Universität zu Köln

Abing, Helen ORCID: 0000-0001-8453-842X, Pick, Carina ORCID: 0000-0002-5514-2167, Steffens, Tabea, Sharma, Jenny Shachi, Klussmann, Jens Peter ORCID: 0000-0002-8223-7954 and Grosheva, Maria ORCID: 0000-0002-5985-468X (2022). Reanimation of the Smile with Neuro-Vascular Anastomosed Gracilis Muscle: A Case Series. Diagnostics, 12 (5). BASEL: MDPI. ISSN 2075-4418

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Abstract

Background: The aim of our manuscript was to evaluate the time course of clinical and electromyographical (EMG) reinnervation after the reanimation of the smile using a gracilis muscle transplant which is reinnervated with the masseteric nerve. Methods: We present a case series of five patients with a longstanding peripheral facial palsy, who underwent a reanimation of the lower face using a gracilis muscle transplant with masseteric nerve reinnervation from June 2019 to October 2020. Trial-specific follow-up examinations were carried out every three months using clinical assessment and EMG, up to 12 months after the surgery. The grading was carried out using the House-Brackmann scale (HB), the Stennert Index, and a self-designed Likert-like scale for graft reinnervation and smile excursion. Results: The surgery was feasible in all of the patients. The reanimation was performed under general anesthesia in an inpatient setting. Postoperative complications which resulted in prolonged hospitalization occurred in two of the five patients. All of the patients showed a preoperative flaccid facial palsy. The first single reinnervation potentials were detected 3.1 +/- 0.1 months after surgery. After 5.6 (+/- 1.4) months, in three (3/5) patients, clear reinnervation patterns were present. Clinically, the patients obtained symmetry of the face at rest after 5.6 (+/- 1.4) months, and could spontaneously smile without the co-activation of the jaw after an average time of 10.8 (+/- 1.8) months. All of the patients were able to express a spontaneous emotion-stimulated smile after one year. Conclusion: Micro-neurovascular gracilis muscle transfer reinnervated with a masseteric nerve is a sufficient and reliable rehabilitation technique for the lower face, and is performed as a single-stage surgery. The nerve supply via the masseteric nerve allows the very rapid and strong reinnervation of the graft, and results in a spontaneous smile within 10 months.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Abing, Helen UNSPECIFIED orcid.org/0000-0001-8453-842X UNSPECIFIED Pick, Carina UNSPECIFIED orcid.org/0000-0002-5514-2167 UNSPECIFIED Steffens, Tabea UNSPECIFIED UNSPECIFIED UNSPECIFIED Sharma, Jenny Shachi UNSPECIFIED UNSPECIFIED UNSPECIFIED Klussmann, Jens Peter UNSPECIFIED orcid.org/0000-0002-8223-7954 UNSPECIFIED Grosheva, Maria UNSPECIFIED orcid.org/0000-0002-5985-468X UNSPECIFIED
URN:	urn:nbn:de:hbz:38-660354
DOI:	10.3390/diagnostics12051282
Journal or Publication Title:	Diagnostics
Volume:	12
Number:	5
Date:	2022
Publisher:	MDPI
Place of Publication:	BASEL
ISSN:	2075-4418
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language FACIAL REANIMATION; FREE-FLAP; MASSETERIC NERVE; RECONSTRUCTION Multiple languages Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66035