Immediate compared with late repair of extracranial branches of the facial nerve: a comparative study

Kannan, Ruben Y.; Hills, Adrian; Shelley, Mike; Bisase, Brian; Kapoor, Karan; Norris, Paul; Nduka, Charles

doi:10.1016/j.bjoms.2019.11.004

Cited by 19 publications

(14 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…16 Similarly, an increasing number of chimeric flaps were being utilized in orofacial reconstruction, 17,18 primarily as tier II reconstruction, followed by isolated reports of tier III reconstructions, providing surface cover, volume, and facial reanimation. 19 The fusion of composite 4 and chimeric flap concepts, 5 along with super-microsurgery and cranial nerve surgery, 20,21 gives us the ability to restore function and form using free flap technology, courtesy of being able to utilize minute structures of up to 0.3 mm (eg, terminal branches of VII, to achieve better outcomes at an earlier stage), 22 before motor end-plate degeneration. Even in chronic facial palsy cases (as shown in case 2), these newer concepts can give rise to increasing permutations and combinations in facial restorative surgery, namely VNFs.…”

Section: Discussionmentioning

confidence: 99%

Facial Nerve Revascularization Strategies in Facial Restoration

Khajuria

Bisase

Norris

et al. 2022

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Background: Facial transplants represent the current exemplar in the reconstruction of severely damaged faces, whereas conventional free flap reconstruction has its limitations in restoring both function and surface cover. Methods: In a retrospective study over 6 years (2014–2020), 5 cases (n = 5) of vascularized nerve flaps (VNFs) were performed by our team. These involved three acute and two late reconstructions. The mean age was 41 years with a maximum of 6-year follow-up. To objectify the different permutations and combinations, we categorized composite, chimeric, and hybrid VNFs into types I, IIa-c, and III, each with a unique characteristic. Postoperative function was evaluated using the validated Sunnybrook and Terzis scores for facial nerve palsy; masticatory function was assessed using dental impression studies. Results: There was a 100% flap survival rate, with no instances of flap necrosis and only one complication: hematoma at 24 hours postoperative. Sunnybrook and Terzis scores showed a statistically significant improvement postoperatively, indicating both improved repose and facial expressions (paired student t test, P < 0.05). Given that each VNF was specifically customized for a particular patient, each type of VNF in this cohort was unique, thereby illustrating each type succinctly. Conclusions: VNFs are separate entities from standard free flaps, as they require extensive preoperative planning to allow the deconstructing of composite blocks of tissue into separate vascularized entities and amalgamating them into a new conglomerate. This allows VNFs to fill a niche area in facial reconstructive surgery between face transplants and conventional free tissue transfers, with enormous potential.

show abstract

Section: Discussionmentioning

confidence: 99%

Facial Nerve Revascularization Strategies in Facial Restoration

Khajuria

Bisase

Norris

et al. 2022

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

show abstract

“…Wu et al [52] reported that superficial radial nerve transfer to the dorsal cutaneous branch and the superficial branch of the ulnar nerve restored sensation in a patient with C7, C8, and T1 roots injury. Kannan et al [53] reported that immediate repair showed no significantly different outcomes than late repair in extracranial branches of the facial nerve, however, their immediate repair showed the greatest likelihood of full recovery. Zang et al [54] found that orthopedic operations combined with external fixators for deformities could help achieve complete correction of said deformity, the healing of ulcers, and in the restoration of functional activity in patients with spinal bifida sequelae.…”

Section: Neurorestorative Surgerymentioning

confidence: 99%

The 2019 yearbook of Neurorestoratology

Huang¹,

Chen

Mao³

et al. 2020

Journal of Neurorestoratology

View full text Add to dashboard Cite

Time is infinite movement in constant motion. We are glad to see that Neurorestoratology, a new discipline, has grown into a rich field involving many global researchers in recent years. In this 2019 yearbook of Neurorestoratology, we introduce the most recent advances and achievements in this field, including findings on the pathogenesis of neurological diseases, neurorestorative mechanisms, and clinical therapeutic achievements globally. Many patients have benefited from treatments involving cell therapies, neurostimulation/neuromodulation, brain–computer interface, neurorestorative surgery or pharmacy, and many others. Clinical physicians can refer to this yearbook with the latest knowledge and apply it to clinical practice.

show abstract

“…The latter study did show that nerve function returns significantly faster in the early repair arms. [4][5][6] There is a large consensus that the best possible functional outcome after complete transection of the FN, regardless of the method of coaptation and time until intervention, is House-Brackmann grade III. 6…”

Section: Timing Of Explorationmentioning

confidence: 99%

“…3 It is found approximately 6.5 cm below the inferior wall of the external acoustic meatus and 0.5 cm above the external jugular vein. 4 Another method of identification is with a line drawn from the angle of the mandible to the mastoid tip, with the GAN bisecting this line as it passes over the sternocleidomastoid. 9 It runs deep to the platysma muscle in the same general course of the external jugular vein (►Fig.…”

Section: Great Auricular Nervementioning

confidence: 99%

Management of Acute Facial Nerve and Parotid Injuries

et al. 2021

View full text Add to dashboard Cite

Acute soft tissue trauma to the head and neck is a common reason for emergency department presentation and should be appropriately evaluated by a facial plastic surgeon. The evaluation of a patient who has suffered facial trauma should always include a comprehensive facial nerve exam and carry a low threshold of suspicion for parotid duct injury when involving the cheek. Injuries to the facial nerve and parotid duct can result in significant long-term functional, cosmetic, and emotional morbidity, particularly when diagnosis is delayed. In the repair of facial nerve transection, neurorrhaphy technique is primarily based on the ability to obtain tension-free anastomosis and outcomes are in large part related to timing of repair. Parotid duct injuries are generally repaired based on the site of ductal injury. In this article, we present a guide to the relevant anatomy of the facial nerve branches and the parotid duct, the important factors guiding treatment decisions alongside their related risks and benefits, as well as the management of complications of facial nerve neurorrhaphy and parotid duct injuries and repair.

show abstract

Immediate compared with late repair of extracranial branches of the facial nerve: a comparative study

Cited by 19 publications

References 15 publications

Facial Nerve Revascularization Strategies in Facial Restoration

Facial Nerve Revascularization Strategies in Facial Restoration

The 2019 yearbook of Neurorestoratology

Management of Acute Facial Nerve and Parotid Injuries

Contact Info

Product

Resources

About