Cross-facial nerve anastomosis in the treatment of facial paralysis: A preliminary report on 10 cases

Gary-Bobo, A; Fuentes, Jean Marc; Guerrier, B.

doi:10.1016/0007-1226(80)90012-0

Cited by 10 publications

(2 citation statements)

References 2 publications

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“…Nevertheless, it is very important to choose a suitable recipient nerve for connecting axons from the motor nerve to the transferred muscle. Using the contralateral facial nerve (cross face), we can achieve a spontaneous nerve impulse (Anderl, ; Baker and Conley, ; Gary‐Bobo et al, ), but the functional results could be far from acceptable to the patients (Bae et al, ). When the contralateral facial nerve is used, nerve grafts are required to join it to the paralyzed side of the face, reaching at least 50% of the axonal load.…”

Section: Discussionmentioning

confidence: 99%

Anatomical study of the masseteric and obturator nerves: Application to face transplant and reanimation procedures

et al. 2019

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The masseteric nerve (MN) and the anterior branch of the obturator nerve (ON) that innervate the transferred gracilis muscle have proved highly efficient for reanimating paralyzed facial muscles when muscle transfer is required. Previous researchers have published the total axonal load for myelinated fibers in both nerves. However, the real motor axonal load has not been established. We performed the study on 20 MN and 13 ON. The segments of the MN and the ON were embedded in paraffin, sectioned at 10 μm, and stained following a standard immunohistochemical procedure using anti‐choline acetyltransferase to visualize the motor fibers. The MN has a higher axonal load than the ON. There were statistically significant differences between the axonal load of the proximal segment of the MN and the ON. These findings confirm that end‐to‐end anastomoses between the MN and the ON should preferably use the proximal segment. However, MN neurotomy should ideally be performed between the proximal and distal segments, preserving innervation to the deep fascicles. Our results show that the MN is ideal as a donor motor nerve for reinnervating transplanted muscle for dynamic reanimation of the paralyzed face. The neurotomy should ideally be performed between the first and second collateral branches of the MN. Clin. Anat. 32:612–617, 2019. © 2019 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Anatomical study of the masseteric and obturator nerves: Application to face transplant and reanimation procedures

et al. 2019

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“…By using the contralateral facial nerve with a cross‐face nerve graft, we can achieve a spontaneous nerve impulse (Anderl, 1979; Baker & Conley, 1979; Gary‐Bobo et al, 1980), but the functional results are usually far from acceptable for the patients (Bae et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

Anatomic and histomorphometric study of the nerve to the vastus lateralis in cadaver for its clinical application in facial reanimation

et al. 2023

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Background The innervated vastus lateralis flap (IVLF) is a barely used possibility for facial palsy reconstruction because of its thickness compared to the gracilis, latissimus dorsi, and pectoralis minor flaps. The aim of this study is to perform a precise description of the intramuscular distribution of the nerve motor branches and its relationship with the vascular pedicle in order to harvest a segmental muscle flap with the best contractile strength to restore facial reanimation. Methods The study was performed on 16 adult cadaver thighs identifying the vastus lateralis muscle and the distribution and relationships of its neurovascular pedicle and branches. We evaluated where the nerve pierced the muscle and the course of the nerve within it. Transverse segments of the nerve were obtained from the proximal and distal ends of the nerve and stained using anti‐ChAT (Choline acetyltransferase) antibodies which are specific of motor neurons. Results A nerve for the vastus lateralis from the posterior division of the femoral nerve divided into 2 branches in 56% of cases; the principal branch coursed along the vascular pedicle and pierced the muscle more proximally than the respective vessels, and a minor branch that pierced the muscle 25–60 mm proximally. There were 3 main intramuscular branches. The nerve length (mean 132.65 ± 22.89 mm) allowed to reach the contralateral side of the face in almost all cases (95%). The mean ChAT positive fibers was 351.0 ± 92.4/mm2 at the proximal end, and 270.3 ± 87.9/mm2 at the distal end (p = 0.49). The number of ChAT negative fibers was higher than ChAT positive in both proximal and distal ends of the nerve. Conclusion We propose the IVLF as a one‐step surgical flap for facial paralysis reanimation due to the constant neurovascular pattern and lengthy pedicle. The amount of motor fibers in several segments of the nerve is appropriate to produce a powerful contraction for dynamic reconstruction.

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Long-term follow-up report on cross-facial nerve grafting in the treatment of facial paralysis

Gary-Bobo¹,

Fuentes²

1983

British Journal of Plastic Surgery

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Cross-facial nerve anastomosis in the treatment of facial paralysis: A preliminary report on 10 cases

Cited by 10 publications

References 2 publications

Anatomical study of the masseteric and obturator nerves: Application to face transplant and reanimation procedures

Anatomical study of the masseteric and obturator nerves: Application to face transplant and reanimation procedures

Anatomic and histomorphometric study of the nerve to the vastus lateralis in cadaver for its clinical application in facial reanimation

Long-term follow-up report on cross-facial nerve grafting in the treatment of facial paralysis

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