title: Prophylactic cross-face nerve flap for muscle protection prior to facial palsy.
abstract: The facial muscles of a 28-year-old woman with left acoustic neuroma were successfully protected with a vascularised cross-face nerve flap using a vascularised lateral femoral cutaneous nerve along with a perforator of the lateral circumflex femoral system. It was transferred as a vascularised cross-face nerve flap to bridge a 15-cm-long defect between the bilateral buccal branches. Three months after the nerve flap transfer, the total tumour including the facial nerve was resected. Postoperatively, rapid nerve sprouting through the nerve flap and excellent facial reanimation were obtained 3-6 months after resection. This method is a one-stage reconstruction procedure, has minimal donor-site morbidity and results in strong postoperative muscle contraction. To our knowledge, this is the first report on a prophylactic cross-face nerve flap technique for the protection of facial muscles before facial nerve transection, and also the usefulness of vascularised lateral femoral cutaneous nerve flap.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. koushimai-pla@h.u-tokyo.ac.jp
authors.forename: Isao
authors.initials: I
authors.lastname: Koshima
authors.forename: Mitsunaga
authors.initials: M
authors.lastname: Narushima
authors.forename: Makoto
authors.initials: M
authors.lastname: Mihara
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Takuya
authors.initials: T
authors.lastname: Iida
authors.forename: Gentaro
authors.initials: G
authors.lastname: Uchida
mesh_terms: D000328:Adult; D003390:Cranial Nerve Neoplasms / Q000601:surgery*; D005152:Facial Muscles / Q000294:innervation; D005154:Facial Nerve / Q000601:surgery; D005158:Facial Paralysis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D016067:Nerve Transfer / Q000379:methods; D009464:Neuroma, Acoustic / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply / Q000294:innervation*