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Speech Characteristics and Oromyofunctional Outcomes in Two Bimaxillary Face Transplantation Patients in Helsinki
- Source :
- The LaryngoscopeBIBLIOGRAPHY. 131(10)
- Publication Year :
- 2021
-
Abstract
- OBJECTIVES/HYPOTHESIS Facial functional restoration is one of the main goals in face transplantation. We report the oromyofacial function outcomes of two bimaxillary face transplantation (FT) patients in Helsinki. STUDY DESIGN Outcome Study. METHODS Two male patients, aged 34 and 59, had severe functional facial disabilities following self-inflicted gunshot injuries sustained to their mid and lower faces several years earlier. Both underwent tooth-bearing maxillomandibular face transplantation in 2016 and 2018. We collected data regarding speech, swallowing, sensory recovery, motor recovery, and olfaction prior to transplantation. Patient charts were reviewed from the follow-up period of 4 and 2 years, respectively. RESULTS Speech intelligibility, acceptability, and articulation continued to improve during follow-up for both patients. Voice quality and resonance were mainly normal at last follow-up. Swallowing improved once lip occlusion was regained, with only minor aspiration evident on videofluorography. Both patients had significant improvement in facial mimic muscle function after FT. The first patient who only had buccal sensory nerves connected has only recovered protective facial sensation, whereas our second patient with buccal, infraorbital, and alveolar nerves connected has almost complete facial two-point discrimination. CONCLUSION Both patients have regained satisfactory facial sensory and motor function. Sensory recovery seems to be faster and more precise if multiple sensory nerve coaptations are performed. Swallowing and speech have continued to improve over time although not reaching the level of the normal population. We demonstrate how speech-corrective surgery can safely be performed in a FT patient and can improve speech recovery. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E2643-E2649, 2021.
- Subjects :
- Adult
Male
medicine.medical_specialty
Voice Quality
Facial Muscles
Sensory system
Suicide, Attempted
030230 surgery
03 medical and health sciences
0302 clinical medicine
Physical medicine and rehabilitation
Swallowing
Sensation
Occlusion
medicine
Humans
030223 otorhinolaryngology
Mastication
Finland
business.industry
Speech Intelligibility
Recovery of Function
Deglutition
Transplantation
Smell
medicine.anatomical_structure
Otorhinolaryngology
Wounds, Gunshot
business
Articulation (phonetics)
Sensory nerve
Facial Transplantation
Subjects
Details
- ISSN :
- 15314995
- Volume :
- 131
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- The LaryngoscopeBIBLIOGRAPHY
- Accession number :
- edsair.doi.dedup.....efc0ee166787ed6c1af70f835a757708