Facial animation with gracilis muscle transplant reinnervated via cross-face graft: Does it change patients' quality of life?
OBJECTIVE
Gracilis muscle reinnervated by the contralateral facial nerve via cross-graft technique is nowadays considered to be a first-line procedure for facial animation in unilateral palsies. Despite the wide number of papers published analyzing technical aspects, refinements, functional results, and cosmetic outcomes, only a few authors have focused their publications on the patient's perspective and impact on QOL of these procedures.


METHODS
Changes in quality of life in 42 patients treated with gracilis muscle transplant reinnervated via cross-face graft were analyzed through a comparison of preoperative and postoperative items on the Facial Disability Index questionnaire. Statistical evaluation with a paired t-test was performed concerning overall results and specific items modifications.


RESULTS
Overall improvement of QOL was found to be highly significant (p = 0.001). Mouth and eye functions were the most improved (p = 0.001), whereas isolation (p = 0.004) and feeling calm and peaceful (p = 0.001) were the most improved among the social functions.


CONCLUSIONS
Facial animation with gracilis neuromuscular transplantation reinnervated with contralateral healthy facial nerve via a cross-graft procedure has been demonstrated to be a safe and reliable procedure in the treatment of congenital or established facial palsies. Our results on quality of life impact support that these operations are not only reliable and safe but also of primary relevance to patients' everyday lives.
Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy.
Bernardo
B
Bianchi
Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy. Electronic address: a.ferri@libero.it.
Andrea
A
Ferri
Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy.
Valentina
V
Poddi
Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy.
Andrea
A
Varazzani
Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy.
Silvano
S
Ferrari
Department of Neuroscience, University of Parma, Parma, Italy.
Giuseppe
G
Pedrazzi
Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy.
Enrico
E
Sesenna
D000293:Adolescent; D000328:Adult; D002648:Child; D005158:Facial Paralysis / Q000151:congenital / Q000601:surgery*; D019066:Facies; D005260:Female; D058752:Free Tissue Flaps / Q000294:innervation; D000071976:Gracilis Muscle / Q000294:innervation / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016067:Nerve Transfer / Q000379:methods; D011788:Quality of Life; D012189:Retrospective Studies; D012904:Smiling; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
Cross-graft; Facial animation; Facial palsy; Quality of life