Cross-facial nerve grafts and microneurovascular free muscle transfer for long established facial palsy

O’Brien, Bernard McC.; Franklin, John D.; Morrison, Wayne A.

doi:10.1016/0007-1226(80)90013-2

Cited by 179 publications

(55 citation statements)

References 3 publications

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“…48 The platysma muscle is thin and ideally suited for orbicularis oculi muscle sub- The extensor digitorum brevis, tensor fascia latae, and palmaris longus muscles are infrequently utilized. 48, 51 The muscle parameters of the various donor sites uti- (Table 6). Less finely tuned movement results from the donor ratio, but contractual force is enhanced due to fewer regenerating axons required to motor more muscle fibers.…”

Section: Nerve Transfermentioning

confidence: 99%

Facial nerve reconstruction in salivary gland pathology: A review

Terzis

Schnarrs

1993

Microsurgery

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e reconstruction of the facial nerve must begin with the realization that, at present, there is no perfect result. Having accepted this premise, the surgeon and patient are then able to formulate a reasonable rehabilitative plan. This will frequently require multiple procedures spanning many years. Many factors will influence the rehabilitative plan, including To effect facial motion, one requires available proximal motor, satisfactory impulse transmission, and functional target muscle. Each component must be individually analyzed within the context of the factors influencing the rehabilitative plan. The goal of facial nerve reconstruction is symmetrical, coordinated and synchronous voluntary and involuntary motion from a normal appearance at rest with competent sphincters and no sacrifice of other functions. As stated previously, this is not within the realm of our current capabilities but does serve as an idealistic point of future endeavour.

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Section: Nerve Transfermentioning

confidence: 99%

Facial nerve reconstruction in salivary gland pathology: A review

Terzis

Schnarrs

1993

Microsurgery

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“…1E,F). [33][34][35] Their final conclusions, however, did not differ from the previously stated opinion of Harii: the extensor Figure 1. A: Schematic drawing of the avascular extensor digitorum brevis muscle (EDB) grafted to the cheek by Thompson 7 in 1971.…”

Section: Historical Reviewmentioning

confidence: 45%

“…O'Brien et al 33 in 1980 and Seckel et al 51 in 1983 simply split the gracilis muscle parallel to its fibre direction into several slips, to cover the diverse functions of the upper, middle and lower face. The result obtained was acceptable, but clearly independent muscle activity of the muscle slips could not be obtained.…”

Section: Discussionmentioning

confidence: 98%

“…Neuronal input was therefore provided by means of a CFNG during a previous intervention. E: Schematic drawing of the two-stage procedure performed by O'Brien and co-workers 33 in 1980. In contrast to previous authors, the neurovascular pedicle was included in the flap close to the nasolabial fold, and thus the facial vessels (FV) became available for anastomosis.…”

Section: Historical Reviewmentioning

confidence: 99%

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Muscle transplantation for reconstruction of a smile after facial paralysis past, present, and future

Guelinckx

Sinsel

1996

Microsurgery

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Reconstruction of a natural, spontaneous, symmetrical smile remains the ultimate goal of reanimation of the mid-face after facial paralysis. Recently the one-stage mini-gracilis muscle transplantation, innervated by the contralateral facial nerve, has been introduced to solve this difficult problem. This paper illustrates by means of a historical review the numerous procedures which have led to the development of this intervention. Moreover, it addresses relevant differences between the classical two-stage procedure using a cross-facial nerve graft and the recently advocated one-stage procedure. The underlying neurophysiological mechanism and determination of the final functional outcome of the neurovascular muscle transfer to the face are discussed, and areas which deserve future research are mentioned.

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“…Encouraged by the survival of replanted or revascularized tissue, many investigators and surgeons fostered the concept of free tissue transfer isolated on the arterial and venous blood supply. McLean and Buncke (omentum flap), 27 Daniel and Taylor (groin flap), 28 and O'Brian (gracilis flap), 29 performed the first successful free tissue transfers in 1972. The new possibilities of microsurgical tissue transfer directed scientific interest again toward retrograde arterial perfusion.…”

Section: Historical Overviewmentioning

confidence: 99%

Concept of arteriovenous loupes in high‐risk free‐tissue transfer: history and clinical experiences

et al. 2004

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The present study describes the concepts of arteriovenous (A-V) loupes prior to microsurgical free flap transfer in a selected high-risk group of patients. A one-stage concept was employed in 26 patients; 5 patients underwent two-stage flap transfer. Seven thrombotic occlusions of the A-V fistula or flap vessels were recorded; 6 patients underwent successful revision. Overall flap survival was 96.8% and compared favorably to reports in the literature. Defect coverage could be achieved in all but one case. It can be concluded from the data that in selected high-risk patient groups, i.e., following radiation, compound trauma, chronic infection, or multiple comorbidities, the creation of an A-V fistula prior to flap transfer may facilitate innovative reconstructive solutions.

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Cross-facial nerve grafts and microneurovascular free muscle transfer for long established facial palsy

Cited by 179 publications

References 3 publications

Facial nerve reconstruction in salivary gland pathology: A review

Facial nerve reconstruction in salivary gland pathology: A review

Muscle transplantation for reconstruction of a smile after facial paralysis past, present, and future

Concept of arteriovenous loupes in high‐risk free‐tissue transfer: history and clinical experiences

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