[Free micro-vascular muscle transplantation for the treatment of late facial paralysis using extensor digitorum brevis and extensor hallucis brevis].
OBJECTIVE
To investigate the result of free vascular transplantation of denervated extensor digitorum brevis and extensor hallucis brevis for the treatment of late facial paralysis.


METHODS
From April 2003 to April 2005, 26 cases of facial paralyses were treated by transplantation of denervated extensor digitorum brevis and extensor hallucis brevis. During operation, the ends of the tendons were fixed at ala nasi, middle point of nasal labial fold,oral commissure and chin; the muscle belly were put around the masseter nerve to correct the nasal and oral deformity, microsurgery was applied to anastomose the tarsus lateral vessels to the superficial temporalis vessels or the facial vessels. The result of the operation was evaluated by the Standard of Douglas Harrison and the Paresis Assessment scoring system of Stennert. RESULTS The static appearance was satisfactory in 26 cases after operation, the bilateral oral commissure was symmetry and the dynamic appearance was greatly improved 6 months after operation. Among the 23 cases whose disease history was above 2 years, all could smile naturally and show their teeth symmetrically except 1 case who could only move the oral commissure. Among the 3 cases whose disease history was less than 2 years, one could smile naturally and show his teeth symmetrically, one could smile but could not show his teeth symmetrically, another could move oral commissure but have no motion appearance. The result was evaluated as "+++" according to Standard of Douglas Harrison, accounting for 88% (23/26). Evaluated according to the Paresis Assessment scoring system of Stennert, the difference before operation and after operation was more than 5, accounting for 86% (22/26).


CONCLUSIONS
The free vascular transplantation of denervated extensor digitorum brevis and extensor hallucis brevis can reconstruct the oral appearance for the treatment of late facial paralysis.
Huang
Weiqing
W
Plastic Surgery Center of Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, 100730, P.R. China. huangweiqing456@sina.com
Wang
Xiancheng
X
Qiao
Qun
Q
D000293:Adolescent; D000328:Adult; D000368:Aged; D003714:Denervation; D005158:Facial Paralysis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006214:Hallux; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply / Q000637:transplantation*; D016378:Tissue Transplantation / Q000379:methods*