title: Facial reanimation by one-stage microneurovascular free abductor hallucis muscle transplantation:  personal experience and long-term outcomes.
abstract: BACKGROUND
  In 1990, Jiang Hua introduced a new method using one-stage reconstruction with free abductor hallucis muscle transfer for dynamic reanimation of established unilateral facial paralysis. The authors present their experience with this procedure and analyze the postoperative complications and long-term functional and aesthetic outcomes.
  
  
  METHODS
  From March of 1990 to March of 2010, 45 patients underwent the free abductor hallucis muscle transfer procedure in the authors' department. Forty-one were followed up for 54.6 months (range, 28 months to 17 years). The Toronto Facial Grading System and Facial Nerve Function Index were used to evaluate facial nerve function at 2 years after surgery and last follow-up. Complications and function of the donor foot were analyzed.
  
  
  RESULTS
  No postoperative mortality was found. Complications occurred in four of 41 patients, including muscle loss, infection, hematoma, and hypertrophic scar. The others obtained satisfactory symmetric faces in the static state and in voluntary contraction of the transferred muscles. Mean values for the Toronto Facial Grading System (50.6±7.8) and the Facial Nerve Function Index (65.7±11.4 percent) were significantly higher at 2 years postoperatively in comparison with preoperative status (21.2±5.3 and 19.5±3.6 percent, respectively) (p<0.05). Long-term outcomes (Toronto Facial Grading System, 54.8±6.9; Facial Nerve Function Index, 79.4±9.6 percent) were awarded higher values than early outcomes shown at 2 years postoperatively (p<0.05).
  
  
  CONCLUSIONS
  Free abductor hallucis muscle transfer is safe and effective in dynamic reanimation of longstanding unilateral facial paralysis. Favorable long-term results demonstrate that the authors' technique is an alternative method for facial reanimation.
  
  
  METHODS
  Therapeutic, IV.
authors: Shanghai and Nanning, People's Republic of China; and Tokyo, Japan From the Department of Plastic Surgery, Changzheng Hospital, Second Military Medical University; the Health Section of PLA Army Reserve Infantry Division; and the Department of Plastic and Reconstructive Surgery, School of Medicine, Keio University.
authors: An-Tang
authors: AT
authors: Liu
authors: Quan
authors: Q
authors: Lin
authors: Hua
authors: H
authors: Jiang
authors: Mei-Qing
authors: MQ
authors: Sun
authors: Jian-Lin
authors: JL
authors: Zhang
authors: Ying-Fan
authors: YF
authors: Zhang
authors: Yao-Zhong
authors: YZ
authors: Zhao
authors: Wen-Jun
authors: WJ
authors: Zhang
authors: Tomohisa
authors: T
authors: Nagasao
mesh_terms: D000293:Adolescent; D000328:Adult; D005158:Facial Paralysis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005528:Foot; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply / Q000294:innervation / Q000637:transplantation*; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult