What is static sling for facial symmetry?
Static sling is one of the oldest surgical approaches for patients living with facial paralysis. The surgery is aimed at achieving static symmetry, meaning the face does not move again with static sling but it holds the face in place mid-smile or resting position. Your surgeon will demonstrate what mid-smile or resting facial position would be in each individual case. In modern facial reanimation, static sling is used as an adjunct to nerve transfers allowing for improved support during non-smile position. However, select patients with facial paralysis may have static sling as their only option. These are rare circumstances where patients need muscle transfer but all donor sites are either exhausted or were used for other purposes. It can also be a temporary option until definitive reanimation takes place. Static sling surgery utilizes fascia from other sites of the body, most commonly using sturdy fascia of the outer thigh called tensor fascia lata.
Static sling is usually one of our last resorts for definitive facial reanimation, or it used as a temporary measure in order to get patients to the next step in facial reanimation. Very few patients are committed to static slings as their only reanimation choice. Most importantly, static slings do not have any movement, their sole purpose is to make the face look more symmetrical. As a result, a particular facial position/expression needs to be selected as that face position will be permanent.
When do I need static sling surgery?
Facial paralysis surgery is different in all patients, your surgeon will be able to create a custom plan for patientsโ unique situation in order to get the best results. Static sling is usually one of our last resorts for definitive facial reanimation as it offers no movement, or it used as a temporary measure in order to get patients to the next step in facial reanimation. Very few patients are committed to static slings as their only reanimation choice.
How do I prepare for static sling surgery?
Prior to static sling surgery, your surgeon may get an electromyography (EMG) study of your facial muscles to determine if you are a candidate for the nerve transfers. Nerve transfers are almost always preferred over other reanimation options. In certain instances, static sling may be patientsโ only option given the extent of prior surgery, trauma or overall general health that precludes dynamic options.
What happens static sling surgery?
Patients are taken in to the operating room and surgery is performed under general anesthesia. Static sling is prepared from fascia taken from other donor sites (outer thigh, hand, lower leg or temple) and used to support the corner of the mouth and the nasolabial fold, it is then suspended from the temple like a sling. The position of the corner of the mouth is discussed with the patient preoperatively. Most commonly either a mid-smile position or resting position is chosen. The reason for this is that if the sling is too tight, it is very difficult to release it surgically.
What are the risks of static sling surgery?
The risks of surgery will vary depending on what nerve transplant or transfer surgery is performed. The general risks of facial surgery include bleeding, bruising, infection, injury to the movement nerves on the donor sites, tight appearing face, scar in around the mouth (nasolabial fold), numbness, the need for additional surgery, chronic pain, numbness, temporary or permanent loss of facial movement on the functional side risks of general anesthesia. Preparing for surgery and following your doctorโs instructions are useful to help minimize risks.