Evaluation of Donor Morbidity Following Single-Stage Latissimus Dorsi Neuromuscular Transfer for Facial Reanimation.

BACKGROUND: Single-stage latissimus dorsi (LD) neuromuscular transfer has been a valuable option for dynamic smile reanimation. However, there is a paucity of studies evaluating the potential donor morbidity in such cases. The present study aimed to comprehensively analyze the donor morbidity following functional LD muscle transfer.

METHODS: Patients who underwent single-stage functional LD muscle transfer for smile reanimation between 2002 and 2016 were reviewed. Postoperative complications and functional impairments at the donor sites were evaluated. The Quick-Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used for assessing postoperative donor-site function.

RESULTS: Sixty patients including 12 pediatric (≤ 18 years) were analyzed. Mean length of a harvested thoracodorsal nerve was 14.9 cm. Fourteen patients were treated with dual innervation technique, in which both a descending and transverse branch of the thoracodorsal nerve were harvested. Donor complications were observed in seven cases; all of them were seroma and resolved by simple aspiration. No other complications including scoliosis and sensory and/or motor disturbances in the upper extremities were encountered. Fifty patients responded to the Quick-DASH questionnaire at a median follow-up period of 51 months. The average score was 2.64 and all but three patients scored less than 10. No variables, including patient age (pediatric versus adult) and the use of dual innervation technique, affected the donor morbidities including the functional deficits.

CONCLUSIONS: Single-stage LD neuromuscular transfer for facial reanimation might be associated with a low rate of complications and minimal functional morbidity at the donor site.