Segmental Gracilis Muscle Transplantation for Midfacial Animation in Möbius Syndrome: A 29-Year Experience

Plastic and Reconstructive Surgery
Mélissa RoyGregory H Borschel

Abstract

Möbius syndrome is a complex congenital disorder of unclear cause involving multiple cranial nerves and typically presenting with bilateral facial and abducens nerves palsies. At The Hospital for Sick Children, Toronto, Ontario, Canada, microneurovascular transfer of free-muscle transplant is the procedure of choice for midfacial animation. The primary aim of this study was to investigate surgical outcomes of the procedure in terms of complications, secondary revisions, and smile excursion gains. A retrospective 29-year review was performed using patient records from a single tertiary care center. The authors included children with Möbius syndrome who had undergone facial animation surgery with a free segmental gracilis muscle transfer and microneurovascular repair between January 1, 1985, and August 31, 2014. Smile excursion measures were obtained using the Facial Assessment by Computer Evaluation-Gram on a subset of the included patients. A total of 107 patients undergoing 197 reconstructive procedures met inclusion criteria. Most reconstructions relied on the motor nerve branch to the masseter for innervation [n = 174 (88 percent)]. Thirteen complications were reported, of which six required surgical interventions. Three rev...Continue Reading

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Citations

Nov 13, 2019·Developmental Medicine and Child Neurology·Francis RenaultMarie-Paule Vazquez
Feb 28, 2021·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Konstantinos GasteratosAdriaan O Grobbelaar
Mar 25, 2021·Plastic and Reconstructive Surgery. Global Open·Ricardo Rodriguez ColonEduardo D Rodriguez
Jul 27, 2021·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·John W StaplesGregory H Borschel

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