title: Long-term results of microvascular free-tissue transfer reanimation of the paralyzed face: three cases.
abstract: We conducted a retrospective case review at our tertiary care academic medical center to assess the long-term results of microvascular free-tissue transfer to achieve facial reanimation in 3 patients. These patients had undergone wide-field parotidectomy with facial nerve resection. Upper facial reanimation was accomplished with a proximal facial nerve-sural nerve graft, and lower facial movement was achieved through proximal facial nerve-long thoracic (serratus muscle) nerve anastomosis. Outcomes were determined by grading postoperative facial nerve function according to the House-Brackmann system. All 3 patients were able to close their eyes independent of lower facial movement, and all 3 had achieved House-Brackmann grade III function. We conclude that reanimating the paralyzed face with microvascular free-tissue transfer provides anatomic coverage and mimetic function after wide-field parotidectomy. Synkinesis is reduced by separating upper- and lower-division reanimation.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Loyola Center for Cranial Base Surgery, Loyola University Medical Center, 2160 S. First Ave., Maywood, IL 60153, USA. jleonet@LUMC.edu
authors.forename: John P
authors.initials: JP
authors.lastname: Leonetti
authors.forename: Chad A
authors.initials: CA
authors.lastname: Zender
authors.forename: Daryl
authors.initials: D
authors.lastname: Vandevender
authors.forename: Sam J
authors.initials: SJ
authors.lastname: Marzo
mesh_terms: D008949:Adenoma, Pleomorphic / Q000000981:diagnostic imaging / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D005145:Face / Q000294:innervation*; D005149:Facial Expression; D005154:Facial Nerve / Q000601:surgery*; D005158:Facial Paralysis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery; D018482:Muscle, Skeletal / Q000601:surgery*; D010307:Parotid Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D013497:Sural Nerve / Q000637:transplantation*; D013524:Surgical Flaps; D013909:Thorax; D013997:Time Factors; D014057:Tomography, X-Ray Computed