Document Detail


The phrenic nerve as a motor nerve donor for facial reanimation with the free latissimus dorsi muscle.
MedLine Citation:
PMID:  19701878     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Free functional muscle transfer for acquired facial paralysis most often involves two stages. In this report, we describe single-stage free muscle transfer using the phrenic nerve as the donor motor nerve. Six patients with unilateral facial paralysis underwent single-stage facial reanimation using a free latissimus dorsi muscle with the ipsilateral phrenic nerve as the donor nerve. These cases were retrospectively studied to review technique and to determine outcomes including time to muscle reinnervation, patient satisfaction, smile symmetry, and complications. The mean age was 33 years. Five patients had complete unilateral facial paralysis and one had incomplete. There was no flap loss. The transferred muscle demonstrated active contraction in all patients at a mean of 14 weeks postoperatively (range, 12 to 16 weeks). Good dynamic symmetry was achieved by 6 to 9 months in all patients. All patients underwent rehabilitation including nerve reeducation. No clinically significant pulmonary morbidity was observed after the unilateral transection of the phrenic nerve. Using the phrenic nerve in free muscle transfer for facial paralysis allows a single-stage procedure with no requirement for nerve grafting and a rapid reinnervation time, shortening the time required for restoring facial animation.
Authors:
Yang-Bin Xu; Junchi Liu; Ping Li; Matthias B Donelan; Brian M Parrett; Jonathan M Winograd
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-08-21
Journal Detail:
Title:  Journal of reconstructive microsurgery     Volume:  25     ISSN:  1098-8947     ISO Abbreviation:  J Reconstr Microsurg     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-05     Completed Date:  2010-01-15     Revised Date:  2011-02-16    
Medline Journal Info:
Nlm Unique ID:  8502670     Medline TA:  J Reconstr Microsurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  457-63     Citation Subset:  IM    
Affiliation:
Department of Plastic and Reconstructive Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, P.R. China.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Facial Muscles / innervation,  surgery
Facial Paralysis / surgery*
Female
Humans
Male
Muscle Contraction / physiology
Muscle, Skeletal / innervation,  transplantation*
Patient Satisfaction
Phrenic Nerve / surgery*
Reconstructive Surgical Procedures / methods
Retrospective Studies
Smiling / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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