The Role of Lengthening Temporalis Myoplasty in the Management of Facial Paralysis: Evaluating Patient-Reported Quality of Life Improvements

Objective This study aims at evaluating the outcomes and patient satisfaction of the Labbé operation, a lengthening temporalis myoplasty procedure, in the treatment of longstanding complete facial paralysis. Study Design We conducted a multicenter, retrospective observational study. Setting The research analyzed 38 patients with unilateral facial paralysis treated at three Italian institutions between 2009 and 2024. Patients The study included patients with severe unilateral facial paralysis, classified as House-Brackmann grades V or VI, of various etiologies. The patients, predominantly females, had a mean age of 43 years. Intervention(s) These patients underwent surgical rehabilitation of facial nerve paralysis through the Labbé procedure, which involves transferring the temporalis muscle tendon to the labial rim while maintaining innervation through the trigeminal nerve, to restore dynamic function of the inferior part of the face. Main Outcome Measure(s) Preoperative and postoperative outcomes were assessed using the Facial Clinimetric Evaluation (FaCE) questionnaire, which measures functional and psychosocial impacts. Results The only early surgical complication recorded was bleeding (1 of 38 cases). Out of the 38 patients, 17 completed the follow-up evaluations. Postoperative results showed significant improvements in quality of life and facial function, with a mean FaCE score increase of 38.6 points. Complications and long-Term sequelae were rare and exclusively related to underlying malignant pathology (and to further treatments). Conclusions In selected cases, the Labbé procedure has proven to be an effective, single-stage surgical option for addressing the aesthetic and functional deficits associated with longstanding facial paralysis. This procedure offers rapid recovery and low morbidity, making it a valuable therapeutic option for improving patient outcomes.