Lessons from Gracilis Free Tissue Transfer for Facial Paralysis

Miller, Matthew Q.; Jowett, Nate; Hadlock, Tessa A.

doi:10.1016/j.fsc.2021.03.001

Cited by 10 publications

(1 citation statement)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Smile reconstruction with a contralateral facial nerve‐driven free functional muscle transfer using a cross‐face nerve graft may result in less movement in the transferred muscle than on the healthy side. Movement synchronization with the contralateral orbicularis oculi or orbicularis oris muscle contraction may also occur(Hembd et al, 2017; Manktelow et al, 2006; Miller et al, 2021). Therefore, the selection of the optimal facial nerve branch is critical; however, electrostimulation during surgery may not always identify the optimal components that exclusively control levator muscle groups, including the zygomaticus major, zygomaticus minor, levator labii superioris, and levator anguli oris muscles.…”

Section: Discussionmentioning

confidence: 99%

Nerve to the zygomaticus major muscle: An anatomical study and surgical application to smile reconstruction

Yoshioka

Fernández-Miranda

2023

Clinical Anatomy

View full text Add to dashboard Cite

Smile reconstruction using the branches that supply the zygomaticus major muscle as a motor source is an established procedure in facial reanimation surgery for facial paralysis. However, the anatomy of the nerve to the muscle remains unclear. Therefore, we herein examined the topographical anatomy of the nerve to the zygomaticus major muscle to obtain more detailed information on donor nerve anatomy. Preserved cadaver dissection was performed under a microscope on 13 hemifaces of 8 specimens. The branches that innervate the zygomaticus major muscle and their peripheral routes medial to the muscle were traced and examined. A median of four (ranges 2–4) branches innervated the zygomaticus major muscle. The proximal two branches (near the muscle origin) arose from the zygomatic branch, the second of which was the major branch. The distal branches (near the oral commissure) arose from the buccal branch or zygomaticobuccal plexus. The vertical distance from the caudal margin of the zygomatic arch to the major branch intersecting point was 19 ± 4.0 mm, while the horizontal distance parallel to the Frankfort plane was 29 ± 5.2 mm. The proximal two branches innervating the zygomaticus major muscle were detected in the majority of specimens. The anatomical findings obtained herein on the nerve to the zygomaticus major muscle will allow for more reliable donor selection in facial reanimation surgery.

show abstract

Section: Discussionmentioning

confidence: 99%