title: Facial reanimation surgery with micro-vascular gracilis free flap for unilateral facial palsy.
abstract: OBJECTIVE
  Micro-neurovascular free muscle flap transfer is currently the procedure of choice for long-standing facial paralysis. We present a case series of patients treated with gracilis muscle free flap with motor innervation by the masseteric nerve. We discuss the surgical technique and quantify the movement granted by the muscle, the improvement in quality of life and aesthetic results.
  
  
  METHODS
  We report ten patients with unilateral facial paralysis who underwent free gracilis muscle flap, between the years 2010 and 2012 in two tertiary hospitals.
  
  
  RESULTS
  It is not reported any failure of the microsuture with survival of all flaps. The muscle movement was quantified by vectors at rest and contraction with an average of 1.7 cm that initiated around the fourth month after surgery. Patients also reported a significant improvement in symmetry at rest as well as oral and ocular competition.
  
  
  CONCLUSIONS
  As currently presented in literature, microvascular free flaps are the technique of choice for facial reanimation. In our experience, we believe that gracilis muscle flap innervated by the masseteric nerve is a reliable and secure technique that provides adequate functional and aesthetic results.
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario de Bellvitge, Barcelona, España; Agrupació Mèdica i Quirúrgica (AMiQ), Unidad Funcional de Otorrinolaringología y Alergia, Hospital Universitario Quirón Dexeus, Barcelona, España.
authors.forename: Ivan
authors.initials: I
authors.lastname: Doménech Juan
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario de Bellvitge, Barcelona, España; Agrupació Mèdica i Quirúrgica (AMiQ), Unidad Funcional de Otorrinolaringología y Alergia, Hospital Universitario Quirón Dexeus, Barcelona, España.
authors.forename: Jordi
authors.initials: J
authors.lastname: Tornero
authors.affiliation: Agrupació Mèdica i Quirúrgica (AMiQ), Unidad Funcional de Otorrinolaringología y Alergia, Hospital Universitario Quirón Dexeus, Barcelona, España. Electronic address: paulitacruz@hotmail.com.
authors.forename: Paula
authors.initials: P
authors.lastname: Cruz Toro
authors.affiliation: Agrupació Mèdica i Quirúrgica (AMiQ), Unidad Funcional de Otorrinolaringología y Alergia, Hospital Universitario Quirón Dexeus, Barcelona, España.
authors.forename: Nuria
authors.initials: N
authors.lastname: Ortiz Laredo
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario de Bellvitge, Barcelona, España.
authors.forename: Jorge
authors.initials: J
authors.lastname: Vega Celiz
authors.affiliation: Servicio de Rehabilitación, Hospital Universitario de Bellvitge, Barcelona, España.
authors.forename: Josefina
authors.initials: J
authors.lastname: Junyent
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitario de Bellvitge, Barcelona, España.
authors.forename: Manel
authors.initials: M
authors.lastname: Maños Pujol
mesh_terms: D000328:Adult; D005152:Facial Muscles / Q000502:physiology / Q000637:transplantation; D005158:Facial Paralysis / Q000473:pathology / Q000601:surgery*; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply*; D006801:Humans; D008297:Male; D055806:Microvessels; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function
keywords: Colgajo muscular libre microvascularizado gracilis; Facial palsy; Facial reanimation; Gracilis muscle free flap; Parálisis facial; Reanimación facial