Conclusion Overall, temporalis-based facial reanimation surgery is a promising option for addressing the negative effects of facial nerve paralysis on patients' quality of life. The study highlights the uncertainty surrounding the technique and the need for further studies.