title: Variations on the "baby-sitter" procedure for reconstruction of facial paralysis.
abstract: Four cases of fresh facial paralysis were treated using the "baby-sitter" procedure, with fairly satisfactory results obtained. This procedure involves a combination of cross-face nerve grafting and a nerve cross-over technique such as using a hypoglossal-facial nerve or accessory-facial nerve anastomosis. Two stages are required. Nerve cross-over and cross-face nerve grafting using the sural nerve are performed in the first stage. After 1 year nerve anastomosis between the stump of the cross-face nerve graft and that of a buccal branch in the paralyzed cheek is performed during the second stage. The recovery of facial animation through this method is good, with patients able to create a near-natural smile. Electromyography demonstrates double innervation in the paralyzed cheek area.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Endo
authors.forename: J
authors.initials: J
authors.lastname: Hata
authors.forename: Y
authors.initials: Y
authors.lastname: Nakayama
mesh_terms: D000055:Accessory Nerve / Q000601:surgery*; D005154:Facial Nerve / Q000601:surgery*; D005158:Facial Paralysis / Q000601:surgery*; D005260:Female; D006801:Humans; D007002:Hypoglossal Nerve / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016067:Nerve Transfer; D019635:Neurosurgical Procedures / Q000379:methods