Extensor digitorum brevis and extensor hallusis brevis transplantation for treatment of long-standing facial paralysis.
OBJECTIVE
To evaluate the efficacy of free transplantation of denervated muscles and vessels in the treatment of long-standing facial paralysis.


METHODS
A total of 26 patients with facial paralysis (10 males and 16 females, aged 16-65 years, mean: 47 years) were enrolled in this study to receive transplantation of denervated extensor digitorum brevis (EDB) and extensor hallusis brevis (EHB). The muscle tendon was slung to the ala nasi, the middle point of the nasolabial sulcus, the angulus oris and the chin to correct the nasal and oral deformity. The muscle belly was buried around the nerves that innervated the masseter muscle. Microsurgery was applied to anastomosing the tarsus lateral vessels to the superficial temporalis vessels.


RESULTS
After operation, all the patients immediately obtained satisfied static appearance. The movement of the paralyzed corner of the mouth could be obtained one month later and the smile of the paralyzed side could be restored after 3 months of training. And 88% patients achieved perfect results, 8% obtained satisfactory results, and 4% got improvement 6 months after operation according to Stennert's paresis scoring system.


CONCLUSIONS
Free transplantation of denervated muscles and vessels for the treatment of long-standing facial paralysis, which seldom causes atrophy or liquefaction of the transferred muscles, can maintain muscle viability and induce reliable nerve regeneration. Therefore, it is a safe and efficient treatment method for the patients suffering from facial paralysis.
Huang
Wei-Qing
WQ
Department of Plastic Surgery, Affiliated Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100032, China. huangweiqing456@sina.com
Fang
Bai-Rong
BR
Fang
Xue-Quan
XQ
Wang
Chang-Jun
CJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D005158:Facial Paralysis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation / Q000637:transplantation*; D009416:Nerve Regeneration