138 results match your criteria Dynamic Reanimation for Facial Paralysis


Blink Restoration in Long-standing Facial Paralysis: Use of Free Neurovascular Platysma Transfer.

Authors:
Paul J Guelinckx

Plast Reconstr Surg Glob Open 2018 Oct 22;6(10):e1939. Epub 2018 Oct 22.

Department of Plastic and Reconstructive Surgery, Jezza ZH, Hasselt, Belgium.

Background: Since 2004, microneurovascular platysma transfer has been used for dynamic eye closure in long-standing facial palsy. The idea was initially presented by Lee and Terzis in 1984 but abandoned owing to its transfer difficulty. This muscle transfer allows forceful closure and blink restoration. Read More

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http://dx.doi.org/10.1097/GOX.0000000000001939DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6250471PMC
October 2018
10 Reads

Pre-operative masseter muscle EMG activation during smile predicts synchronicity of smile development in facial palsy patients undergoing reanimation with the masseter nerve: A prospective cohort study.

J Plast Reconstr Aesthet Surg 2019 Mar 22;72(3):505-512. Epub 2018 Nov 22.

Department of Plastic and Hand Surgery, University of Freiburg Medical Centre, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany. Electronic address:

Background: Synchronicity of the oral commissure movement of a bilateral smile is a significant goal for reconstruction in facial reanimation and may only be guaranteed with use of the facial nerve as a donor nerve. Yet over the years several studies report some degree of spontaneity in certain patients when using a non-facial donor nerve, which indicates that synchronous initiation of the smile might be achievable with other donor nerves. We designed a prospective cohort study to evaluate whether pre-operative involuntary activation of the masseteric nerve during smile predicts development of a synchronous smile development when using the masseteric nerve for reanimation. Read More

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http://dx.doi.org/10.1016/j.bjps.2018.11.011DOI Listing
March 2019
1 Read

Closed Loop Microfabricated Facial Reanimation Device Coupling EMG-Driven Facial Nerve Stimulation with a Chronically Implanted Multichannel Cuff Electrode.

Conf Proc IEEE Eng Med Biol Soc 2018 Jul;2018:2206-2209

Permanent facial paralysis and paresis (FP) results from damage to the facial nerve (FN), and is a debilitating condition with substantial functional and psychological consequences for the patient. Unfortunately, surgeons have few tools with which they can satisfactorily reanimate the face. Current strategies employ static (e. Read More

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http://dx.doi.org/10.1109/EMBC.2018.8512778DOI Listing
July 2018
1 Read

A comparative retrospective study: hypoglossofacial versus masseterofacial nerve anastomosis using Sunnybrook facial grading system.

Eur Arch Otorhinolaryngol 2019 Jan 30;276(1):209-216. Epub 2018 Oct 30.

Department of Otolaryngology, Facial Plastic and Cervicofacial Surgery, Edouard Herriot Hospital, 5 place d'Arsonval, 69437, Lyon Cedex 03, France.

Introduction: The aim of our study is to compare the functional results between two surgical techniques for reanimation of facial paralysis: hypoglossal-to-facial versus masseteric-to-facial nerve anastomosis.

Methods: This is a retrospective study of 13 patients treated for complete facial paralysis in two medical tertiary centers. The patients were classified into two groups. Read More

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http://dx.doi.org/10.1007/s00405-018-5186-yDOI Listing
January 2019

Comparison of Objective Outcomes in Dynamic Lower Facial Reanimation With Temporalis Tendon and Gracilis Free Muscle Transfer.

JAMA Otolaryngol Head Neck Surg 2018 Oct 11. Epub 2018 Oct 11.

Facial Plastic & Reconstructive Surgery, Department of Otolaryngology, Johns Hopkins Hospital, Baltimore, Maryland.

Importance: Facial paralysis affects patients' physical, social, and psychological function. Dynamic smile reanimation can mitigate these effects, but there are limited data to guide the surgeon in selecting the best reanimation procedure for each patient.

Objective: To compare quantitative changes in oral commissure symmetry and smile excursion following temporalis tendon transfer (T3) and gracilis free muscle transfer. Read More

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http://archotol.jamanetwork.com/article.aspx?doi=10.1001/jam
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http://dx.doi.org/10.1001/jamaoto.2018.1964DOI Listing
October 2018
9 Reads

Facial Rehabilitation: Evaluation and Treatment Strategies for the Patient with Facial Palsy.

Otolaryngol Clin North Am 2018 Dec 24;51(6):1151-1167. Epub 2018 Sep 24.

Facial Plastic and Reconstructive Surgery Department, Facial Nerve Center, Massachusetts Eye and Ear Infirmary, Facial Nerve Center, 9th Floor, 243 Charles Street, Boston, MA 02114, USA.

This article describes the most widely used clinician-graded and patient-reported outcome measures, and describes facial rehabilitation strategies for acute and chronic facial palsy, and rehabilitation following dynamic facial reanimation surgery. The multimodality rehabilitation of the facial palsy patient is determined by the extent of facial nerve injury, specific functional deficits, the presence of synkinesis, and the patient's individual goals. Appropriate intervention, including patient education, soft tissue mobilization, neuromuscular reeducation, and chemodenervation, decreases facial tension and improves facial muscle motor control, physical function, facial expression, and quality of life. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00306665183013
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http://dx.doi.org/10.1016/j.otc.2018.07.011DOI Listing
December 2018
25 Reads

Management of Long-Standing Flaccid Facial Palsy: Static Approaches to the Brow, Midface, and Lower Lip.

Otolaryngol Clin North Am 2018 Dec 24;51(6):1141-1150. Epub 2018 Sep 24.

Facial Nerve Center, Vascular Birthmark Institute of New York, Department of Otolaryngology-Head and Neck Surgery, Manhattan Eye, Ear, and Throat Hospital, Lenox Hill Hospital, 210 East 64th Street, 7th Floor, New York, NY 10065, USA. Electronic address:

Chronic flaccid facial paralysis (FFP>2 years) may be approached with static and dynamic techniques. A horizontal zonal assessment evaluates the upper, middle, and lower thirds of the face. Surgery is tailored to an individual's deficits, goals, and health status. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00306665183013
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http://dx.doi.org/10.1016/j.otc.2018.07.010DOI Listing
December 2018
3 Reads

Depressor Reanimation After Facial Nerve Paralysis.

Ann Plast Surg 2018 Sep 26. Epub 2018 Sep 26.

Department of Plastic Surgery, University of Tennessee Health Sciences Center, Memphis, TN.

Facial expressions play a fundamental role in interpersonal communication and interaction; consequently, facial palsy has profound effects on the quality of life of patients. Reanimation of lower lip depressors is rarely addressed during facial reanimation but is as important as treating the eye sphincter and the lip levators. Depressors of lower lip are vital for full denture smile and the expression of facial emotions. Read More

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http://dx.doi.org/10.1097/SAP.0000000000001616DOI Listing
September 2018
13 Reads

Management of the paralyzed face using temporalis tendon transfer via intraoral and transcutaneous approach: Temporalis tendon transfer.

Maxillofac Plast Reconstr Surg 2018 Dec 5;40(1):24. Epub 2018 Sep 5.

3Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, 309, Pilmun-daero, Dong-gu, Gwangju, 501-759 South Korea.

Temporalis tendon transfer is a technique for dynamic facial reanimation. Since its inception, nearly 80 years ago, it has undergone a wealth of innovation to produce the modern operation. Temporalis tendon transfer is a relatively minimally invasive technique for the dynamic reanimation of the paralyzed face. Read More

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http://dx.doi.org/10.1186/s40902-018-0160-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6123326PMC
December 2018
3 Reads

Facial Asymmetry Index: Validation and Applications in Various Smile Restoration Techniques.

Facial Plast Surg 2018 Aug 24;34(4):381-383. Epub 2018 Jul 24.

Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, Maryland.

Consistent and objective evaluation of the paralyzed face is imperative for documenting preoperative findings and assessing postoperative outcomes of reanimation techniques. Static and dynamic facial asymmetry are the key features of the paralyzed face. To date, there is no consensus among surgeons on how best to document facial asymmetry. Read More

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http://dx.doi.org/10.1055/s-0038-1660836DOI Listing
August 2018
4 Reads
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Use of Objective Metrics in Dynamic Facial Reanimation: A Systematic Review.

JAMA Facial Plast Surg 2018 Dec;20(6):501-508

Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland.

Importance: Facial nerve deficits cause significant functional and social consequences for those affected. Existing techniques for dynamic restoration of facial nerve function are imperfect and result in a wide variety of outcomes. Currently, there is no standard objective instrument for facial movement as it relates to restorative techniques. Read More

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http://dx.doi.org/10.1001/jamafacial.2018.0398DOI Listing
December 2018
6 Reads

Facial Reanimation in the Seventh and Eighth Decades of Life.

Plast Reconstr Surg 2018 05;141(5):1239-1251

Dallas, Texas From the University of Texas Southwestern Medical Center.

Background: Treatment of facial paralysis in the older population is often relegated to static rather than dynamic reanimation for fear of poor outcomes. This pervasive approach lacks physiologic foundation and is not evidence based. Thus, the authors present an extensive literature review demonstrating weak evidence supporting this misguided concept, followed by detailed outcomes from three centers of the largest reported series to date of patients older than 60 years after reanimation performed using three techniques-lengthening temporalis myoplasty, free functional muscle, and nerve transfers. Read More

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http://Insights.ovid.com/crossref?an=00006534-201805000-0003
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http://dx.doi.org/10.1097/PRS.0000000000004329DOI Listing
May 2018
9 Reads

Incomplete Facial Paralysis: The Use of the Ipsilateral Residual Facial Nerve as a Donor Nerve for Facial Reanimation.

Plast Reconstr Surg 2018 07;142(1):202-214

Tel Aviv, Israel; and Toronto, Ontario, Canada From the Department of Plastic and Reconstructive Surgery, Microsurgery Unit, Tel Aviv Sourasky Medical Center affiliated with the Sackler Faculty of Medicine, Tel Aviv University; and the Division of Plastic Surgery, The Hospital for Sick Children, University of Toronto.

Background: The reconstructive approach for incomplete facial paralysis is not yet determined. In this article, the authors present a new surgical approach for patients with incomplete facial paralysis in which residual, ineffective movement is detected preoperatively in the ipsilateral buccozygomatic territory of the paretic facial nerve.

Methods: Sixteen patients with incomplete facial paralysis were found eligible for the procedure and underwent one-stage facial reanimation performed by the senior author (E. Read More

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http://dx.doi.org/10.1097/PRS.0000000000004536DOI Listing
July 2018
5 Reads

Functional outcomes assessment following free muscle transfer for dynamic reconstruction of facial paralysis: A literature review.

J Craniomaxillofac Surg 2018 May 22;46(5):875-882. Epub 2018 Mar 22.

Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada; Institute for Reconstructive Sciences in Medicine, Misericordia Community Hospital, Edmonton, AB, Canada. Electronic address:

Facial reanimation provides patients affected by chronic facial paralysis a chance to regain basic human functions such as emotional expression, verbal communication, and oral competence for eating and swallowing, but there is still no consensus as to the best way to measure surgical outcomes. We performed a literature review to investigate the different functional outcomes that surgeons use to evaluate facial function after reanimation surgery, focusing on outcomes other than facial expressions such as speech, oral competence, and patient quality of life/satisfaction. A total of 37 articles were reviewed, with the majority reporting outcomes through subjective facial expression ratings and only 15 dealing with other functional outcomes. Read More

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http://dx.doi.org/10.1016/j.jcms.2018.03.008DOI Listing
May 2018
6 Reads

Comparison of symmetry after smile reconstruction for flaccid facial paralysis with combined fascia lata grafts and functional gracilis transfer for static suspension or gracilis transfer alone.

Microsurgery 2018 Sep 30;38(6):634-642. Epub 2018 Mar 30.

Department of Plastic and Hand Surgery, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.

Purpose: Facial paralysis has a profound impact on functionality and esthetics of the oral region. In patients with strong skin laxity and soft tissue ptosis, functional smile reconstruction is challenging due to the accentuated asymmetry at rest. Thus, the purpose of the study was to analyze facial symmetry in this patient clientele following a combination of dynamic reanimation with fascial strips for static suspension compared to functional gracilis transfer alone. Read More

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http://dx.doi.org/10.1002/micr.30324DOI Listing
September 2018
2 Reads

The Multivector Gracilis Free Functional Muscle Flap for Facial Reanimation.

JAMA Facial Plast Surg 2018 Jul;20(4):300-306

Johns Hopkins University School of Medicine, Baltimore, Maryland.

Importance: A multivector functional muscle flap that closely simulates the biomechanical effects of facial muscle groups is essential for complete smile restoration after facial paralysis.

Objective: To determine the feasibility of a multivector gracilis muscle flap design for reanimation after facial paralysis and to analyze the effect on the smile display zone.

Design, Setting, And Participants: Prospective analysis of patients who underwent a double paddle multivector gracilis flap for complete facial paralysis between June 2015 and December 2016 was carried out in a tertiary hospital. Read More

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http://dx.doi.org/10.1001/jamafacial.2018.0048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145838PMC
July 2018
8 Reads

Free gracilis muscle transfer for smile reanimation after treatment for advanced parotid malignancy.

Head Neck 2018 03 20;40(3):561-568. Epub 2017 Nov 20.

Department of Facial Plastic Reconstructive Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.

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. Read More

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http://dx.doi.org/10.1002/hed.25022DOI Listing
March 2018
4 Reads

Facial reanimation surgery in Möbius syndrome: Experience from 76 cases from a tertiary referral hospital in Latin America.

Ann Chir Plast Esthet 2018 Jul 15;63(4):338-342. Epub 2017 Nov 15.

Plastic and Reconstructive Surgery Department, Hospital General "Dr. Manuel Gea González", Avenida Calzada de Tlalpan #4800, Col. Sección XVI, Delegación Tlalpan, 14080 Mexico City, Mexico. Electronic address:

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. Read More

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http://dx.doi.org/10.1016/j.anplas.2017.10.008DOI Listing
July 2018
12 Reads

Primary facial reanimation in head and neck cancer.

Oral Oncol 2017 11 12;74:171-180. Epub 2017 Sep 12.

Department of Otolaryngology-Head and Neck Surgery, London Health Sciences Centre, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. Electronic address:

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. Read More

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http://dx.doi.org/10.1016/j.oraloncology.2017.08.013DOI Listing
November 2017
4 Reads

Lengthening Temporalis Myoplasty: Objective Outcomes and Site-Specific Quality-of-Life Assessment.

Otolaryngol Head Neck Surg 2017 12 4;157(6):966-972. Epub 2017 Jul 4.

1 Otolaryngology Unit of Azienda Ospedaliera Giovanni XXIII, Ospedali Riuniti, Bergamo, Italy.

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. Read More

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http://dx.doi.org/10.1177/0194599817717458DOI Listing
December 2017
3 Reads

Symmetry Restoration at Rest after Masseter-to-Facial Nerve Transfer: Is It as Efficient as Smile Reanimation?

Plast Reconstr Surg 2017 Oct;140(4):793-801

Shanghai, People's Republic of China From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.

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. Read More

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http://dx.doi.org/10.1097/PRS.0000000000003698DOI Listing
October 2017
10 Reads

Masseteric to buccal branch nerve transfer.

Curr Opin Otolaryngol Head Neck Surg 2017 Aug;25(4):280-285

Department of Otolaryngology - Head and Neck Surgery, Kansas University Medical Center, Kansas City, Kansas, USA.

Purpose Of Review: To review recent literature pertaining to the use of masseteric-facial nerve neurorrhaphy (MFNN) for facial reanimation in patients with facial paralysis.

Recent Findings: First, MFNN effectively restores some midface tone and function, including the ability to smile. Second, use of the masseteric nerve minimizes synkinesis, dysarthria, and dysphagia that frequently occur after hypoglossal-facial nerve neurorrhaphy. Read More

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http://dx.doi.org/10.1097/MOO.0000000000000380DOI Listing
August 2017
3 Reads

A Rodent Model of Dynamic Facial Reanimation Using Functional Electrical Stimulation.

Front Neurosci 2017 5;11:193. Epub 2017 Apr 5.

Department of Neurosurgery, Center for Neuroengineering and Therapeutics, Perelman School of Medicine, University of PennsylvaniaPhiladelphia, PA, USA.

Facial paralysis can be a devastating condition, causing disfiguring facial droop, slurred speech, eye dryness, scarring and blindness. This study investigated the utility of closed-loop functional electric stimulation (FES) for reanimating paralyzed facial muscles in a quantitative rodent model. The right buccal and marginal mandibular branches of the rat facial nerve were transected for selective, unilateral paralysis of whisker muscles. Read More

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http://dx.doi.org/10.3389/fnins.2017.00193DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5380723PMC
April 2017
2 Reads

Facial Reanimation: Basic Surgical Tools and Creation of an Effective Toolbox for Treating Patients with Facial Paralysis. Part A: Functional Muscle Transfers in the Long-Term Facial Palsy Patient.

Authors:
Shai M Rozen

Plast Reconstr Surg 2017 Feb;139(2):469-471

Dallas, Texas From the Department of Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center.

The literature on facial paralysis is vast; however, detailed videos of the basic tools of dynamic reanimation within the context of patient scenarios accompanied by detailed narrative emphasizing both technique and thought processes are not common. Although not all scenarios of facial paralysis can be discussed in one setting, videographic visualization of basic surgical procedures, including facial marking, facial dissection, donor nerve preparation, cross-facial nerve graft, nerve transfers, and muscle harvest and inset, may provide a strong toolbox. Using these tools in various combinations depending on the unique case details enables the surgeon to treat a great majority of facial palsy patients. Read More

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http://Insights.ovid.com/crossref?an=00006534-201702000-0004
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http://dx.doi.org/10.1097/PRS.0000000000003025DOI Listing
February 2017
9 Reads

Single innervated segmented vastus lateralis for midfacial reanimation during radical parotidectomy.

Head Neck 2017 03 9;39(3):602-604. Epub 2017 Jan 9.

Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.

Background: Innervated free muscle transfer using the gracilis muscle or temporalis myoplasty has been successfully utilized for facial reanimation in chronic facial palsy. These techniques are less suited to immediate facial reconstruction in the setting of radical parotidectomy, in which the complexity of the defect, patient age, postoperative radiotherapy, and limited life expectancy pose particular challenges.

Methods: We present a novel description of the use of a chimeric anterolateral thigh (ALT) flap and innervated vastus lateralis to achieve midface static suspension and dynamic reanimation in the setting of radical parotidectomy. Read More

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http://dx.doi.org/10.1002/hed.24668DOI Listing
March 2017
4 Reads

Test-Retest Reliability and Agreement Between In-Person and Video Assessment of Facial Mimetic Function Using the eFACE Facial Grading System.

JAMA Facial Plast Surg 2017 May;19(3):206-211

Facial Nerve Center, Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston.

Importance: Use of a robust high-resolution instrument for grading of facial symmetry would enhance reporting the outcomes of facial reanimation interventions. The eFACE is one such tool.

Objective: To determine test-retest reliability of the eFACE tool over time and agreement between eFACE assessments made in person vs those made using video of facial mimetic function. Read More

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http://dx.doi.org/10.1001/jamafacial.2016.1620DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5815128PMC
May 2017
15 Reads

Correction of Residual Static and Dynamic Labial Deviations in a Paralyzed Face After Free Gracilis Muscle Transplantation.

J Craniofac Surg 2016 Nov;27(8):2143-2145

Department of Plastic, Reconstructive and Maxillo-Facial Surgery, and Burn Unity, Centro Hospitalar de São João, Faculty of Medicine-Porto University, Alameda Professor Hernâni Monteiro, Porto, Portugal.

Free muscle flap transfer is currently the procedure of choice for longstanding facial paralysis to restore symmetry both at rest and when smiling. However, movements obtained are generally localized, unidirectional, and philtrum centralization and lower lip movement is not proportionally achieved. The stability of free flap insertion at the lips also interferes with the results, as gradual disinsertion and shifting of the nasolabial fold can be caused by repetitive movements. Read More

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http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:land
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http://dx.doi.org/10.1097/SCS.0000000000002970DOI Listing
November 2016
2 Reads

Reanimation surgery in patients with acquired bilateral facial palsy.

Br J Oral Maxillofac Surg 2017 Apr 22;55(3):305-307. Epub 2016 Sep 22.

Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, Pond Street, London NW3 2QG.

Acquired bilateral facial palsy is rare and causes difficulty with speech and eating, but dynamic reanimation of the face can reduce the effect of these problems. Of 712 patients who had these procedures during our study period, two had an acquired bilateral facial paralysis. In both, reanimation was completed in a single operation using a free-functional transfer of the latissimus dorsi muscle that was coapted to the masseteric branch of the trigeminal nerve. Read More

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http://dx.doi.org/10.1016/j.bjoms.2016.09.006DOI Listing
April 2017
3 Reads

Lengthening Temporalis Myoplasty: Virtual Animation-Assisted Technical Video.

Plast Reconstr Surg 2016 Sep;138(3):506e-9e

Lille and Caen, France; and Jeddah, Saudi Arabia From the Department of Plastic, Reconstructive and Aesthetic Surgery, Roger Salengro Hospital, University Hospitals of Lille; the Department of Plastic and Reconstructive Surgery, Clinique Saint Martin; and the Department of Plastic, Reconstructive and Aesthetic Surgery, King Fahad Hospital.

Lengthening temporalis myoplasty is a well-established procedure for dynamic palliative reanimation of the lip in facial palsy sequelae. The particularity of this technique is that the entire temporal muscle is transferred from the coronoid process to the upper half of the lip without interposition of aponeurotic tissue. To date, no video describing the technique was available. Read More

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http://dx.doi.org/10.1097/PRS.0000000000002512DOI Listing
September 2016
21 Reads

The Deep Temporal Nerve Transfer: An Anatomical Feasibility Study and Implications for Upper Facial Reanimation.

Plast Reconstr Surg 2016 Sep;138(3):498e-505e

Dallas, Texas; Mexico City, Mexico; and Beirut, Lebanon From the Departments of Plastic Surgery and Pathology, University of Texas Southwestern Medical Center; the Division of Plastic Surgery, Hospital General Dr. Manuel Gea Gonzalez; and the Department of Plastic Surgery, American University in Beirut Medical Center.

Background: Facial paralysis has a profound impact on the brow, and currently static procedures are the mainstay of treatment. The deep temporal branches of the trigeminal nerve, given their proximity to the brow, may serve as possible donor nerves for both potential innervation of a free muscle transfer in patients with prolonged facial palsy or nerve transfers in acute or subacute palsy. As such, the authors present the detailed surgical anatomy of the deep temporal nerve, assessing feasibility for both functional muscle and nerve transfers, including a proposed surgical technique. Read More

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http://dx.doi.org/10.1097/PRS.0000000000002482DOI Listing
September 2016
8 Reads

Spontaneity of smile after facial paralysis rehabilitation when using a non-facial donor nerve.

J Craniomaxillofac Surg 2016 Sep 9;44(9):1305-9. Epub 2016 Jul 9.

Department of Plastic and Reconstructive Surgery, Clinica Universidad de Navarra, Avenida Pio XII, 36, 31008 Pamplona, Spain. Electronic address:

Introduction: The current focus in dynamic reanimation of facial paralysis lies not only in restoring movement but also regaining smile spontaneity. It has been argued that a spontaneous smile can only be achieved using the contralateral facial nerve as donor via cross-face nerve grafting. Techniques based on the motor nerve to the masseter, however, have shown good rates of spontaneity as well. Read More

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http://dx.doi.org/10.1016/j.jcms.2016.06.031DOI Listing
September 2016
1 Read

Controversies in Contemporary Facial Reanimation.

Facial Plast Surg Clin North Am 2016 Aug;24(3):275-97

Division of Facial Plastic & Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medicine, 601 North Caroline Street, 6th Floor, Baltimore, MD 21287-0910, USA. Electronic address:

Facial palsy is a devastating condition with profound functional, aesthetic, and psychosocial implications. Although the complexity of facial expression and intricate synergy of facial mimetic muscles are difficult to restore, the goal of management is to reestablish facial symmetry and movement. Facial reanimation surgery requires an individualized treatment approach based on the cause, pattern, and duration of facial palsy while considering patient age, comorbidities, motivation, and goals. Read More

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http://dx.doi.org/10.1016/j.fsc.2016.03.016DOI Listing
August 2016
5 Reads

Use of the submental vessels for free gracilis muscle transfer for smile reanimation.

Head Neck 2016 10 24;38(10):E2499-503. Epub 2016 Jun 24.

Department of Otolaryngology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.

Background: Free muscle transfer is an important in dynamic facial reanimation; however, suitable donor vessels in this population can be inadequate. In this case series, the submental vessels were used as donors to free gracilis muscle in vessel-depleted patients.

Methods: Five patients underwent free gracilis muscle transfer for smile reanimation, 2 with a prior failed free gracilis transfer, 2 with vascular anomalies, and 1 with previous distal ligation of the facial vessels. Read More

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http://dx.doi.org/10.1002/hed.24478DOI Listing
October 2016
5 Reads

[Microsurgery in reanimation, lymphoedema and hand surgery].

Ugeskr Laeger 2016 Jun;178(23)

Microsurgery is defined as surgery performed with the aid of ocular magnification. In Denmark, this is undertaken by four units. This review describes the history of microsurgery which evolved during the 1960s. Read More

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June 2016
2 Reads

Emerging vs Time-Tested Methods of Facial Grading Among Patients With Facial Paralysis.

JAMA Facial Plast Surg 2016 Jul;18(4):251-7

Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston.

Importance: Most rehabilitation specialists and many facial reanimation surgeons use the Sunnybrook Facial Grading System (FGS) to measure and detect changes in facial function. The eFACE, an electronic and digitally graded facial measurement scale, was recently created to provide similar information to the Sunnybrook FGS, but with scaling uniformity across all categories of facial function, graphical outputs, and easy-to-use visual analog scales.

Objectives: To establish the correlation between the scores on the eFACE and the Sunnybrook FGS among patients with facial paralysis and to compare the reliability of the 2 scales. Read More

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http://dx.doi.org/10.1001/jamafacial.2016.0025DOI Listing
July 2016
12 Reads

Lengthening Temporalis Myoplasty for Single-Stage Smile Reconstruction in Children with Facial Paralysis.

Authors:
Andre Panossian

Plast Reconstr Surg 2016 Apr;137(4):1251-61

Los Angeles, Calif. From the Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles.

Background: Free muscle transfer for dynamic smile reanimation in facial paralysis is not always predictable with regard to cosmesis. Hospital stays range from 5 to 7 days. Prolonged operative times, longer hospital stays, and excessive cheek bulk are associated with free flap options. Read More

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http://dx.doi.org/10.1097/PRS.0000000000002009DOI Listing
April 2016
7 Reads

Temporalis Muscle Tendon Unit Transfer for Smile Restoration After Facial Paralysis.

Facial Plast Surg Clin North Am 2016 Feb;24(1):37-45

Department of Otolaryngology Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD 21878, USA. Electronic address:

Temporalis muscle tendon unit (MTU) transfer may be used as a single-stage procedure for dynamic reanimation of the paralyzed face. Principles and biomechanics of muscle function and tendon transposition are essential in optimizing outcome. Critical steps and pearls for success include minimizing scarring, maintaining glide plains, mobilizing adequate tendon length, insertion of MTU at ideal tension based on intraoperative dynamic tension-excursion relationship, and insertion of tendon as close to the lip margin as possible. Read More

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http://dx.doi.org/10.1016/j.fsc.2015.09.004DOI Listing
February 2016
2 Reads

Transoral orthodromic temporalis muscle transfer technique for dynamic reanimation of the paralysed face.

Clin Otolaryngol 2016 Dec 4;41(6):831-833. Epub 2016 Feb 4.

Department of Otorhinolaryngology - Head and Neck Surgery, The Royal National Throat, Nose & Ear Hospital, London, UK.

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http://dx.doi.org/10.1111/coa.12450DOI Listing
December 2016
4 Reads

A prospective 4-year study of the objective and subjective outcomes of fifteen patients after dynamic facial reanimation surgery.

Clin Otolaryngol 2016 Dec 11;41(6):825-829. Epub 2016 Feb 11.

The Royal National Throat Nose and Ear Hospital London, London, UK.

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http://dx.doi.org/10.1111/coa.12574DOI Listing
December 2016
3 Reads

[Lengthening temporalis myoplasty: Technical refinements].

Ann Chir Plast Esthet 2015 Oct 1;60(5):393-402. Epub 2015 Oct 1.

Clinique Saint-Martin, 4, place Fontette, 14000 Caen, France.

First described by Labbé in 1997, the lengthening temporalis myoplasty (LTM) ensures the transfer of the entire temporal muscle from the coronoid process to the upper half of the lip without interposition of aponeurotic tissue. Thanks to brain plasticity, the temporal muscle is able to change its function because it is entirely mobilized towards another effector: the labial commissure. After 6 months of speech rehabilitation, the muscle loses its chewing function and it acquires its new smiling function. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S02941260150012
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http://dx.doi.org/10.1016/j.anplas.2015.07.004DOI Listing
October 2015
3 Reads

Facial reanimation: evolving from static procedures to free tissue transfer in head and neck surgery.

Curr Opin Otolaryngol Head Neck Surg 2015 Oct;23(5):399-406

Department of Otolaryngology - Head and Neck Surgery, University of California, Davis, Sacramento, California, USA.

Purpose Of Review: The purpose of this article is to review and evaluate the surgical options for treating patients with facial paralysis, covering primary neurorrhaphy to facial reanimation, with microvascular free tissue transfer.

Recent Findings: In recent years, free tissue transfer has been increasingly common for rehabilitating the paralyzed face, providing a more dynamic and aesthetic outcome, than has been possible prior to microvascular surgery in facial plastic and head and neck surgery.

Summary: Although primary facial nerve repair attains the best results, nerve grafting with the sural nerve and commercially available motor nerve allografts can be used alone, or in combination with masseteric nerve grafts to attain facial tone and protect eyelid function. Read More

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http://pdfs.journals.lww.com/co-otolaryngology/2015/10000/Fa
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http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:land
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http://dx.doi.org/10.1097/MOO.0000000000000193DOI Listing
October 2015
6 Reads

[Rehabilitation of facial paralysis using autogenous fascia lata graft. Stable results over time].

Ann Chir Plast Esthet 2015 Oct 2;60(5):442-7. Epub 2015 Jul 2.

Service de chirurgie plastique, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France.

Dynamic facial reanimation with free muscle or nerve transfers represents the mainstay of facial paralysis treatments particularly for perioral area and smile. These techniques are not always feasible, in such cases we perform a perioral suspension with fascia lata graft. However many teams blame this technique for short-term recurrence of the deformity. Read More

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http://dx.doi.org/10.1016/j.anplas.2015.05.009DOI Listing
October 2015
2 Reads

Cross-facial nerve grafting for facial reanimation.

Facial Plast Surg 2015 Apr 8;31(2):128-33. Epub 2015 May 8.

Department of Otolaryngology-Head and Neck Surgery, University of California, Los Angeles, California.

Dynamic facial reanimation is the gold standard treatment for a paralyzed face. Over the last century, multiple nerves have been utilized for grafting to the facial nerve in an attempt to produce improved movement. However, in recent years, the use of cross facial nerve grafting with a second stage gracilis free flap has gained popularity due to the ability to generate a spontaneous smile and facial movement. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/s-0035-1549046
Publisher Site
http://dx.doi.org/10.1055/s-0035-1549046DOI Listing
April 2015
6 Reads

Lengthening temporalis myoplasty: a surgical tool for dynamic labial commissure reanimation.

Facial Plast Surg 2015 Apr 8;31(2):123-7. Epub 2015 May 8.

Department of Plastic and Reconstructive Surgery, Clinique Saint Martin, Caen, France.

Lengthening temporalis myoplasty (LTM), first described by Labbé in 1997, ensures the transfers of the entire temporal muscle from the coronoid process to the upper half of the lip without interposition of aponeurotic tissue. The temporal muscle changes function because it is entirely mobilized toward another effector: the labial commissure. Thanks to brain plasticity, the muscle loses its chewing function, and after 6 months of speech rehabilitation it acquires its new smiling function. Read More

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http://dx.doi.org/10.1055/s-0035-1549039DOI Listing
April 2015
2 Reads

Management of Facial Paralysis due to Extracranial Tumors.

Facial Plast Surg 2015 Apr 8;31(2):110-6. Epub 2015 May 8.

Section of Facial Plastic and Reconstructive Surgery, Cleveland Clinic Head and Neck Institute, Cleveland, Ohio.

Treatment of advanced parotid or cutaneous malignancies often requires sacrifice of the facial nerve as well as resection of the parotid gland and surrounding structures. In addition to considerations regarding reinnervation and dynamic reanimation, reconstruction in this setting must take into account unique factors such as soft tissue volume deficits and the high likelihood of adjunctive radiation therapy. Furthermore, considerations of patient comorbidities including advanced age and poor long-term prognosis often influence reconstructive modality. Read More

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http://dx.doi.org/10.1055/s-0035-1549045DOI Listing
April 2015
5 Reads

How to rehabilitate long-term facial paralysis.

J Craniofac Surg 2015 May;26(3):831-5

Department of Otorhinolaryngology-Head and Neck Surgery, Okmeydani Training and Research Hospital, Istanbul, Turkey.

Objective: To project the surgical resuscitation methods that we apply to the lower part of the face and the eyes with the aim of preventing functional and psychological problems that can occur in patients with facial paralysis.

Materials And Methods: Twenty-two patients with facial nerve paralysis due to acoustic neuroma, trauma, cholesteatoma, and parotid carcinoma were included in this study. In the lower facial region, the temporal muscle was suspended to the lower lip. Read More

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http://dx.doi.org/10.1097/SCS.0000000000001571DOI Listing
May 2015
5 Reads

Single-stage dynamic reanimation of the smile in irreversible facial paralysis by free functional muscle transfer.

J Vis Exp 2015 Mar 1(97). Epub 2015 Mar 1.

Department of Plastic and Hand Surgery, University of Freiburg Medical Centre.

Unilateral facial paralysis is a common disease that is associated with significant functional, aesthetic and psychological issues. Though idiopathic facial paralysis (Bell's palsy) is the most common diagnosis, patients can also present with a history of physical trauma, infectious disease, tumor, or iatrogenic facial paralysis. Early repair within one year of injury can be achieved by direct nerve repair, cross-face nerve grafting or regional nerve transfer. Read More

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http://dx.doi.org/10.3791/52386DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4401027PMC
March 2015
5 Reads

Lengthening temporalis myoplasty for facial paralysis reanimation: an objective analysis of each surgical step.

JAMA Facial Plast Surg 2015 May-Jun;17(3):179-82

Otolaryngology-Head and Neck Surgery Service, Department of Surgery, Maisonneuve-Rosemont Hospital, Montreal, Quebec, Canada.

Importance: Lengthening temporalis myoplasty is a dynamic procedure used to reanimate the middle third of the paralyzed face. Since its original description, it has been progressively modified over the years, with a reduction in the number of surgical steps. However, these modifications can decrease lengthening needed for the tendon to reach the oral commissure and upper lip without tension or overcorrection. Read More

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http://archfaci.jamanetwork.com/article.aspx?doi=10.1001/jam
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http://dx.doi.org/10.1001/jamafacial.2015.46DOI Listing
March 2016
4 Reads

Using a double-layered palmaris longus tendon for suspension of facial paralysis.

Dan Med J 2015 Mar;62(3)

Plastikkirurgisk Afdeling Z, Odense Universitetshospital, Søndre Boulevard 29, 5000 Odense C, Denmark.

Introduction: Facial palsy is a debilitating condition entailing both cosmetic and functional limitations. Static suspension procedures can be performed when more advanced dynamic techniques are not indicated. Since 2006, we have used a double-layered palmaris longus tendon graft through an ovular skin excision in the nasolabial fold for access. Read More

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March 2015
2 Reads

Facial nerve trauma: evaluation and considerations in management.

Craniomaxillofac Trauma Reconstr 2015 Mar;8(1):1-13

Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.

The management of facial paralysis continues to evolve. Understanding the facial nerve anatomy and the different methods of evaluating the degree of facial nerve injury are crucial for successful management. When the facial nerve is transected, direct coaptation leads to the best outcome, followed by interpositional nerve grafting. Read More

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http://dx.doi.org/10.1055/s-0034-1372522DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4329040PMC
March 2015
7 Reads