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INTRODUCTION Facial paralysis impairs the mimetic functions of the facial musculature. In pediatric patients, free functioning muscle transfer neurotized with an intact contralateral facial nerve is the gold standard for smile reanimation. In response to requests from families of children with facial paralysis, the Division of Plastic and Reconstructive Surgery at the Hospital for Sick Children hosted an inaugural "Facial Paralysis Family Day." The objective was to create an opportunity for families to meet, exchange stories, and build support networks. METHODS This study was a quality improvement project to conduct a needs assessment and evaluate the feasibility and satisfaction of implementing a family support intervention for individuals living with facial paralysis. RESULTS The needs assessment demonstrated that families were most interested in advances in medicine, therapy and coping sessions and meeting other families. The post-event evaluation questionnaire indicated that attendees enjoyed the event, would attend again and found it highly valuable connecting and networking other families. It also indicated that key needs identified were addressed, with excellent ratings for the presentation discussing advances in medicine (100% rated "good" or "very good"), the therapy sessions (92% rated "good" or "very good") and the presentations by patients and their families (100% rated "good" or "very good.") DISCUSSION:: Two areas of improvement highlighted were elaborating further on medical advances and facilitating interactions between families. Overall, this event was well regarded and will likely be repeated at our institution and serve as a valuable resource for other hospitals planning to organize a similar event.

A review of the literature on clinical manifestations of facial paralysis shows a lack of well-integrated, cohesive methods of classification. The aim of the classification system presented here is to provide a clinically relevant, generalized scheme for categorization, focusing on clinical presentation and general etiology. This article will also describe some of the more common conditions that have shaped the organization of the classification charts.

Speech and communication are major problems for children with Moebius syndrome, a congenital anomaly that includes facial and abducens nerve paralysis and, often, other cranial nerve deficits. In addition, these children frequently have severe functional problems such as drooling as well as poor self-esteem. The purpose of this study was to investigate the outcome of speech with bilateral gracilis muscle transplants innervated by the masseteric nerve in children with Moebius syndrome. The outcome of this two-stage procedure was investigated in 12 patients. Assessments were done before and after surgery, and additional data were collected from video records. After surgery, the children showed improved intelligibility of speech with a significantly lower frequency of all compensatory phonemes, including the sounds of /p/, /b/, /m/, /w/, "sh", /f/, and /v/. This procedure had evident positive impact in all problematic areas and is the procedure of choice for these unfortunate children.