A comparison of one- versus two-stage surgery in an experimental model of functional muscle transfer with interposed nerve grafting

Urso-Baiarda, Fulvio; Grobbelaar, Adriaan O.

doi:10.1016/j.bjps.2008.01.008

Cited by 14 publications

(4 citation statements)

References 26 publications

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“…Interestingly, previous studies have normalized the results of maximal tetanic force of rectus femoris to muscle weight and expressed as a percentage of the opposite side to correct weight differences after free muscle transplantation. [43][44][45] However, the ratio force/weight should be used with a caution for the evaluation of muscle recovery, because both the parameters, force and weight, are related and will change in the same direction. On the basis of our results, muscle force and muscle weight demonstrated some variability; however, their ratio varies <5% suggesting side dominance.…”

Section: Discussionmentioning

confidence: 98%

Description and validation of isometric tetanic muscle force test in rabbits

et al. 2011

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Isometric tetanic muscle force has been described in a rat model to evaluate motor recovery in a segmental sciatic nerve defect reconstructions. However, to test longer nerve defects, an alternative and larger animal model is necessary. The purpose of this study is to describe and validate a technique for isometric force measurement of the tibialis anterior (TA) muscle in New Zealand rabbits. Muscle preload and electrical stimulation parameters were optimized to obtain the highest tetanic contraction bilaterally in 10 animals. Electrophysiology, muscle weight, peroneal nerve length, and histomorphometry were also analyzed. Only the peroneal nerve length and the ratio of highest muscle force/muscle weight demonstrated the equivalence between the sides. A small variability of TA muscle force and TA muscle weight was observed between the sides suggesting dominance. Optimization of electrical stimulation and preload as well as the use of correct anesthesia were fundamental to acquire the highest muscle force.

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Section: Discussionmentioning

confidence: 98%

Description and validation of isometric tetanic muscle force test in rabbits

et al. 2011

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“…48 Reconstructions are performed in either one or two stages. 49,50 The two-stage protocol requires neuroregeneration across a cross-face nerve graft before subsequent muscle transfer. The facial nerve recipient by means of a cross-face graft provides a simultaneous, bilateral stimulus when unconscious emotions are elicited.…”

Section: Contiguous Regional Musclementioning

confidence: 99%

Contemporary Solutions for the Treatment of Facial Nerve Paralysis

Garcia

Hadlock²,

Klebuc

et al. 2015

Plastic and Reconstructive Surgery

111

100

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Facial expression is a complex neuromotor and psychomotor process that is disrupted in patients with facial paralysis breaking the link between emotion and physical expression. Contemporary reconstructive options are being implemented in patients with facial paralysis. While static procedures provide facial symmetry at rest, true 'facial reanimation' requires restoration of facial movement. Contemporary treatment options include neurotization procedures (a new motor nerve is used to restore innervation to a viable muscle), contiguous regional muscle transfer (most commonly temporalis muscle transfer), microsurgical free muscle transfer, and nonsurgical adjuvants used to balance facial symmetry. Each approach has advantages and disadvantages along with ongoing controversies and should be individualized for each patient. Treatments for patients with facial paralysis continue to evolve in order to restore the complex psychomotor process of facial expression.

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“…A report evaluated CFNG with free‐muscle transfer in a single stage, showing comparable results with the two‐stage technique (Kumar & Hassan, ). Experimental studies have also shown that there is no difference between the single‐stage and two‐stage CFNG procedures, as the total axon area, tetanic force, and re‐innervation index were comparable (Urso‐Baiarda & Grobbelaar, ). Similarly, our results showed that there was no significant difference between the single‐stage and two‐stage procedures.…”

Section: Discussionmentioning

confidence: 99%

Single‐stage cross‐facial nerve grafting has a result equivalent to that of two‐stage cross‐facial nerve grafting

Park

Kim

et al. 2019

Microsurgery

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Backgrounds Cross‐face nerve grafting (CFNG) is an important treatment for patients with facial palsy. Currently, two‐stage CFNG is frequently performed. CFNG is performed first, followed by coaptation when innervation reaches the grafted nerve ending. The present study compared single‐stage CFNG with conventional two‐stage CFNG. Methods We retrospectively reviewed data of 17 patients who underwent CFNG with zygomatic and buccal branch with hypoglossal crossover. Patients with single‐stage (group 1) and two‐stage (group 2) CFNG were comparatively analyzed 2 years postoperatively. There were nine and eight patients in groups 1 and 2, respectively. The patient's perioperative status was measured with imaging and animation using the Yanagihara grade, altitude, and angle differences of the oral commissure and eye closure. Results Patients in group 1 could recognize their first postoperative spontaneous movement earlier than those in group 2 (268.3 ± 25.1 days vs. 327.5 ± 51.3 days, respectively, p = 0.015). The Yanagihara grade significantly improved for patients in both groups postoperatively (group 1: 12.8 ± 5.5 to 25.3 ± 6.1, p < 0.01; group 2: 12.4 ± 5.6 to 24.3 ± 5.0, p = 0.012). Height and angle difference of the oral commissure showed a significant improvement during resting and smiling in both groups. Eye closure also showed significant improvement in both groups (group 1: 4.1 ± 0.6 to 2.6 ± 0.5, p < 0.01; group 2: 4.0 ± 0.5 to 2.8 ± 0.7, p < 0.01). There was no significant difference in the postoperative improvement rate between the groups. Conclusions Single‐stage CFNG shows results equivalent to those of two‐stage CFNG. Single‐stage CFNG is associated with a shorter treatment period and fewer operations.

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A comparison of one- versus two-stage surgery in an experimental model of functional muscle transfer with interposed nerve grafting

Cited by 14 publications

References 26 publications

Description and validation of isometric tetanic muscle force test in rabbits

Description and validation of isometric tetanic muscle force test in rabbits

Contemporary Solutions for the Treatment of Facial Nerve Paralysis

Single‐stage cross‐facial nerve grafting has a result equivalent to that of two‐stage cross‐facial nerve grafting

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