159 results match your criteria Dynamic Reanimation for Facial Paralysis


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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http://dx.doi.org/10.1055/s-0039-3400673DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7225014PMC

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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http://dx.doi.org/10.5125/jkaoms.2020.46.2.143DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7222615PMC

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 Mar 17. 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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http://dx.doi.org/10.1016/j.bjps.2020.02.042DOI Listing

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

JAMA Otolaryngol Head Neck Surg 2020 Mar 26. Epub 2020 Mar 26.

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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http://dx.doi.org/10.1001/jamaoto.2020.0065DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7099528PMC

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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http://dx.doi.org/10.1007/s12070-019-01758-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7040122PMC

Lipofilling of the upper eyelid to treat paralytic lagophthalmos.

Br J Oral Maxillofac Surg 2020 Mar 4. 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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http://dx.doi.org/10.1016/j.bjoms.2020.02.017DOI Listing

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

Injury 2020 Feb 21. 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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http://dx.doi.org/10.1016/j.injury.2020.02.107DOI Listing
February 2020

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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http://dx.doi.org/10.1177/0003489419893722DOI Listing

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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http://dx.doi.org/10.1097/PRS.0000000000006236DOI Listing
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 Burns, Plastic, and Reconstructive Surgery, Clinical Centre of Serbia Faculty of Medicine, University of Belgrade, and, Clinic for Neurosurgery, Clinical Centre of Serbia, Belgrade, Serbia.

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http://dx.doi.org/10.1097/PRS.0000000000006235DOI Listing
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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http://dx.doi.org/10.1016/j.bjps.2019.09.048DOI Listing
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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http://dx.doi.org/10.1097/SCS.0000000000005885DOI Listing

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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http://dx.doi.org/10.1177/0003489419875473DOI Listing
February 2020
1 Read

Sequelae of Facial Palsy: A Comprehensive Treatment.

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

Lille and Caen, France 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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http://dx.doi.org/10.1097/PRS.0000000000006079DOI Listing
October 2019

Polytetrafluoroethylene granuloma-associated facial palsy following microvascular decompression.

Laryngoscope 2020 Jun 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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http://dx.doi.org/10.1002/lary.28257DOI Listing
June 2020
2 Reads

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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https://linkinghub.elsevier.com/retrieve/pii/S17486815193022
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http://dx.doi.org/10.1016/j.bjps.2019.05.027DOI Listing
August 2019
6 Reads

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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http://dx.doi.org/10.1002/ca.23357DOI Listing
July 2019
10 Reads

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

Plast Reconstr Surg 2019 02;143(2):567-571

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

Failed primary dynamic smile reanimation procedures present significant challenges for the patient and surgeon alike. This is particularly true in older patients with a history of previous neck dissection and radiation therapy who underwent previous reconstruction with a free functional muscle transfer innervated with an ipsilateral masseter nerve. The objective of this study was to demonstrate feasibility, describe surgical technique, and assess results of reusing the masseter nerve to reinnervate a new free functional muscle transfer. Read More

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http://dx.doi.org/10.1097/PRS.0000000000005253DOI Listing
February 2019
13 Reads

Toward the Bionic Face: A Novel Neuroprosthetic Device Paradigm for Facial Reanimation Consisting of Neural Blockade and Functional Electrical Stimulation.

Plast Reconstr Surg 2019 Jan;143(1):62e-76e

Boston, Mass.; and Montreal, Quebec, Canada From the Massachusetts Eye and Ear Infirmary, Harvard Medical School, the Department of Otolaryngology, Surgical Photonics & Engineering Laboratory; and the Department of Biomedical Engineering, McGill University.

Background: Facial palsy is a devastating condition potentially amenable to rehabilitation by functional electrical stimulation. Herein, a novel paradigm for unilateral facial reanimation using an implantable neuroprosthetic device is proposed and its feasibility demonstrated in a live rodent model. The paradigm comprises use of healthy-side electromyographic activity as control inputs to a system whose outputs are neural stimuli to effect symmetric facial displacements. Read More

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http://Insights.ovid.com/crossref?an=00006534-201901000-0002
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http://dx.doi.org/10.1097/PRS.0000000000005164DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311722PMC
January 2019
29 Reads

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
22 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
5 Reads

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 07;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
7 Reads

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
2 Reads

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

JAMA Otolaryngol Head Neck Surg 2018 12;144(12):1162-1168

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
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6583085PMC
December 2018
21 Reads

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

Plast Reconstr Surg 2019 Jan;143(1):152e-164e

Seoul, Republic of Korea From the Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.

Background: Single-stage latissimus dorsi 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 latissimus dorsi muscle transfer. Read More

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http://dx.doi.org/10.1097/PRS.0000000000005168DOI Listing
January 2019
18 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
68 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
11 Reads

Depressor Reanimation After Facial Nerve Paralysis.

Ann Plast Surg 2019 05;82(5):582-590

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
May 2019
108 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
8 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
7 Reads
0.992 Impact Factor

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
21 Reads

Relational Anatomy of the Mimetic Muscles and Its Implications on Free Functional Muscle Inset in Facial Reanimation.

Ann Plast Surg 2018 08;81(2):203-207

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

Background: The human smile is a complex coordinated activity of mimetic muscles predominantly recognizable by a superolateral pull at the commissure and elevation of the upper lip. The aim of this study was to revisit the muscles of facial expression responsible for these motions, evaluate their relational anatomy and orientation, and relate this to optimal positioning of free muscle transfer in smile reanimation.

Methods: Nineteen hemifaces from fresh cadaveric specimens were dissected. Read More

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http://Insights.ovid.com/crossref?an=00000637-900000000-9735
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http://dx.doi.org/10.1097/SAP.0000000000001507DOI Listing
August 2018
24 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
15 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
21 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
10 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
7 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
15 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
15 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
22 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
10 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
7 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
17 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
8 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
5 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
13 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
11 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
29 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
9 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
6 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://Insights.ovid.com/crossref?an=00006534-201609000-0003
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http://dx.doi.org/10.1097/PRS.0000000000002512DOI Listing
September 2016
42 Reads