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Facial reanimation

Tarek A Amer, Mohamed S El Kholy
Long-standing cases of facial paralysis are currently treated with free functional muscle transfer. Several nerves are mentioned in the literature to supply the free muscle transfer. The aim of this study is to compare the split hypoglossal nerve and the cross-face nerve graft to supply the free functional muscle transfer in facial reanimation. Of 94 patients with long-standing, unilateral facial palsy, 49 were treated using the latissimus dorsi muscle supplied by the split hypoglossal nerve, and 45 patients were treated using the latissmus dorsi muscle supplied by healthy contralateral buccal branch of the facial nerve...
January 31, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Miyuki Uehara, Fumiaki Shimizu
BACKGROUND: Double innervation of the transferred muscle with the contralateral facial nerve and the ipsilateral masseteric nerve has recently been reported by some authors. The aim of this study was to assess the utility of our procedure of double innervation of free gracilis muscle for reconstruction of long-standing facial palsy. PATIENTS AND METHODS: In our department, 6 cases of long-standing facial paralysis (4 cases of complete palsy and 2 of incomplete palsy) were reconstructed using a free gracilis muscle double innervated with the masseteric and contralateral facial nerves...
January 19, 2018: Journal of Craniofacial Surgery
Ross Elledge, Satyesh Parmar
PURPOSE OF REVIEW: To review recent literature on the subject of free tissue transfer options in paediatric head and neck surgery, with a particular emphasis on highlighting the advantages and disadvantages of different reconstructions in the paediatric patient. RECENT FINDINGS: Free tissue transfer in paediatric patients is predictable and applicable for a wide range of congenital and acquired defects in the head and neck. The free fibula flap is a mainstay of mandibular reconstruction and allows excellent implant-supported prosthodontic rehabilitation and growth potential at the recipient site with little or no donor site morbidity...
January 22, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Federico Biglioli, Matteo Zago, Fabiana Allevi, Daniela Ciprandi, Giovanni Dell'Aversana Orabona, Valentina Pucciarelli, Dimitri Rabbiosi, Ilaria Pacifici, Filippo Tarabbia, Chiarella Sforza
Alterations of facial muscles may critically humper patients' quality of life. One of the worst conditions is the reduction or abolition of eye blinking. To prevent these adverse effects, surgical rehabilitation of eyelid function is the current treatment choice. In the present paper, we present a modification of the technique devised by Nassif to recover lids from long-standing paralysis. In our modification, the upper lid is rehabilitated by a platisma graft innervated by the contralateral facial nerve branches using a cross-face sural nerve graft...
December 27, 2017: Journal of Cranio-maxillo-facial Surgery
Sertac Yetiser
Hypoglossal-facial anastomosis provides excellent motor supply to the mimetic muscles of the face when there is no chance of recovery of the damaged facial nerve. However, to achieve optimal results, the timing of facial nerve surgery based on electrophysiological testing and clinical evaluation requires close follow-up of the patient. Functional results after delayed surgery are not predictable and depend on the number of surviving fibers, type of injury, severity of damage, degree of infiltration of inflammatory cells, and local fibrosis...
December 27, 2017: Journal of Craniofacial Surgery
C Sforza, E Ulaj, D M Gibelli, F Allevi, V Pucciarelli, F Tarabbia, D Ciprandi, G Dell'Aversana Orabona, C Dolci, F Biglioli
Facial palsy is a severe condition that may be ameliorated by facial reanimation, but there is no consensus about how to judge its success. In this study we aimed to test a new method for assessing facial movements based on 3-dimensional analysis of the facial surfaces. Eleven patients aged between 42 and 77 years who had recently been affected by facial palsy (onset between 6 and 18 months) were treated by an operation based on triple innervation: the masseteric to temporofacial nerve branch, 30% of the hypoglossal fibres to the cervicofacial nerve branch, and the contralateral facial nerve through two cross-face sural nerve grafts...
January 2018: British Journal of Oral & Maxillofacial Surgery
Alexander W Murphey, William B Clinkscales, Samuel L Oyer
Importance: A review of the role of masseteric nerve transfer is needed to guide its use in facial reanimation. Objective: To systematically review the available literature, and, when applicable, analyze the combined outcomes of masseteric nerve transfer to better define its role in reanimation and to guide further research. Data Sources: Two independent researchers conducted the review using PubMed-NCBI and Scopus literature databases for studies on masseteric nerve transfer for facial nerve paralysis...
December 7, 2017: JAMA Facial Plastic Surgery
Callum Faris, Alyssa Heiser, Tessa Hadlock, Nate Jowett
BACKGROUND: The purpose of this study was to characterize the outcomes of free gracilis muscle transfer for delayed smile reanimation after radical parotidectomy. METHODS: A retrospective chart review of patients who underwent free gracilis muscle transfer for smile reanimation after radical parotidectomy between 2003 and 2016 was performed. Patient-reported quality of life (Facial Clinimetric Evaluation Scale [FaCE]), physician-reported facial function ("eFACE" facial grading scale), and oral commissure excursion were compared preoperatively and postoperatively...
November 20, 2017: Head & Neck
A Cardenas-Mejia, D Palafox
INTRODUCTION: Möbius syndrome is defined as a combined congenital bilateral facial and abducens nerve palsies. The main goal of treatment is to provide facial reanimation by means of a dynamic surgical procedure. The microneurovascular transfer of a free muscle transplant is the procedure of choice for facial animation in a child with facial paralysis. OBSERVATION: Between January 2008 and January 2017, 124 patients with the syndrome have been approached at our institution...
November 15, 2017: Annales de Chirurgie Plastique et Esthétique
Masayuki Okochi, Hiromi Okochi, Emiko Asai, Takao Sakaba, Kazuki Ueda
BACKGROUND: To reanimate the mimetic muscles, crossface nerve graft (CFNG) is an effective surgical option. However, muscle atrophy after facial paralysis may influence the surgical result. We analyzed the relationship between surgical result and preoperative paralysis duration. METHODS: We performed CFNG on 15 patients. The sural nerve was transferred between the affected and nonaffected sides of the zygomatic branch. Eyelid function and eyelid lid were evaluated using the modified House-Brackmann scale...
November 10, 2017: Microsurgery
Michal Brichacek, Babar Sultan, Kofi D Boahene, Lisa Ishii, Patrick J Byrne
OBJECTIVES: We describe an approach to reanimation of complete, prolonged facial paralysis using minimally invasive temporalis tendon transfer (MIT3) by the melolabial or transoral approach. Objective outcome measures are evaluated based on symmetry, and grading of preoperative/post-operative results and the scar at the melolabial fold. STUDY DESIGN: Retrospective cohort study. METHODS: Twenty-five patients undergoing the MIT3 technique were studied...
August 2017: Plastic Surgery
Mark A Mahan, Walavan Sivakumar, David Weingarten, Justin M Brown
BACKGROUND: Facial nerve palsy is a disabling condition that may arise from a variety of injuries or insults and may occur at any point along the nerve or its intracerebral origin. OBJECTIVE: To examine the use of the deep temporal branches of the motor division of the trigeminal nerve for neural reconstruction of the temporal branches of the facial nerve for restoration of active blink and periorbital facial expression. METHODS: Formalin-fixed human cadaver hemifaces were dissected to identify landmarks for the deep temporal branches and the tension-free coaptation lengths...
September 8, 2017: Operative Neurosurgery (Hagerstown, Md.)
Shai M Rozen
No abstract text is available yet for this article.
October 2017: Plastic and Reconstructive Surgery
Alexánder Cárdenas-Mejía, Damián Palafox, Daniela Téllez-Palacios, Sara Contreras-Merida, Lilia de La Maza-Krzeptowsky, Rubén López, Tzilacatzin Hernández
Direct muscle neurotization has been proved to be a feasible technique for facial reanimation microsurgical procedures. Direct muscle neurotization is performed by implanting the interposition nerve graft directly into the substance of the muscle. The authors present the case of a 36-year-old male patient with upper eyelid dysfunction secondary to facial trauma. The levator palpebrae superioris muscle was macroscopically unaffected; however, neurophysiological test proved a selective denervation of the CN III motor branch to the levator palpebrae superioris muscle...
November 2017: Journal of Craniofacial Surgery
Apichai Angspatt, Chirayu Pannanusorn
BACKGROUND: The use of the masseteric nerve has been escalated as a donor nerve for facial reanimation in facial palsy patient (Wang et al., 2014; Manktelow et al., 2006; Klebuc, 2011; Bianchi et al., 2012; Zuker et al., 2000; Bae et al., 2006; Terzis, Konofaos, 2013; Terzis, Olivares, 2009; Bianchi et al., 2014). Previous studies had been done in Euro-Caucasian cadavers (Kaya et al., 2014). However, difference in anatomical details does exist between Asian and Euro-Caucasian population (Tzou et al...
September 13, 2017: Asian Journal of Surgery
Axel Sahovaler, David Yeh, John Yoo
Facial Paralysis (FP) profoundly impairs the life of individuals, both functionally and psychosocially. Surgical approaches to treat this condition are myriad, but the ultimate goal is to restore symmetry and movement. Ablative surgery for tumors of the head and neck region are amongst the most common etiologies causing FP and this group of patients represents unique challenges. Surgical defects may have multiple competing reconstructive requirements and addressing the FP must be considered in this context...
November 2017: Oral Oncology
Victor Vlad Costan, Eugenia Popescu, Daniela Sulea, Ioan Sorin Stratulat
PURPOSE: The objective of this study was to present the authors' experience in static facial reanimation using a straightforward incisionless procedure adapted from techniques commonly used for performing minimally invasive facelifts. MATERIALS AND METHODS: Seventeen patients were treated by static suspension using barbed sutures and all resulting changes were reviewed. The technique used for suture placement is described in detail, as are the author's tips for achieving the best esthetic and functional results...
August 5, 2017: Journal of Oral and Maxillofacial Surgery
Davide Thomas Panciera, Claudio Sampieri, Alberto Deganello, Giovanni Danesi
Objective Evaluate outcomes of the lengthening temporalis myoplasty in facial reanimations. Study Design Case series with planned data collection. Setting Ospedali Riuniti, Bergamo, and AOUC Careggi, Florence, Italy. Subjects and Methods From 2011 to 2016, 11 patients underwent lengthening temporalis myoplasty; demographic data were collected for each. Pre- and postoperative photographs and videos were recorded and used to measure the smile angle and the excursion of the oral commissure, according to the SMILE system (Scaled Measurements of Improvement in Lip Excursion)...
December 2017: Otolaryngology—Head and Neck Surgery
Nathaniel E Helwig, Nick E Sohre, Mark R Ruprecht, Stephen J Guy, Sofía Lyford-Pike
Facial expression of emotion is a foundational aspect of social interaction and nonverbal communication. In this study, we use a computer-animated 3D facial tool to investigate how dynamic properties of a smile are perceived. We created smile animations where we systematically manipulated the smile's angle, extent, dental show, and dynamic symmetry. Then we asked a diverse sample of 802 participants to rate the smiles in terms of their effectiveness, genuineness, pleasantness, and perceived emotional intent...
2017: PloS One
Gang Chen, Wenjin Wang, Wei Wang, Wei Ding, Xianxian Yang
BACKGROUND: Masseter-to-facial nerve transfer is a highly efficient technique for reanimating paralyzed muscle and has been reported to restore facial symmetry at rest. However, no systematic studies have been performed, and the effects of preoperative droop of the oral commissure on postoperative symmetry at rest have rarely been reported. METHODS: The authors retrospectively analyzed 35 patients with masseteric-to-facial nerve anastomosis and assessed the quality and quantity of the dynamic recovery and the oral commissure symmetry at rest...
October 2017: Plastic and Reconstructive Surgery
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