The evolution of facial reanimation techniques

Pan, Debbie R.; Clark, Nicolas W.; Chiang, Harry; Kahmke, Russel; Phillips, Brett T.; Barrett, Dane M.

doi:10.1016/j.amjoto.2023.103822

Cited by 2 publications

(2 citation statements)

References 77 publications

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“…Immediate facial reanimation is commonly considered the gold standard to try to achieve the best function possible after parotidectomy [22,23]. However, when facial nerve sacrifice is required, ablative surgery can already be a challenge for both patient and surgeon due to severe malignancy or advanced disease.…”

Section: Discussionmentioning

confidence: 99%

A Novel Approach to Facial Reanimation and Restoration Following Radical Parotidectomies

Pannuto,

Soh,

Duah-Asante

et al. 2024

JCM

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Background: Parotidectomies are indicated for a variety of reasons. Regardless of the indication for surgery, facial reanimation may be required because of facial nerve sacrifice or iatrogenic damage. In these cases, facial restoration performed concurrently with ablative surgery is considered the gold standard, and delayed reanimation is usually not attempted. Methods: A retrospective review of all patients who underwent parotidectomies from 2009 to 2022 in a single institution was performed. Indications, surgical techniques, and outcomes of an algorithmic template were applied to these cases using the Sunnybrook, Terzis scores, and Smile Index. A comparison was made between immediate vs. late repairs. Results: Of a total of 90 patients who underwent parotidectomy, 17 (15.3%) had a radical parotidectomy, and 73 (84.7%) had a total or superficial parotidectomy. Among those who underwent complete removal of the gland and nerve sacrifice, eight patients (47.1%) had facial restoration. There were four patients each in the immediate (n = 4) and late repair (n = 4) groups. Surgical techniques ranged from cable grafts to vascularized cross facial nerve grafts (sural communicating nerve flap as per the Koshima procedure) and vascularized nerve flaps (chimeric vastus lateralis and anterolateral thigh flaps, and superficial circumflex perforator flap with lateral femoral cutaneous nerve). Conclusions: The algorithm between one technique and another should take into consideration age, comorbidities, soft tissue defects, presence of facial nerve branches for reinnervation, and donor site morbidity. While immediate facial nerve repair is ideal, there is still benefit in performing a delayed repair in this algorithm.

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Section: Discussionmentioning

confidence: 99%

A Novel Approach to Facial Reanimation and Restoration Following Radical Parotidectomies

Pannuto,

Soh,

Duah-Asante

et al. 2024

JCM

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“…Surgery in this patient population is based on severity of palsy, impact on quality of life, the type of surgical techniques appropriate for the patient presentation, and the predicated outcomes of surgery, as evaluated by the expert clinician. 26 The goals of facial reanimation reported by Pan et al 27 include "obtaining facial symmetry at rest, providing corneal protection, restoring smile symmetry, and facial movement for functional and aesthetic purposes." For patients requiring a surgical opinion and intervention, facial therapists should be involved throughout the surgical journey.…”

Section: Timing Of Facial Rehabilitationmentioning

confidence: 99%

A Combined Approach of Facial Neuromuscular Rehabilitation and Surgical Reconstruction in the Remediation of Facial Palsy: A Multidisciplinary Team Approach

Kimber,

Rodger,

Higgins

et al. 2024

Facial Plast Surg

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Facial neuromuscular rehabilitation (fNMR) is an evidence-based practice for the treatment of peripheral facial palsy (PFP). Surgical reconstruction can be indicated for patients who demonstrate poor or no recovery to support symmetry, function, and aesthesis. There is paucity of research demonstrating the therapeutic benefit of a multidisciplinary team (MDT) in facial recovery of this specific subpopulation of patients. This article will outline the role of specialist facial therapy in the remediation of PFP, focusing on those who undergo surgical reconstruction to optimize their facial recovery. Case studies are used to demonstrate surgical and therapeutic outcomes as well as the results of a patient survey conducted for a service evaluation. We discuss the role of the MDT in supporting recovery as well as the role of targeted fNMR. The term fNMR is often used interchangeably with facial therapy or facial rehabilitation. We will refer to fNMR as a technique of facial rehabilitation.We aim to demonstrate that an MDT approach to the treatment of people with facial palsy provides positive outcomes for this surgical population and that future research would be beneficial to support this service delivery model.

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The evolution of facial reanimation techniques

Cited by 2 publications

References 77 publications

A Novel Approach to Facial Reanimation and Restoration Following Radical Parotidectomies

A Novel Approach to Facial Reanimation and Restoration Following Radical Parotidectomies

A Combined Approach of Facial Neuromuscular Rehabilitation and Surgical Reconstruction in the Remediation of Facial Palsy: A Multidisciplinary Team Approach

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