PDF herunterladen
Facial Plast Surg 2015; 31(02): 134-139
DOI: 10.1055/s-0035-1549044
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Gracilis Microneurovascular Transfer for Facial Paralysis

Peter C. Revenaugh
1   Division of Facial Plastic and Reconstructive Surgery, Department of Otorhinolaryngology—Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois
,
Patrick J. Byrne
2   Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology—Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
08. Mai 2015 (online)

    Lizenzen und Reprints

Abstract

Facial nerve dysfunction occurs in varying degrees of severity due to several causes, and leads to asymmetric or absent facial movements. Regardless of the etiology, facial nerve dysfunction can be functionally and psychologically devastating. Many techniques to restore facial symmetry both at rest and with motion have been pursued throughout history. Within the past 30 years, free muscle microneurovascular transfer techniques have been developed to provide symmetric motion to the face. The aim of this article is to describe one of the most common and reliable techniques to restore midface mobility, namely, gracilis microneurovascular transfer.

Keywords

gracilis - facial paralysis - free flap
 

  • References

  • 1 Boahene KD, Farrag TY, Ishii L, Byrne PJ. Minimally invasive temporalis tendon transposition. Arch Facial Plast Surg 2011; 13 (1) 8-13
    CrossrefPubMedGoogle Scholar
  • 2 Labbè D, Bussu F, Iodice A. A comprehensive approach to long-standing facial paralysis based on lengthening temporalis myoplasty. Acta Otorhinolaryngol Ital 2012; 32 (3) 145-153
    PubMedGoogle Scholar
  • 3 Matic DB, Yoo J. The pedicled masseter muscle transfer for smile reconstruction in facial paralysis: repositioning the origin and insertion. J Plast Reconstr Aesthet Surg 2012; 65 (8) 1002-1008
    CrossrefPubMedGoogle Scholar
  • 4 Hata Y, Yano K, Matsuka K, Ito O, Matsuda H, Hosokawa K. Treatment of chronic facial palsy by transplantation of the neurovascularized free rectus abdominis muscle. Plast Reconstr Surg 1990; 86 (6) 1178-1187 , discussion 1188–1189
    CrossrefPubMedGoogle Scholar
  • 5 Harrison DH. The pectoralis minor vascularized muscle graft for the treatment of unilateral facial palsy. Plast Reconstr Surg 1985; 75 (2) 206-216
    CrossrefPubMedGoogle Scholar
  • 6 Mackinnon SE, Dellon AL. Technical considerations of the latissimus dorsi muscle flap: a segmentally innervated muscle transfer for facial reanimation. Microsurgery 1988; 9 (1) 36-45
    CrossrefPubMedGoogle Scholar
  • 7 Harii K, Ohmori K, Torii S. Free gracilis muscle transplantation, with microneurovascular anastomoses for the treatment of facial paralysis. A preliminary report. Plast Reconstr Surg 1976; 57 (2) 133-143
    Google Scholar
  • 8 Jiang H, Guo ET, Ji ZL, Zhang ML, Lu V. One-stage microneurovascular free abductor hallucis muscle transplantation for reanimation of facial paralysis. Plast Reconstr Surg 1995; 96 (1) 78-85
    CrossrefPubMedGoogle Scholar
  • 9 Alam DS, Haffey T, Vakharia K , et al. Sternohyoid flap for facial reanimation: a comprehensive preclinical evaluation of a novel technique. JAMA Facial Plast Surg 2013; 15 (4) 305-313
    CrossrefPubMedGoogle Scholar
  • 10 Chuang DC. Technique evolution for facial paralysis reconstruction using functioning free muscle transplantation—experience of Chang Gung Memorial Hospital. Clin Plast Surg 2002; 29 (4) 449-459 , v
    CrossrefPubMedGoogle Scholar
  • 11 Hallock GG. The conjoint medial circumflex femoral perforator and gracilis muscle free flap. Plast Reconstr Surg 2004; 113 (1) 339-346
    CrossrefPubMedGoogle Scholar
  • 12 O’Brien BM, Franklin JD, Morrison WA. Cross-facial nerve grafts and microneurovascular free muscle transfer for long established facial palsy. Br J Plast Surg 1980; 33 (2) 202-215
    CrossrefPubMedGoogle Scholar
  • 13 Ueda K, Harii K, Yamada A. Free neurovascular muscle transplantation for the treatment of facial paralysis using the hypoglossal nerve as a recipient motor source. Plast Reconstr Surg 1994; 94 (6) 808-817
    CrossrefPubMedGoogle Scholar
  • 14 Chuang DC, Lu JC, Anesti K. One-stage procedure using spinal accessory nerve (XI)-innervated free muscle for facial paralysis reconstruction. Plast Reconstr Surg 2013; 132 (1) 117e-129e
    CrossrefPubMedGoogle Scholar
  • 15 Zuker RM, Goldberg CS, Manktelow RT. Facial animation in children with Möbius syndrome after segmental gracilis muscle transplant. Plast Reconstr Surg 2000; 106 (1) 1-8 , discussion 9
    CrossrefPubMedGoogle Scholar
  • 16 Lifchez SD, Matloub HS, Gosain AK. Cortical adaptation to restoration of smiling after free muscle transfer innervated by the nerve to the masseter. Plast Reconstr Surg 2005; 115 (6) 1472-1479 , discussion 1480–1482
    CrossrefPubMedGoogle Scholar
  • 17 Faria JC, Scopel GP, Busnardo FF, Ferreira MC. Nerve sources for facial reanimation with muscle transplant in patients with unilateral facial palsy: clinical analysis of 3 techniques. Ann Plast Surg 2007; 59 (1) 87-91
    CrossrefPubMedGoogle Scholar
  • 18 Hontanilla B, Marre D, Cabello A. Facial reanimation with gracilis muscle transfer neurotized to cross-facial nerve graft versus masseteric nerve: a comparative study using the FACIAL CLIMA evaluating system. Plast Reconstr Surg 2013; 131 (6) 1241-1252
    CrossrefPubMedGoogle Scholar
  • 19 Biglioli F, Colombo V, Tarabbia F , et al. Double innervation in free-flap surgery for long-standing facial paralysis. J Plast Reconstr Aesthet Surg 2012; 65 (10) 1343-1349
    CrossrefPubMedGoogle Scholar
  • 20 Watanabe Y, Akizuki T, Ozawa T, Yoshimura K, Agawa K, Ota T. Dual innervation method using one-stage reconstruction with free latissimus dorsi muscle transfer for re-animation of established facial paralysis: simultaneous reinnervation of the ipsilateral masseter motor nerve and the contralateral facial nerve to improve the quality of smile and emotional facial expressions. J Plast Reconstr Aesthet Surg 2009; 62 (12) 1589-1597
    CrossrefPubMedGoogle Scholar
  • 21 Collar RM, Byrne PJ, Boahene KD. The subzygomatic triangle: rapid, minimally invasive identification of the masseteric nerve for facial reanimation. Plast Reconstr Surg 2013; 132 (1) 183-188
    CrossrefPubMedGoogle Scholar
  • 22 Revenaugh PC, Fritz MA, Haffey TM, Seth R, Markey J, Knott PD. Minimizing morbidity in microvascular surgery: small-caliber anastomotic vessels and minimal access approaches. JAMA Facial Plast Surg 2015; 17 (1) 44-48
    CrossrefPubMedGoogle Scholar
  • 23 Chuang DC. Free tissue transfer for the treatment of facial paralysis. Facial Plast Surg 2008; 24 (2) 194-203
    Artikel in Thieme ConnectPubMedGoogle Scholar