The evolution of facial reanimation techniques.
Am J Otolaryngol
; 44(3): 103822, 2023.
Article
in En
| MEDLINE
| ID: mdl-36934594
ABSTRACT
This review article provides an updated discussion on evidence-based practices related to the evaluation and management of facial paralysis. Ultimately, the goals of facial reanimation include obtaining facial symmetry at rest, providing corneal protection, restoring smile symmetry and facial movement for functional and aesthetic purposes. The treatment of facial nerve injury is highly individualized, especially given the wide heterogeneity regarding the degree of initial neuronal insult and eventual functional outcome. Recent advancements in facial reanimation techniques have better equipped clinicians to approach challenging patient scenarios with reliable, effective strategies. We discuss how technology such as machine learning software has revolutionized pre- and post-intervention assessments and provide an overview of current controversies including timing of intervention, choice of donor nerve, and management of nonflaccid facial palsy with synkinesis. We highlight novel considerations to mainstay conservative management strategies and examine innovations in modern surgical techniques with a focus on gracilis free muscle transfer. Innervation sources, procedural staging, coaptation patterns, and multi-vector and multi-muscle paddle design are modifications that have significantly evolved over the past decade.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Nerve Transfer
/
Plastic Surgery Procedures
/
Facial Paralysis
Limits:
Humans
Language:
En
Journal:
Am J Otolaryngol
Year:
2023
Document type:
Article
Affiliation country: