172 results match your criteria Dynamic Reanimation for Facial Paralysis


Paediatric facial paralysis: An overview and insights into management.

J Paediatr Child Health 2021 May 13. Epub 2021 May 13.

The Welsh Centre of Burns and Plastic Surgery, Morriston Hospital, Swansea, United Kingdom.

The aim of this article is to provide an overview on paediatric facial paralysis, looking into aetiology, epidemiology, assessment and investigation and subsequent treatment options available. Facial paralysis describes the inability to activate the muscles of fascial expression. Overall, it affects 2. Read More

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Lower Lip Reanimation: Experience Using the Anterior Belly of Digastric Muscle in 2-stage Procedure.

Plast Reconstr Surg Glob Open 2021 Mar 15;9(3):e3461. Epub 2021 Mar 15.

St Andrew's Centre for Plastic Surgery & Burns, Broomfield Hospital, Chelmsford, United Kingdom.

Lower lip depression was historically regarded a neglected area of facial paralysis, but, with refinement of techniques, has gained increasing attention. We present the first detailed description and evaluation of a 2-stage technique, using first cross facial nerve graft and then the anterior belly of digastric muscle (ABDM), innervated by the cross facial nerve graft, to restore dynamic and spontaneous lower lip depression.

Methods: Retrospective analysis of 2-stage lower lip reanimations between 2010 and 2018 was performed. Read More

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Rehabilitation of facial palsy by the lengthening temporalis myoplastie: A case report.

Ann Med Surg (Lond) 2021 Feb 5;62:10-12. Epub 2021 Jan 5.

Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, B.P 5696, Casablanca, Morocco.

Introduction: The lengthening temporalis myoplasty (LTM) is defined as a transfer of the entire temporal muscle from the coronoid process to the labial commissure reinserted into the orbicularis muscle.

Presentation Of Case: a 60-year-old man with grade III longstanding facial paralysis of the right hemi-face secondary to a right total parotidectomy. The surgery was performed for the rehabilitation of the right hemi-facial side by the lengthening temporalis myoplasty. Read More

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February 2021

Reliability Between In-Person and Still Photograph Assessment of Facial Function in Facial Paralysis Using the eFACE Facial Grading System.

Facial Plast Surg Aesthet Med 2020 Dec 16. Epub 2020 Dec 16.

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

Assessing facial function using high-quality photographs would improve long-term and objective outcomes tracking in facial palsy, facilitate automated facial grading using artificial intelligence algorithms, and allow for remote follow up. To determine agreement between in-person and photographic electronic facial function scale (eFACE) assessments, and evaluate inter-rater reliability of photographic eFACE evaluation. Retrospective review of eFACE scores from in-person interviews and standardized photographs using the Massachusetts Eye and Ear (MEE) Standard Facial Palsy Dataset. Read More

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December 2020

A Novel Flap for Dynamic Reanimation of Facial Paralysis: Microvascular Sternohyoid Muscle Free Flap.

J Oral Maxillofac Surg 2021 04 29;79(4):925-931. Epub 2020 Oct 29.

Associate professor and Head Department of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, University Hospital "12 de Octubre", Madrid, Spain.

The main objectives of facial reanimation procedures include restoring facial symmetry at resting state and regaining facial mobility. Static procedures usually provide unsatisfactory results, especially in younger patients. For this reason, over the years, several different surgical alternatives based on autologous, locoregional, or muscle free flaps have been proposed. Read More

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Facial nerve management in patients with malignant skull base tumors.

J Neurooncol 2020 Dec 28;150(3):493-500. Epub 2020 Oct 28.

Facial Paralysis Institute, Center for Advanced Facial Plastic Surgery, Beverly Hills, CA, USA.

Introduction: The course of the facial nerve through the cerebellopontine angle, temporal bone, and parotid gland puts the nerve at risk in cases of malignancy. In contrast to Bell's palsy, which presents with acute facial paralysis, malignancies cause gradual or fluctuating weakness.

Methods: We review malignancies affecting the facial nerve, including those involving the temporal bone, parotid gland, and cerebellopontine angle, in addition to metastatic disease. Read More

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December 2020

Age-dependent outcomes of Gillies and McLaughlin's dynamic muscle support in irreversible facial paralysis with up to 25-year follow-up.

J Craniomaxillofac Surg 2020 Sep 29;48(9):885-895. Epub 2020 Jun 29.

Department of Plastic and Aesthetic, Reconstructive and Hand Surgery at AGAPLESION Markus Hospital, Frankfurt am Main, Germany.

The purpose of this study was to analyse the long-term outcomes of Gillies and McLaughlin's dynamic muscle support in patients with irreversible facial paralysis with regard to age-dependent outcomes of three different age groups. A retrospective single-centre study of 154 patients with surgical correction of irreversible facial paralysis that underwent either Gillies procedure or McLaughlin or a combination of both techniques between 1994-2018 was conducted. Gillies and McLaughlin's combination was performed in 69 cases and was the most commonly used procedure in middle-aged and older patients. Read More

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September 2020

The mini-temporalis turnover flap for midface reanimation: Photogrammetric and patient-rated outcomes.

J Plast Reconstr Aesthet Surg 2020 Dec 26;73(12):2185-2195. Epub 2020 May 26.

St Andrew's Centre for Plastic Surgery and Burns, Chelmsford, UK.

Background: Mini-temporalis transposition (MTT) flaps, modified from Gillies' technique, have become less popular than temporalis tendon transfers for midface reanimation. MTT involves raising the middle third of the temporalis, transposition over the zygomatic arch and lengthening with deep temporalis fascia which is sutured to the orbicularis oris.

Aim: This retrospective study assessed subjective and objective outcomes following MTTs by a single surgeon from 2009 to 2019. Read More

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December 2020

Dual innervation of free gracilis muscle for facial reanimation: What we know so far.

J Plast Reconstr Aesthet Surg 2020 Dec 29;73(12):2196-2209. Epub 2020 May 29.

Division of Plastic Surgery, Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, US.

Background: In the last decade, some institutions have begun combining the CFNG and masseteric nerve to provide dual innervation to the gracilis muscle for dynamic facial reanimation in facial paralysis patients. We reviewed the various ways that these two nerves have been coapted to provide dual innervation, and summarized the functional outcome for these methods.

Methods: A search of the Ovid EMBASE, MEDLINE, Cochrane, and Scopus databases was performed from 1946 to May 2019 for dual innervation of gracilis muscle using CFNG plus masseteric nerve for facial reanimation. Read More

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December 2020

Twenty-Five-Year Outcomes of Treatment of Irreversible Facial Paralysis with Gillies and McLaughlin Techniques.

ORL J Otorhinolaryngol Relat Spec 2020;82(5):245-256. Epub 2020 Jun 9.

Department of Plastic and Aesthetic, Reconstructive and Hand Surgery, AGAPLESION Markus Hospital, Frankfurt am Main, Germany.

Introduction: Data on treatment outcomes of surgical correction of irreversible facial paralysis is rare and long-term outcomes are scarce in the literature, making treatment choices difficult for operating surgeons.

Objective: This study evaluated 25-year outcomes of treatment of irreversible facial paralysis with Gillies and McLaughlin techniques with a focus on general functional and age-related functional outcomes.

Methods: Data of all patients who underwent surgical correction of facial paralysis using either Gillies or McLaughlin procedure between 1994 and 2018 were included in the analysis of this retrospective, single-centre study (n = 154). Read More

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Temporalis Tendon Transfer/Lengthening Temporalis Myoplasty for Midfacial Static and Dynamic Reanimation After Head and Neck Oncologic Surgery.

Facial Plast Surg Aesthet Med 2021 Jan-Feb;23(1):31-35. Epub 2020 Jun 2.

Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA.

Facial nerve paralysis is an unfortunate, yet relatively common sequela in the treatment of head and neck cancer. Static options for reanimation of the paralyzed midface and oral commissure offer limited quality-of-life improvement and may stretch over time. Reinnervation offers a prolonged recovery and may not be possible among patients with advanced cancer or in salvage situations. Read More

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Changes in Electrical Activity of the Masseter Muscle and Masticatory Force after the Use of the Masseter Nerve as Donor in Facial Reanimation Surgery.

Indian J Plast Surg 2020 Mar 28;53(1):59-63. Epub 2020 Apr 28.

Division of Plastic and Reconstructive Surgery, Postgraduate Division of the Medical School, Hospital General "Dr Manuel Gea Gonzalez," Universidad Nacional Autonoma de Mexico, Mexico City, Mexico.

 The masseter nerve has been used as a donor nerve for facial reanimation procedures due to the multiple advantages it offers; it has been generally considered that sacrifice of the masseter nerve does not alter the masticatory apparatus; however, there are no objective studies to support this claim.  To evaluate the impact that the use of the masseter nerve in dynamic facial reconstruction has on the electrical activity of the masseter muscle and on bite force.  An observational and prospective longitudinal study was performed measuring bite force and electrical activity of the masseter muscles before and 3 months after dynamic facial reconstructive surgery using the masseter nerve. Read More

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Dynamic smile reanimation in facial nerve palsy.

J Korean Assoc Oral Maxillofac Surg 2020 Apr;46(2):143-149

Department of Plastic, Reconstructive and Burns Surgery, Baby Memorial Hospital, Kozhikode, India.

Objectives: Long-term facial paralysis results in degeneration of the distal nerve segment and atrophy of the supplied muscles. Options for these patients include free muscle transfer, temporalis myoplasty, and botulinum toxin injections for smile reanimation. In this study we aimed to evaluate the subjective and objective outcomes of these procedures. Read More

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Long-term outcomes of Gillies and McLaughlin's dynamic muscle support in irreversible facial paralysis: A retrospective single-centre study with 25-year follow-up.

J Plast Reconstr Aesthet Surg 2020 Sep 17;73(9):1706-1716. Epub 2020 Mar 17.

Department of Plastic and Aesthetic, Reconstructive and Hand Surgery at AGAPLESION Markus Hospital, Goethe University Frankfurt am Main, Wilhelm-Epstein-Str. 4, 60431 Frankfurt am Main, Germany.

The aim of this study was to evaluate the long-term outcomes of Gillies and McLaughlin's dynamic muscle support with regard to functional outcomes and assess possible effects of comorbidities on both functional outcomes and reoperation and complication rates. A retrospective single-centre study was conducted in all patients (n = 154) who underwent surgical correction of irreversible facial paralysis from 1994 to 2018. Patients with either Gillies procedure or McLaughlin's dynamic muscle support or a combination of these techniques were included in the analysis. Read More

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September 2020

Powering the Gracilis for Facial Reanimation: A Systematic Review and Meta-analysis of Outcomes Based on Donor Nerve.

JAMA Otolaryngol Head Neck Surg 2020 05;146(5):429-436

Division of Facial Plastic & Reconstructive Surgery, Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri.

Importance: Free gracilis transfer for dynamic reanimation in chronic facial paralysis is the gold standard, but there remains a need to better understand outcomes with respect to the donor nerve.

Objective: To characterize outcomes in adults undergoing primary gracilis transfer for facial paralysis stratified by donor nerve used for neurotization.

Data Sources: Search strategies were used in Ovid MEDLINE (1946-2019), Embase (1947-2019), Scopus (1823-2019), Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials. Read More

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Masseteric-Facial Nerve Anastomosis: Surgical Techniques and Outcomes-A Pilot Indian study.

Indian J Otolaryngol Head Neck Surg 2020 Mar 6;72(1):92-97. Epub 2019 Nov 6.

Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, 110029 India.

Masseteric-facial anastomosis has gained popularity in recent days compared to the facial-hypoglossal anastomosis. Masseteric nerve has numerous advantages like its proximity to the facial nerve, stronger motor impulse, its reliability, low morbidity in harvesting and sacrificing the nerve and faster re-innervation that is achievable in most patients. The present case series demonstrate the surgical technique and the effectiveness of the masseteric nerve as donor for early facial reanimation. Read More

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Lipofilling of the upper eyelid to treat paralytic lagophthalmos.

Br J Oral Maxillofac Surg 2020 06 4;58(5):558-563. Epub 2020 Mar 4.

Maxillo-Facial Surgery Department, San Paolo Hospital, University of Milan, Milan, Italy. Electronic address:

Lagophthalmos is one of the most unpleasant and dangerous conditions that affect patients with facial palsy. The lack of ocular protection leads to corneal problems (such as conjunctival infections, acute and chronic keratitis, corneal ulcerations, and blindness). A dynamic reanimation of blinking eyelids is the therapeutic gold standard. Read More

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Α modified temporalis transfer technique for facial paralysis in elderly patients.

Injury 2020 Dec 21;51 Suppl 4:S88-S92. Epub 2020 Feb 21.

Department of Plastic Surgery & Burns, Alexandroupoli University Hospital, School of Medicine, Democritus University of Thrace, GR-68100 Alexandroupolis, Greece; 1st Department of Surgery, Alexandroupoli University Hospital, School of Medicine, Democritus University of Thrace, GR-68100 Alexandroupolis, Greece.

Introduction: In patients with chronic facial palsy where the treatment by conservative means or only nerve grafting is no longer an option, reconstruction by dynamic procedures such as pedicled and/or free muscle transfer is required.

Patients And Methods: Five patients with chronic facial palsy were treaded by temporalis muscle transfer to the eye and mouth simultaneously. In four of them, the combined Gillies-McLaughlin technique was used, but for the fifth one, a modified technique was applied. Read More

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December 2020

Intraoral temporalis transposition for facial reanimation: A novel technique in facial nerve palsy.

J Craniomaxillofac Surg 2020 Mar 31;48(3):235-241. Epub 2020 Jan 31.

Department of Plastic and Reconstructive Surgery, Korea University Hospital, Seoul, Republic of Korea. Electronic address:

Background: Facial palsy patients require reconstructive surgery because they suffer from an expressionless and deformed appearance especially during smiling. To gain a natural smile, various dynamic procedures rather than static procedures are performed. Through cadaveric studies with clinical implications on temporalis muscle and intraoral transposition, we were able to come up with a more effective and less invasive procedure than the conventional temporalis muscle transposition or lengthening temporalis myoplasty. Read More

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Orbicularis Oculi Muscle Reinnervation Confers Corneal Protective Advantages over Static Interventions Alone in the Subacute Facial Palsy Patient.

Plast Reconstr Surg 2020 03;145(3):791-801

From the Departments of Plastic and Reconstructive Surgery and Ophthalmology, University of Texas Southwestern Medical Center.

Background: Corneal protection is a priority in flaccid facial palsy patients. Denervation of the orbicularis oculi muscle results in weak palpebral closure and predisposes patients to severe corneal sequelae. While periorbital static procedures enhance corneal coverage in repose, voluntary closure is only regained through dynamic reinnervation of the muscle. Read More

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Dual Coaptation of Facial Nerve Using Masseteric Branch of Trigeminal Nerve for Iatrogenic Facial Palsy: Preliminary Reports.

Ann Otol Rhinol Laryngol 2020 May 30;129(5):505-511. Epub 2019 Dec 30.

Department of Otolaryngology, Asan Medical Centre, College of Medicine, University of Ulsan, Seoul, Korea.

Objectives: Immediate facial nerve substitution or graft technique has been used for the repair of facial nerve defects occurring as a result of tumour dissection. However, some patients report unsatisfactory outcomes, such as difficulty in maintaining resting or smiling symmetry, due to persistent flaccid facial palsy. Here we evaluated the functional outcomes of transferring the masseteric branch of the trigeminal nerve to the facial nerve adjunct to facial nerve graft. Read More

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Reply: Reuse of the Masseteric Nerve for Dynamic Reanimation in Facial Palsy Patients with Previously Failed One-Stage Dynamic Smile Reanimation.

Authors:
Shai M Rozen

Plast Reconstr Surg 2019 12;144(6):1124e-1125e

Department of Plastic Surgery, University of Texas Southwestern Medical Center, 1801 Inwood Road, Dallas, Texas 75390-8593,

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December 2019

Reuse of the Masseteric Nerve for Dynamic Reanimation in Facial Palsy Patients with Previously Failed One-Stage Dynamic Smile Reanimation.

Plast Reconstr Surg 2019 12;144(6):1123e-1125e

Faculty of Medicine, University of Belgrade, and, Clinic for Neurosurgery, Clinical Centre of Serbia, Belgrade, Serbia.

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December 2019

Masseteric or facial nerve? Intricacies in dynamic facial reanimation.

J Plast Reconstr Aesthet Surg 2019 12 1;72(12):2064-2094. Epub 2019 Oct 1.

Group for Academic Plastic Surgery, Blizard Institute, Queen Mary University of London, London E1 2AT, UK.

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December 2019

Comparison of Lengthening Temporalis Myoplasty and Free-Gracilis Muscle Transfer for Facial Reanimation in Children.

J Craniofac Surg 2020 Jan/Feb;31(1):85-90

Division of Plastic and Reconstructive Surgery, Children's Hospital of Philadelphia and the University of Pennsylvania.

Background: Lengthening temporalis myoplasty (LTM) and cross-face nerve graft with free gracilis muscle transfer (CFNG-FGMT) are the 2 most common procedures used to restore dynamic facial animation and improve facial symmetry. There has not been direct comparison or consensus. Here, the authors compare our experience with respect to muscle activity, symmetry, and excursion. Read More

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Sterno-omohyoid Free Flap for Dual-Vector Dynamic Facial Reanimation.

Ann Otol Rhinol Laryngol 2020 Feb 3;129(2):195-200. Epub 2019 Oct 3.

Otolaryngology-Head and Neck Surgery, Madigan Army Medical Center, Tacoma, WA, USA.

Background: Dynamic rehabilitation of longstanding facial palsy with damaged, atrophied, or absent facial muscles requires replacement of neural and muscular components. The ideal reconstruction would include a fast-twitch muscle that is small, a reliable donor vessel and nerve, and the potential to provide a natural, synchronous, dentate smile with minimal donor site morbidity. Many flaps have been successfully used historically, but none has produced ideal rehabilitation. Read More

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February 2020

Sequelae of Facial Palsy: A Comprehensive Treatment.

Plast Reconstr Surg 2019 10;144(4):682e-692e

From the Plastic Surgery Department, University Hospital of Lille; the Competence Center for Clefts and CranioFacial Malformations; and the Plastic Surgery Department, Centre Hospitalier Privé Saint Martin.

Learning Objectives: After studying this article, the participant should be able to: 1. Identify the different types of facial paralysis sequelae and define the several medical and surgical techniques commonly available today. 2. Read More

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October 2019

Polytetrafluoroethylene granuloma-associated facial palsy following microvascular decompression.

Laryngoscope 2020 06 31;130(6):1422-1427. Epub 2019 Aug 31.

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

Objective: Microvascular decompression (MVD) may be employed in the management of hemifacial spasm (HFS), wherein a pledget of polytetrafluoroethylene (i.e., Teflon, Chemours, Wilmington DE) is sometimes introduced to separate an offending vessel from the cisternal segment of facial nerve. Read More

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Effectiveness and safety of the use of gracilis muscle for dynamic smile restoration in facial paralysis: A systematic review and meta-analysis.

J Plast Reconstr Aesthet Surg 2019 Aug 24;72(8):1254-1264. Epub 2019 May 24.

Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. Electronic address:

Background: Smiling is a fundamental component of social interactions. Significant challenges arise for patients with facial palsy. One of the key procedures for dynamic smile restoration is the microneurovascular transfer of a gracilis muscle. Read More

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Anatomical study of the masseteric and obturator nerves: Application to face transplant and reanimation procedures.

Clin Anat 2019 Jul 4;32(5):612-617. Epub 2019 Apr 4.

Department of Anatomy and Embryology, School of Medicine, Complutense University of Madrid, Madrid, Spain.

The masseteric nerve (MN) and the anterior branch of the obturator nerve (ON) that innervate the transferred gracilis muscle have proved highly efficient for reanimating paralyzed facial muscles when muscle transfer is required. Previous researchers have published the total axonal load for myelinated fibers in both nerves. However, the real motor axonal load has not been established. Read More

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