ABSTRACT
A case of immediate replantation of an avulsed scalp by microvascular anastomosis
is presented. Microvascular replantation of the scalp seems to offer significant social
and psychological advantages over secondary reconstructive procedures. The significance
of the case presented is the regaining of the motor neural function of the facial
nerve after 38 months.
KEYWORD
Scalp amputation - scalp replantation - neural function
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Miller G D, Austee E J, Shell J A.
Successful replantation of an avulsed scalp by microvascular anastomoses.
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Buncke H J, Rose E H, Brownstein M J.
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1 *Editorial Note: Clearly, transverse forehead creases are noted all across the forehead,
including the area lateral to the replantation scar. I suspect that an appropriate
explanation is that the plane of avulsion was superficial to the temporal fascia in
the right temporal area, leaving the trunk of the frontal branch of the facial nerve
intact as it courses obliquely over the zygomatic arch on its way to innervate the
frontalis muscle. Over time, direct neurotization of the replanted muscle was achieved
by sprouting from the depth into the muscle fibers. Additionally, I would speculate
that there was some degree of cross-neurotization from the contralateral frontal branch
of the facial nerve from the contralateral frontalis muscle on the uninjured side.
This case is a good example of the fact that sometimes our laborious efforts are rewarded
with results that are beyond our level of expectation! Elliot H. Rose, M.D.
