Facial reanimation by transplantation of a microneurovascular muscle: long-term follow-up
- 1 January 2004
- journal article
- research article
- Published by Taylor & Francis Ltd in Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery
- Vol. 38 (5), 272-276
- https://doi.org/10.1080/02844310410029138
Abstract
The two-stage operation for reanimation of long-standing facial paralysis by cross-facial nerve grafting and later free microneurovascular muscle transfer has been the treatment of choice for nearly 25 years. However, the functional outcome may be unpredictable. We therefore need to know more about the factors that influence the final result. We have recorded the long-term results of microneurovascular surgery in facial paralysis, and evaluated which factors influenced the functional outcome. Twenty-seven of 40 patients aged 7 to 65 years (mean 40) operated on at Helsinki University Hospital between 1986 and 2000 were available for interview and video recording. The gracilis, latissimus dorsi, and serratus anterior muscles were used for microneurovascular transfer in 11, 10, and 6 cases, respectively. The outcome of microneurovascular muscle transfer was graded on House's scale 1 to 6. The mean follow-up period was 8.5 years (range 2 to 15). Sixteen patients (59%) displayed only mild or moderate dysfunction (grades 2 to 3) after reconstruction. In 8 patients (30%) dysfunction was graded as moderately severe, and in 3 (11%) as severe. There was a correlation between final functional outcome and the follow-up time after microneurovascular facial reanimation. The longer the follow-up time after muscle transplantation the poorer the functional result (p = 0.003). Twenty-one patients (78%) considered that their quality of life was better or much better after facial reanimation. Patients' satisfaction correlated with a good functional result.Keywords
This publication has 18 references indexed in Scilit:
- Management of the Paralyzed Face With Microneurovascular Free Muscle TransferJAMA Otolaryngology–Head & Neck Surgery, 1992
- Results of Management of Facial Palsy with Microvascular Free-Muscle TransferPlastic and Reconstructive Surgery, 1990
- The Comparison of Facial Grading SystemsJAMA Otolaryngology–Head & Neck Surgery, 1986
- Functioning free muscle transplantationThe Journal of Hand Surgery, 1984
- Facial nerve grading systems.The Laryngoscope, 1983
- Experimental Free-Muscle Transplantation with Microneurovascular AnastomosesPlastic and Reconstructive Surgery, 1983
- The regeneration of skeletal muscle fibers following injuryMedicine & Science in Sports & Exercise, 1983
- FREE GRACILIS MUSCLE TRANSPLANTATION, WITH MICRONEUROVASCULAR ANASTOMOSES FOR THE TREATMENT OF FACIAL PARALYSISPlastic and Reconstructive Surgery, 1976
- Reconstruction of the face through cross-face-nerve transplantation in facial paralysisEuropean Journal of Plastic Surgery, 1973