Neurotized Platysma Graft: A New Technique for Functional Reanimation of the Eye Sphincter in Longstanding Facial Paralysis

Telich-Tarriba, José E; Villate, Pamela; Morano-Aguirre, Cecilia; Gómez-Villegas, Thamar; Cárdenas-Mejía, Alexander

doi:10.1097/prs.0000000000007210

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…Terzis 54 and our group are in agreement that the most critical aspect of OOM paralysis treatment is the return of spontaneous blink reflex as this protects the eye from corneal abrasions, keratopathy, ulcers and vision loss. 55 Although DMN has been used for OOM reanimation 56 and in conjunction with muscular grafts, 57,58 authors have potentially inadequately considered development of upper eyelid movement as a sign of clinical success. Further study is necessary to determine whether spontaneous movement is truly restored.…”

Section: Facial Reanimationmentioning

confidence: 99%

Direct Neurotization

2021

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Direct neurotization is a method that involves direct implantation of nerve fascicles into a target tissue, that is, muscle fibers, skin, cornea, and so on, with the goal of restoring aesthetic, sensation and or functional capacity. This technique has been implemented since the early 1900s, with numerous experimental and clinical reports of success. Applications have included both sensory and motor neurotization of muscle, as well as protective sensory provision for other organs. These techniques have been used to restore corneal sensation, repair brachial plexus injuries, reestablish tongue movement and function through direct tongue neurotization, and reinnervate multiple facial muscles in patients with facial paralysis. Most recently, these methods have even been used in conjunction with acellular cadaveric nerve grafts to directly neurotize skin. Indications for direct neurotization remain limited, including those in which neural coaptation is not feasible (ie, surgical or traumatic damage to neuromuscular junction, severe avulsion injuries of the distal nerve); however, the success and wide-range application of direct neurotization shows its potential to be implemented as an adjunct treatment in contrast to views that it should solely be used as a salvage therapy. The purpose of the following review is to detail the historic and current applications of direct neurotization and describe the future areas of investigation and development of this technique.

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