Gracilis Muscle-Free Flap Objective Improvement of Oral Commissure Excursion in Facial Palsy Reanimation Surgery: Systematic Review and Meta-Analysis

González, Isabel Fernández-Carrera; Gavilanes-Plasencia, Javier; Mata‐Castro, Nieves

doi:10.1089/fpsam.2022.0283

Cited by 2 publications

(1 citation statement)

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“…Many techniques and modifications of existing procedures have been proposed to improve the outcomes. According to the recent literature, 97% of treated patients reported a significant improvement in their ability to smile and speak and in their quality of life (Fernández‐Carrera González et al, 2023; Roy et al, 2019; Vila et al, 2020). Performing such intervention in a vessel‐depleted condition is not a common scenario.…”

Section: Discussionmentioning

confidence: 99%

Inverted gracilis muscle free flap with intraoral vascular anastomoses for facial reanimation in vessel depleted neck: A case report

De Cicco,

Bottini,

Lizambri

et al. 2023

Microsurgery

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The reinnervated gracilis muscle free flap represents a workhorse of facial reanimation. This procedure is carried out secondarily to parotid resections, due to advanced tumors that spread to the surrounding structures. Finding recipient vessels might be problematic if other reconstructive procedures are needed to address the defects. This paper describes a procedure to inset a reinnervated gracilis muscle free flap in a vessel depleted patient, through intraoral anastomoses to avoid venous interposition grafts. A 52‐year‐old man developed an advanced adenocarcinoma of the deep parotid lobe and underwent radical surgical excision including the mandibular ramus, condyle, and facial soft tissues (defect size: 8 cm × 4 cm). A secondary double‐flap reconstruction restored the mandibular defect and inset a cross‐face nerve graft. A third intervention finalized the facial reanimation with a 10 cm reinnervated gracilis muscle free flap. The gracilis flap inset was inverted resulting in the proximal flap (pedicle side) lying on the buccal aspect. This allowed vessel joining from the contralateral side via intraoral anastomoses. No complications occurred within and after the intervention. However, the adenocarcinoma relapsed before reinnervation of the gracilis. The patient also had distant brain and lung metastases and received best supportive care. The inverted gracilis muscle free flap may represent an option for attaining facial reanimation in vessel‐depleted patients avoiding long interposition venous grafts.

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Section: Discussionmentioning

confidence: 99%