title: The incidence of facial vessel agenesis in patients with syndromic congenital facial palsy.
abstract: BACKGROUND
  Congenital facial palsy can result in significant disfigurement. A potential treatment option is free functional muscle transfer to reanimate the face. For this to be possible, a suitable recipient artery and vein must be present in the affected hemiface. In this study, the authors aim to identify whether patients with syndromic congenital facial palsy have a higher rate of facial vessel agenesis than those with isolated congenital facial palsy.
  
  
  METHODS
  Patients were identified between November of 2006 and October of 2013. Patients were stratified into two groups: those with syndromic congenital facial palsy and those with isolated congenital facial palsy. The presence or absence of facial vessels was determined intraoperatively.
  
  
  RESULTS
  Forty-seven eligible patients were included in the study. Those with syndromic congenital facial palsy were significantly more likely to have an absent facial vein than patients with isolated congenital facial palsy (p = 0.015). There was a strong trend toward those with syndromic facial palsy lacking a facial artery (p = 0.08). Subgroup analysis of patients with Möbius syndrome revealed that these patients were significantly more likely to have facial artery agenesis than those with isolated congenital facial palsy (p = 0.03).
  
  
  CONCLUSIONS
  Facial vessel agenesis is significantly more common in patients with syndromic congenital facial palsy compared with those with isolated congenital facial palsy. This must be considered in the preoperative planning for facial reanimation with free functional muscle transfer. The operating surgeon should consider vascular studies of the affected hemiface before undertaking the procedure.
authors.affiliation: London, United Kingdom From the Department of Plastic and Reconstructive Surgery, The Royal Free Hospital.
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Butler
authors.forename: Francis P
authors.initials: FP
authors.lastname: Henry
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Leckenby
authors.forename: Adriaan O
authors.initials: AO
authors.lastname: Grobbelaar
mesh_terms: D000015:Abnormalities, Multiple / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D058747:CHARGE Syndrome / Q000473:pathology / Q000601:surgery; D016022:Case-Control Studies; D002648:Child; D005145:Face / Q000002:abnormalities / Q000098:blood supply* / Q000601:surgery; D005158:Facial Paralysis / Q000151:congenital* / Q000473:pathology / Q000601:surgery; D058752:Free Tissue Flaps; D006053:Goldenhar Syndrome / Q000473:pathology / Q000601:surgery; D006801:Humans; D015994:Incidence; D020331:Mobius Syndrome / Q000473:pathology / Q000601:surgery; D011045:Poland Syndrome / Q000473:pathology / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D054079:Vascular Malformations / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D055815:Young Adult