Facial Reanimation Using Free Functional Muscle Transfer: Lessons Learnt From a Long Term Experience Comparing Innervation With Cross Facial Nerve Graft and Masseter Nerve

Abstract

Current trends in local anesthesia in cosmetic plastic surgery of the head and neck: results of a German national survey and observations on the use of ropivacaine.

Outcomes of Free Flap Transfer in Facial Reanimation: A Review

“…The results of a modified technique for muscle transfer achieved a shorter surgery time and recovery period as described in the methods which involved a modified facelift incision which exposed the temporalis muscle and fascia. 35 Similar results to Bayezid et al 33 was found by Chuang et al 36 and Kalra et al 37 whose results indicated that the cross-face nerve graft achieved positive results in relation to a natural and spontaneous smile after a 2-year follow-up period. Furthermore, the study by Chuang et al 36 also analyzed the outcomes of free functional muscle flap transfer using spinal accessory nerve innervation, finding that this was a good alternative option to the cross-face nerve graft gracilis transfer.…”

“…Positive outcomes were noted in Zuo et al's 39 study as free functional muscle flap transfer achieved improved muscle contraction, lip symmetry, and oral commissure excursion. Conversely to Bayezid et al, 33 Chuang et al 36 and Kalra et al, 37 Roy et al 40 concluded that masseter nerve innervation produced more positive results in relation to smile excursion in comparison to cross-face nerve graft innervation.…”

Nerve guide conduits, nerve transfers, and local and free muscle transfer in facial nerve palsy

“…However, the procedure is associated with longer operative time, possible vascular complications, and longer delays in muscle function in contrast to local muscle transfer, as the final result can take years following surgery to achieve [25 ▪▪ ]. Several muscles have been used, most commonly the gracilis muscle, latissimus dorsi, extensor digitorum brevis, and serratus anterior [52 ▪ ]. Gracilis is the preferred muscle for FFMT by most reconstructive surgeons, partly because it provides a reliable neurovascular pedicle, and there are no significant donor functional deficits, yet there remain controversies regarding choice of innervating nerve, and staging of the procedures.…”