A Novel Flap for Dynamic Reanimation of Facial Paralysis: Microvascular Sternohyoid Muscle Free Flap

Alegret, Mario Santás; García, Antonio Fernández; Vallejo, Víctor Zafra; Calle, Álvaro Rivero; Aniceto, Gregorio Sánchez

doi:10.1016/j.joms.2020.10.036

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…Vincent et al 48 later described a dual vector transfer technique using the sternohyoid and omo-hyoid muscles together in cadaveric studies and report good outcomes with one patient who successfully underwent a dual-vector sterno-omohyoid flap with the superior thyroid artery, middle thyroid vein, and ansa cervicalis innervated by the nerve to masseter. Alegret et al 49 reported a sternohyoid flap innervated by the hypoglossal nerve in a single case. Positive spontaneous smile reanimation outcomes were reported in a retrospective analysis of 7 patients 7 months after undergoing a single-stage combined latissimus dorsi-serratus anterior flap with dual innervation supplied by the thoracodorsal nerve which was coapted with the contralateral facial nerve and long thoracic nerve which was coapted with a branch of the ipsilateral masseter nerve, and the remaining ipsilateral masseter motor nerve was sutured directly into the muscle flap to promote direct intramuscular neurotization.…”

Section: Novel Flaps For Dynamic Reanimationmentioning

confidence: 99%

Advances and future directions in the care of patients with facial paralysis

Davis

Greene

2022

Operative Techniques in Otolaryngology-Head and Neck Surgery

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Section: Novel Flaps For Dynamic Reanimationmentioning

confidence: 99%

Advances and future directions in the care of patients with facial paralysis

Davis

Greene

2022

Operative Techniques in Otolaryngology-Head and Neck Surgery

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Dynamic eyelid reconstruction in facial nerve palsy

Hussain¹

2023

Survey of Ophthalmology

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Dynamic Repair Surgery for Late-Stage Facial Paralysis: Advances in Restoring Movement and Function

Sun,

Li,

Zhu

et al. 2024

JCM

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Purpose: Facial paralysis results from congenital or acquired facial nerve damage, leading to significant cosmetic and functional deficits. Surgical resection of parotid and midface tumors can cause facial paralysis, necessitating effective treatment strategies. This review addresses the challenge of restoring movement and function in late-stage facial paralysis, focusing on dynamic repair techniques involving nerve and muscle transplantation. Methods: The review encompasses studies on dynamic repair surgery for late facial paralysis, including techniques such as local muscle flap with pedicle transfer, vascularized nerve flap with pedicle transfer, and multiple muscle flap procedures. A systematic literature search was conducted using PubMed, Web of Science, and Google Scholar, covering studies from 2000 to 2024. Keywords included “dynamic repair”, “late-stage facial paralysis”, “nerve and muscle transplantation”, “muscle flap”, and “tendon transposition”. Included were clinical studies, systematic reviews, and meta-analyses reporting surgical outcomes. Exclusion criteria included studies with insufficient data and non-peer-reviewed articles. Results: Dynamic repair techniques involving nerve and muscle transplantation are essential for treating late-stage facial paralysis. Each surgical method has strengths and limitations. The masseter muscle flap demonstrates high success rates, although it can cause horizontal tension and jaw contour issues. The temporalis muscle flap is effective for smile restoration but may lead to temporal concavity. The gracilis muscle flap is widely used, especially with dual nerve innervation, showing high success in spontaneous smiles but requiring a longer recovery period. The latissimus dorsi flap is effective but can cause edema and shoulder issues. The serratus anterior free flap offers flexibility with precise vector positioning but may not achieve adequate lip elevation and can cause cheek swelling. Combined multi-flap surgeries provide more natural facial expressions but increase surgical complexity and require advanced microsurgical skills. Conclusions: Dual nerve innervation shows promise for restoring spontaneous smiles. One-stage surgery offers faster recovery and reduced financial burden. Comprehensive patient evaluation is crucial to select the most suitable surgical method. Dynamic repair techniques involving nerve and muscle transplantation provide effective solutions for restoring function and aesthetics in late-stage facial paralysis. Future research should focus on long-term outcomes, patient satisfaction, and standardizing surgical protocols to optimize treatment strategies.

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A Novel Flap for Dynamic Reanimation of Facial Paralysis: Microvascular Sternohyoid Muscle Free Flap

Cited by 3 publications

References 6 publications

Advances and future directions in the care of patients with facial paralysis

Advances and future directions in the care of patients with facial paralysis

Dynamic eyelid reconstruction in facial nerve palsy

Dynamic Repair Surgery for Late-Stage Facial Paralysis: Advances in Restoring Movement and Function

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