PMID: 9424370May 1, 1997Paper

Facial asymmetry after vascular pedicled muscle transfer. Additional criterion for evaluating outcome in managing chronic facial paralysis

Mund-, Kiefer- und Gesichtschirurgie : MKG
H SchierleH Schliephake

Abstract

Today neurotization and muscle transplantation are considered an ideal method of reconstructing the function of the facial nerve and the mimetic muscles in long-established facial palsy. Transplantation of the gracilis muscle as a segmental muscle provides an appropriate size for the face; however, determining the amount of muscle is difficult in order to obtain the desired dynamic and symmetric results. Prompted by the question of an "ideal" transplant size, a retrospective study was undertaken. Since 1991, 11 microneurovascular gracilis muscle transfers have been performed in 10 patients with long-established facial palsy (one patient underwent an additional transfer due to excessive scarring in a severe case of neurofibromatosis). Computed axial tomography scans were performed on six patients using a method for obtaining muscle-volume measurements of corresponding areas in each individual by using bony landmarks for reference. Cross-section area measurements by a digitalized mode were obtained from each scan, determining 20-70 Hounsfield units as appropriate for muscle tissue. Muscle-volume measurements ranged on the transplantation sites between 3.85 and 62 cm3 compared to 1.4 and 22.3 mm3 for the corresponding sites. The i...Continue Reading

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