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A higher quality of life with cross-face-nerve-grafting as an adjunct to a hypoglossal-facial nerve jump graft in facial palsy treatment.
- Source :
-
Journal of plastic, reconstructive & aesthetic surgery : JPRAS [J Plast Reconstr Aesthet Surg] 2017 Nov; Vol. 70 (11), pp. 1666-1674. Date of Electronic Publication: 2017 Jun 10. - Publication Year :
- 2017
-
Abstract
- Nerve reconstructions are the preferred technique for short-standing facial paralysis, most commonly using the contralateral facial nerve or ipsilateral hypoglossal nerve. The hypoglossal nerve provides a strong motor signal, whereas the signal of a cross-face nerve graft is weaker but spontaneous. Spontaneity in facial expression is believed to be important for psychological wellbeing. Therefore, a combination of the two procedures incorporates the best of both: a strong motor signal and a spontaneous smile. This study aimed to objectify this expected benefit. Of the 20 patients who received a hypoglossal-facial nerve anastomosis from 1995 to 2015 in our institutions, 12 patients were included in this study, 5 with and 7 without a cross-face nerve graft. The outcomes were compared using photographs, disease-specific quality of life (Facial Clinimetric Evaluation (FaCE) scale), a self-reported synkinesis scale (Synkinesis Assessment Questionnaire) and the presence of a spontaneous smile. Significant differences were found in preoperative excursion of the affected side of the mouth and the change in excursion. Median Total FaCE scores were considerably larger (18.3 points) for patients who underwent the combined procedure. A spontaneous smile was observed both with (n = 2) and without (n = 1) a cross-face nerve graft. The addition of a cross-face nerve graft to a hypoglossal-facial nerve anastomosis resulted in a positive trend in disease-specific quality of life. This benefit could also be present with the combination of a cross-face nerve graft with another nerve transfer such as a masseteric-facial nerve anastomosis.<br /> (Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Child
Facial Expression
Facial Paralysis physiopathology
Female
Follow-Up Studies
Humans
Male
Microsurgery methods
Middle Aged
Retrospective Studies
Smiling
Time Factors
Treatment Outcome
Young Adult
Facial Nerve surgery
Facial Paralysis surgery
Hypoglossal Nerve transplantation
Muscle, Skeletal transplantation
Nerve Transfer methods
Quality of Life
Rhytidoplasty methods
Subjects
Details
- Language :
- English
- ISSN :
- 1878-0539
- Volume :
- 70
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Journal of plastic, reconstructive & aesthetic surgery : JPRAS
- Publication Type :
- Academic Journal
- Accession number :
- 28684285
- Full Text :
- https://doi.org/10.1016/j.bjps.2017.06.002