Facial Reanimation with Microneurovascular Free Flaps

ABSTRACT

Numerous options are available for rehabilitation of chronic facial nerve paralysis, ranging from simple slings to complex procedures such as microneurovascular tissue transfer. Microneurovascular muscle transfer is generally indicated: 1) if the patient desires dynamic facial reanimation, particularly restoration of involuntary emotional facial expressions; 2) in the absence of distal facial nerve fibers or motor endplate fucntion; 3) with an associated large soft tissue defect in the cheek; and 4) when other dynamic reanimation procedures have not been successful. The most commonly used free flaps for facial reanimation are gracilis, latissimus dorsi and inferior rectus abdominus muscle. When successfully performed free flaps yield excellent functional and aesthetic results in facial reanimation.

KEYWORD

Facial paralysis - Facial reanimation - microvascular free flaps

REFERENCES

• 1 Dellon A L, Mackinnon S E. Segmentally innervated latissimus dorsi muscle: microsurgical transfer for facial reanimation.  J Reconstr Microsurg . 1985;  2 7-12
• 2 Mackinnon S E. Technical considerations of the latissimus dorsi muscle flap: a segmentally innervated muscle transfer for facial reanimation.  Microsurgery . 1988;  9 36-45
• 3 Kumar P A. Cross-face reanimation of the paralyzed face, with a single stage microneurovascular gracilis transfer without nerve graft. A preliminary report.  Br J Plast Surg . 1995;  48 519-520
• 4 Harii K, Asato H, Yoshimura K. One-stage transfer of the latissimus dorsi muscle for reanimation of a paralyzed face: a new alternative.  Plast Reconstr Surg . 1998;  102 941-951
• 5 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;  94 808-817
• 6 O'Brien B M, Pederson W C, Khazanchi R K. Results of management of facial palsy with microvascular free-muscle transfer.  Plast Reconstr Surg . 1990;  86 12-22
• 7 Ueda K, Harii K, Asato H. Neurovascular free muscle transfer combined with cross-face nerve grafting for the treatment of facial paralysis in children.  Plast Recontruct Surg . 1998;  101 1765-1773