Facial animation with gracilis muscle transplant reinnervated via cross-face graft: Does it change patients' quality of life?

Bianchi, Bernardo; Ferri, Andrea; Poddi, Valentina; Varazzani, Andrea; Ferrari, Silvano; Pedrazzi, Giuseppe; Sesenna, Enrico

doi:10.1016/j.jcms.2016.05.009

Cited by 22 publications

(10 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consequent impairments in emotional expression, corneal protection, nasal airway patency, oral competence, and vocal articulation may have significant functional implications on quality of life. 30,31 Our findings support the safe and reliable use of free functioning muscle transfer to restore smile function in children with craniofacial microsomia and severe facial paralysis. All patients in our case series who returned for follow-up had improved facial symmetry during smile with respect to philtrum, upper lip, and lower lip, and a median increase of 8 mm for commissure excursion.…”

Section: Discussionsupporting

confidence: 66%

See 1 more Smart Citation

Dynamic Reconstruction of Facial Paralysis in Craniofacial Microsomia

Zuo¹,

Heinelt²,

Ho³

et al. 2022

Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

Background: Craniofacial microsomia is associated with maxillomandibular hypoplasia, microtia, soft-tissue deficiency, and variable severity of cranial nerve dysfunction, most often of the facial nerve. This study evaluated the incidence of facial paralysis in patients with craniofacial microsomia and outcomes after free functioning muscle transfer for dynamic smile reconstruction. Methods: A single-center, retrospective, cross-sectional study was performed from 1985 to 2018 to identify pediatric patients with craniofacial microsomia and severe facial nerve dysfunction who underwent dynamic smile reconstruction with free functioning muscle transfer. Preoperative and postoperative facial symmetry and oral commissure excursion during maximal smile were measured using photogrammetric facial analysis software. Results: This study included 186 patients with craniofacial microsomia; 41 patients (21 male patients, 20 female patients) had documented facial nerve dysfunction (22 percent) affecting all branches (51 percent) or the mandibular branch only (24 percent). Patients with severe facial paralysis (n = 8) underwent smile reconstruction with a free functioning muscle transfer neurotized either with a cross-face nerve graft (n = 7) or with the ipsilateral motor nerve to masseter (n =1). All patients achieved volitional muscle contraction with improvement in lip symmetry and oral commissure excursion (median, 8 mm; interquartile range, 3 to 10 mm). The timing of orthognathic surgery and facial paralysis reconstruction was an important consideration in optimizing patient outcomes. Conclusions: The authors’ institution’s incidence of facial nerve dysfunction in children with craniofacial microsomia is 22 percent. Free functioning muscle transfer is a reliable option for smile reconstruction in children with craniofacial microsomia. To optimize outcomes, a novel treatment algorithm is proposed for craniofacial microsomia patients likely to require both orthognathic surgery and facial paralysis reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

show abstract

Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Dynamic Reconstruction of Facial Paralysis in Craniofacial Microsomia

Zuo¹,

Heinelt²,

Ho³

et al. 2022

Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

show abstract

“…the best results are obtained in cases treated early (Bianchi et al, 2016(Bianchi et al, , 2017Kleiss, Hohman, Susarla, Marres, & Hadlock, 2015). However, the esthetic and functional outcomes of our patients were satisfactory, Abbreviations: df, degrees of freedom; Std, standard.…”

Section: Discussionmentioning

confidence: 61%

“…Our major concern is the quality of the results. The literature shows that the quality of recovery is strictly (negatively) correlated with the time that has elapsed since denervation of the mimic muscle; the best results are obtained in cases treated early (Bianchi et al, ; Kleiss, Hohman, Susarla, Marres, & Hadlock, ). However, the esthetic and functional outcomes of our patients were satisfactory, as demonstrated by their scores on the Sunnybrook Facial Grading System.…”

Section: Discussionmentioning

confidence: 99%

Masseteric cooptation and crossfacial nerve grafting: Is it still applicable 22 months after the onset of facial palsy?

et al. 2018

View full text Add to dashboard Cite

show abstract

“…The described technique needs to be improved further to solve the following issues: the complexity of harvesting a graft comprising 2 muscle flaps; the bulkiness of the muscle flaps; and the involvement of multiple microscopic nerve‐suturing procedures to interconnect 2 motor nerves for dual innervation. Bianchi et al () reported that two‐stage surgery comprising gracilis muscle transplantation and cross grafting, which is one of the gold standard procedures for facial animation, improved quality of life (QOL), as assessed by the Facial Disability Index questionnaire. The present authors will examine to what extent the described procedure improves QOL in a greater number of cases in the future.…”

Section: Discussionmentioning

confidence: 99%

One‐stage reconstruction by dual‐innervated double muscle flap transplantation with the neural interconnection between the ipsilateral masseter and contralateral facial nerve for reanimating established facial paralysis: A report of 2 cases

et al. 2018

View full text Add to dashboard Cite

The authors developed a one‐stage double‐muscle reconstruction technique for facial paralysis using a latissimus dorsi (LD) flap and a serratus anterior (SA) flap, which were dually reinnervated by the contralateral facial nerve (FN) and ipsilateral masseter nerve (MN). The procedure was performed for 61‐year‐old man 3‐years after resection of a malignant tumor and a 24‐year‐old woman 10‐years after temporal fracture with facial paralysis. A double‐muscle flap comprising left LD and SA flaps was harvested, a 15‐cm thoracodorsal nerve (TN) section was attached to the LD flap, and 5‐cm and 1‐cm sections of the long thoracic nerve (LTN) were attached to the proximal and distal sides of SA flap. The LD flap and SA flap were sutured along the direction of motion of the zygomaticus major and risorius muscles, respectively. The contralateral FN and ipsilateral MN were interconnected by nerve suturing: the medial branch of TN to the distal end of LTN, the proximal end of LTN to the ipsilateral MN, and the buccal branch of contralateral FN to the main trunk of TN. After surgery, good contraction of the transferred flaps resulted in reanimation of a natural symmetrical smile; no complications were observed during the 12‐month follow‐up period.

show abstract

Facial animation with gracilis muscle transplant reinnervated via cross-face graft: Does it change patients' quality of life?

Cited by 22 publications

References 19 publications

Dynamic Reconstruction of Facial Paralysis in Craniofacial Microsomia

Dynamic Reconstruction of Facial Paralysis in Craniofacial Microsomia

Masseteric cooptation and crossfacial nerve grafting: Is it still applicable 22 months after the onset of facial palsy?

One‐stage reconstruction by dual‐innervated double muscle flap transplantation with the neural interconnection between the ipsilateral masseter and contralateral facial nerve for reanimating established facial paralysis: A report of 2 cases

Contact Info

Product

Resources

About