Prospective evaluation of quality of life in the flaccid
Reviewed by Bilal Gani Taib

Flaccid midface paralysis causes nasal valve collapse due to the lack of tonic muscular support. This causes both external nasal valve narrowing and collapse during inspiration. Correction of the nasal valve is performed in functional rhinoplasty. However, these procedures do not adequately address inferior and medial displacement of the ala with facial paralysis. This paper describes a procedure which involves placement of a fascia lata sling from the accessory cartilages of the ala to the temporalis fascia. This prospective study recruited 68 patients who were treated for nasal valve collapse with a fascia lata sling. The sling is tunnelled subcutaneously and the medial edge is sewn to the sesamoid cartilages of the ala. The lateral edge of the graft is then secured to the true temporalis fascia. Thirty-seven of the 68 patients completed preoperative and postoperative questionnaires (NOSE). A statically significant improvement in the NOSE scores was noted. The authors stated that the technique provided superior and lateral displacement of the ala necessary for valve restoration in the paralysed face.

Prospective evaluation of quality-of-life improvement after correction of the alar base in the flaccidly paralyzed face.
Lindsay RW, Bharma P, Hohman M, Hadlock T.
JAMA FACIAL PLASTIC SURGERY
2015;17(2):108-12.