Triple innervation for re-animation of recent facial paralysis

Biglioli, Federico; Allevi, Fabiana; Rabbiosi, Dimitri; Cupello, Silvia; Battista, Valeria Marinella Augusta; Saibene, Alberto Maria; Colletti, Giacomo

doi:10.1016/j.jcms.2018.02.014

Cited by 36 publications

(12 citation statements)

References 30 publications

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“…This significant result is due to two reasons: first, an increment of the pareticside motion due to the masseteric motor source with also a synkinesis reduction; second, the role of rehabilitative recovery that allows learning how to modulate the movements of the healthy side of the face. This result confirms our previous studies, which showed a restricted activity of the non-paralyzed face and improved symmetry [5,36]. Indeed, in normal subjects, asymmetry increases as a function of the labial displacement for both spontaneous and posed smiles [43,44].…”

Section: Discussionsupporting

confidence: 92%

“…Unfortunately, an interpositional nerve graft is often necessary, thus entailing a further neurorrhaphy with a consequent reduction in axon growth [15,35]. Moreover, for most patients it is almost impossible to reach the cerebral adaptation necessary to perform smiling by lingual movements naturally; therefore, we prefer to use only a part of the fibers of the hypoglossal nerve to restore the correct muscle tone at rest while treating the lower third of the face in recent facial paralysis [36,37]. Additionally, hypoglossal nerve use can lead to a worsening of synkinesis [38].…”

Section: Discussionmentioning

confidence: 99%

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Smile Reanimation with Masseteric-to-Facial Nerve Transfer plus Cross-Face Nerve Grafting in Patients with Segmental Midface Paresis: 3D Retrospective Quantitative Evaluation

et al. 2022

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Facial paresis involves functional and aesthetic problems with altered and asymmetric movement patterns. Surgical procedures and physical therapy can effectively reanimate the muscles. From our database, 10 patients (18–50 years) suffering from unilateral segmental midface paresis and rehabilitated by a masseteric-to-facial nerve transfer combined with a cross-face facial nerve graft, followed by physical therapy, were retrospectively analyzed. Standardized labial movements were measured using an optoelectronic motion capture system. Maximum teeth clenching, spontaneous smiles, and lip protrusion (kiss movement) were detected before and after surgery (21 ± 13 months). Preoperatively, during the maximum smile, the paretic side moved less than the healthy one (23.2 vs. 28.7 mm; activation ratio 69%, asymmetry index 18%). Postoperatively, no differences in total mobility were found. The activity ratio and the asymmetry index differed significantly (without/with teeth clenching: ratio 65% vs. 92%, p = 0.016; asymmetry index 21% vs. 5%, p = 0.016). Postoperatively, the mobility of the spontaneous smiles significantly reduced (healthy side, 25.1 vs. 17.2 mm, p = 0.043; paretic side 16.8 vs. 12.2 mm, p = 0.043), without modifications of the activity ratio and asymmetry index. Postoperatively, the paretic side kiss movement was significantly reduced (27 vs. 19.9 mm, p = 0.028). Overall, the treatment contributed to balancing the displacements between the two sides of the face with more symmetric movements.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Smile Reanimation with Masseteric-to-Facial Nerve Transfer plus Cross-Face Nerve Grafting in Patients with Segmental Midface Paresis: 3D Retrospective Quantitative Evaluation

et al. 2022

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“…11 This makes us understand how variable the treatment of a maxillofacial trauma can be, from a closed reduction of a fracture of the nasal bones up to the treatment of facial fracas with complex reconstruction interventions, or more complex eventual microsurgical facial paralysis reanimations. [12][13][14][15][16][17] Understanding the different causes that most frequently determine facial trauma is of fundamental importance if we consider that traumas, and among these also maxillofacial ones, represent a primary cause of health care costs and productive morbidity for the entire community. The latter is in direct proportionality between the severity of the trauma and the duration of inactivity.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID19 on Maxillofacial Fractures in the Province of L’Aquila, Abruzzo, Italy. Review of 296 Patients Treated With Statistical Comparison of the Two-Year Pre-COVID19 and COVID19

Giovannetti

Lupi

Giorgio

et al. 2022

Journal of Craniofacial Surgery

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The aim of this study was to understand the impact of the COVID-19 pandemic on the epidemiology of maxillofacial trauma in a regional trauma center in L'Aquila, Abruzzo, Italy, during the first wave of the pandemic and comparted it to an equivalent period from 2015 to 2018. The authorshave retrospectively analyzed personal data, site of trauma, etiology, and mechanism of injury. Statistical analysis has been carried out utilizing IBM SPSS Statistics software (IBM Corp., Armonk, NY) and significance was accepted for P values of <0.05. From January 2015 to December 2020, a total of 296 were analyzed. In Pre-COVID era, 195 patients were evaluated, 130 males (66.6%) and 65 females (33.4%). Zygomatic-malar complex fractures were the most common site of trauma in both genders (53%), followed by mandibular fractures (23%) and orbital ones (15%). The highest incidences of injuries were recorded between 15 and 34 years (21%) with the most common etiology attributed to road accidents traumas (49%). In COVID19 era, the authors recorded 101 traumas, 58 males (57.4%), 43 females (42.6%). Zygomatic-malar complex fractures were confirmed as the most common ones in both genders (41%). The most common etiology was related to casual domestic accident and assaults (37% and 30%, respectively). There was no statistically significant difference in terms of incidence in the comparison of Pre-COVID19 and COVID19 periods (P > 0.05) as opposed to the etiology in which the road traffic accidents decreased in favor of domestic accidents and interpersonal assaults (P < 0.05). Our scientific study represents the first epidemiologic study related to the impact of COVID-19 on maxillo-facial trauma in the Province of L'Aquila, Abruzzo, Italy. A decrease in the number of Maxillofacial injuries related to road traffic accidents can be demonstrated as the benefit of lockdown, however, a significant increase in the number of physical assaults shows how isolation and restrictions have had a highly negative psychological impact on society.

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“…Also, patients with facial paralysis have been added to the list of urgent surgeries if the onset of paralysis was close to 18 months in order to avoid losing the chance to reanimate mimetic musculature. 5 Even if some regional specific hubs have been identified to collect all patients affected by a specific pathology in a COVID-19-free location, allowing them to not suspend all the elective surgery, the questionnaire focuses the attention on the missed visits and surgical procedures since the COVID-19 epidemic started. The huge reduction of outpatient visits (-87%) and outpatient (-86%) and inpatient surgical procedures (-78%) that the questionnaire shows four weeks after the beginning of the pandemic suggests a longer and longer waiting lists for all non-urgent pathologies.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 epidemic on maxillofacial surgery in Italy

Allevi

Dionisio

Baciliero

et al. 2020

British Journal of Oral and Maxillofacial Surgery

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Maxillofacial departments in 23 surgical units in Italy have been increasingly involved in facing the COVID-19 emergency. Elective surgeries have been progressively postponed to free up beds and offer human and material resources to those infected. We compiled an inventory of 32 questions to evaluate the impact of the SARS-COV2 epidemic on maxillofacial surgery in 23 selected Italian maxillofacial departments. The questionnaire focused on three different aspects: the variation of the workload, showing both a reduction of the number of team members

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Triple innervation for re-animation of recent facial paralysis

Cited by 36 publications

References 30 publications

Smile Reanimation with Masseteric-to-Facial Nerve Transfer plus Cross-Face Nerve Grafting in Patients with Segmental Midface Paresis: 3D Retrospective Quantitative Evaluation

Smile Reanimation with Masseteric-to-Facial Nerve Transfer plus Cross-Face Nerve Grafting in Patients with Segmental Midface Paresis: 3D Retrospective Quantitative Evaluation

Impact of COVID19 on Maxillofacial Fractures in the Province of L’Aquila, Abruzzo, Italy. Review of 296 Patients Treated With Statistical Comparison of the Two-Year Pre-COVID19 and COVID19

Impact of COVID-19 epidemic on maxillofacial surgery in Italy

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