DOI QR코드

DOI QR Code

Facial palsy reconstruction

  • Soo Hyun Woo (Department of Plastic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine) ;
  • Young Chul Kim (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Tae Suk Oh (Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2023.10.17
  • Accepted : 2023.11.08
  • Published : 2024.02.20

Abstract

The facial nerve stimulates the muscles of facial expression and the parasympathetic nerves of the face. Consequently, facial nerve paralysis can lead to facial asymmetry, deformation, and functional impairment. Facial nerve palsy is most commonly idiopathic, as with Bell palsy, but it can also result from a tumor or trauma. In this article, we discuss traumatic facial nerve injury. To identify the cause of the injury, it is important to first determine its location. The location and extent of the damage inform the treatment method, with options including primary repair, nerve graft, cross-face nerve graft, nerve crossover, and muscle transfer. Intracranial proximal facial nerve injuries present a challenge to surgical approaches due to the complexity of the temporal bone. Surgical intervention in these cases requires a collaborative approach between neurosurgery and otolaryngology, and nerve repair or grafting is difficult. This article describes the treatment of peripheral facial nerve injury. Primary repair generally offers the best prognosis. If primary repair is not feasible within 6 months of injury, nerve grafting should be attempted, and if more than 12 months have elapsed, functional muscle transfer should be performed. If the affected nerve cannot be utilized at that time, the contralateral facial nerve, ipsilateral masseter nerve, or hypoglossal nerve can serve as the donor nerve. Other accompanying symptoms, such as lagophthalmos or midface ptosis, must also be considered for the successful treatment of facial nerve injury.

Keywords

References

  1. Brown S, Isaacson B, Kutz W, Barnett S, Rozen SM. Facial nerve trauma: clinical evaluation and management strategies. Plast Reconstr Surg 2019;143:1498-512.  https://doi.org/10.1097/PRS.0000000000005572
  2. Hohman MH, Hadlock TA. Etiology, diagnosis, and management of facial palsy: 2000 patients at a facial nerve center. Laryngoscope 2014;124:E283-93.  https://doi.org/10.1002/lary.24542
  3. Kim MJ, Oh TS. A nasolabial fold reset technique for enhancing midface lifts in facial reanimation: three-dimensional volumetric analysis. J Craniomaxillofac Surg 2020;48:162-9.  https://doi.org/10.1016/j.jcms.2020.01.001
  4. Fattah A, Borschel GH, Manktelow RT, Bezuhly M, Zuker RM. Facial palsy and reconstruction. Plast Reconstr Surg 2012;129:340e-352e.  https://doi.org/10.1097/PRS.0b013e31823aedd9
  5. Ho AL, Scott AM, Klassen AF, Cano SJ, Pusic AL, Van Laeken N. Measuring quality of life and patient satisfaction in facial paralysis patients: a systematic review of patient-reported outcome measures. Plast Reconstr Surg 2012;130:91-9.  https://doi.org/10.1097/PRS.0b013e318254b08d
  6. Kleiss IJ, Hohman MH, Susarla SM, Marres HA, Hadlock TA. Health-related quality of life in 794 patients with a peripheral facial palsy using the FaCE Scale: a retrospective cohort study. Clin Otolaryngol 2015;40:651-6.  https://doi.org/10.1111/coa.12434
  7. May M. Trauma to the facial nerve. Otolaryngol Clin North Am 1983;16:661-70.  https://doi.org/10.1016/S0030-6665(20)32050-8
  8. Baumann BM, Jarecki J. Posttraumatic delayed facial nerve palsy. Am J Emerg Med 2008;26:115. 
  9. Diaz RC, Cervenka B, Brodie HA. Treatment of temporal bone fractures. J Neurol Surg B Skull Base 2016;77:419-29.  https://doi.org/10.1055/s-0036-1584197
  10. Seddon HJ. A classification of nerve injuries. Br Med J 1942;2:237-9.  https://doi.org/10.1136/bmj.2.4260.237
  11. Sunderland S. The anatomy and physiology of nerve injury. Muscle Nerve 1990;13:771-84.  https://doi.org/10.1002/mus.880130903
  12. Han SW, Kim JH, Kim SW, Kim SH, Kang DR, Kim J. Sensory change and recovery of infraorbital area after zygomaticomaxillary and orbital floor fractures. Arch Craniofac Surg 2022;23:262-8.  https://doi.org/10.7181/acfs.2022.01011
  13. Gordin E, Lee TS, Ducic Y, Arnaoutakis D. Facial nerve trauma: evaluation and considerations in management. Craniomaxillofac Trauma Reconstr 2015;8:1-13.  https://doi.org/10.1055/s-0034-1372522
  14. Hohman MH, Bhama PK, Hadlock TA. Epidemiology of iatrogenic facial nerve injury: a decade of experience. Laryngoscope 2014;124:260-5.  https://doi.org/10.1002/lary.24117
  15. Cannon CR, Jahrsdoerfer RA. Temporal bone fractures: review of 90 cases. Arch Otolaryngol 1983;109:285-8.  https://doi.org/10.1001/archotol.1983.00800190007002
  16. Gantz BJ, Rubinstein JT, Gidley P, Woodworth GG. Surgical management of Bell's palsy. Laryngoscope 1999;109:1177-88.  https://doi.org/10.1097/00005537-199908000-00001
  17. Humphrey CD, Kriet JD. Nerve repair and cable grafting for facial paralysis. Facial Plast Surg 2008;24:170-6.  https://doi.org/10.1055/s-2008-1075832
  18. Agnew SP, Dumanian GA. Technical use of synthetic conduits for nerve repair. J Hand Surg Am 2010;35:838-41.  https://doi.org/10.1016/j.jhsa.2010.02.025
  19. Scaramella LF. Anastomosis between the two facial nerves. Laryngoscope 1975;85:1359-66.  https://doi.org/10.1288/00005537-197508000-00012
  20. Hontanilla B, Marre D. Comparison of hemihypoglossal nerve versus masseteric nerve transpositions in the rehabilitation of short-term facial paralysis using the Facial Clima evaluating system. Plast Reconstr Surg 2012;130:662e-672e.  https://doi.org/10.1097/PRS.0b013e318267d5e8
  21. Klebuc MJA. Facial reanimation using the masseter-to-facial nerve transfer. Plast Reconstr Surg 2011;127:1909-15.  https://doi.org/10.1097/PRS.0b013e31820e9138
  22. Park H, Jeong SS, Oh TS. Masseter nerve-based facial palsy reconstruction. Arch Craniofac Surg 2020;21:337-44.  https://doi.org/10.7181/acfs.2020.00682
  23. Koo WY, Park SO, Ahn HC, Ryu SR. Facial reanimation using the hypoglossal nerve and ansa cervicalis: a short-term retrospective analysis of surgical outcomes. Arch Craniofac Surg 2021;22:303-9.  https://doi.org/10.7181/acfs.2021.00444
  24. Kwon BS, Sun H, Kim JW. Modified temporalis tendon transfer extended with periosteum for facial paralysis patients. Arch Craniofac Surg 2020;21:351-6.  https://doi.org/10.7181/acfs.2020.00570
  25. Conley J, Baker DC, Selfe RW. Paralysis of the mandibular branch of the facial nerve. Plast Reconstr Surg 1982;70:569-77.  https://doi.org/10.1097/00006534-198211000-00007
  26. Conley J. Facial rehabilitation: new potentials. Clin Plast Surg 1979;6:421-31.  https://doi.org/10.1016/S0094-1298(20)32046-0
  27. Boahene KD. Dynamic muscle transfer in facial reanimation. Facial Plast Surg 2008;24:204-10.  https://doi.org/10.1055/s-2008-1075835
  28. Labbe D, Huault M. Lengthening temporalis myoplasty and lip reanimation. Plast Reconstr Surg 2000;105:1289-98.  https://doi.org/10.1097/00006534-200004000-00005
  29. Harii K, Ohmori K, Torii S. Free gracilis muscle transplantation, with microneurovascular anastomoses for the treatment of facial paralysis: a preliminary report. Plast Reconstr Surg 1976;57:133-43.  https://doi.org/10.1097/00006534-197602000-00001
  30. Harii K, Asato H, Yoshimura K, Sugawara Y, Nakatsuka T, Ueda K. One-stage transfer of the latissimus dorsi muscle for reanimation of a paralyzed face: a new alternative. Plast Reconstr Surg 1998;102:941-51.  https://doi.org/10.1097/00006534-199809020-00001
  31. Chuang DC. Free tissue transfer for the treatment of facial paralysis. Facial Plast Surg 2008;24:194-203.  https://doi.org/10.1055/s-2008-1075834
  32. Manktelow RT, Tomat LR, Zuker RM, Chang M. Smile reconstruction in adults with free muscle transfer innervated by the masseter motor nerve: effectiveness and cerebral adaptation. Plast Reconstr Surg 2006;118:885-99.  https://doi.org/10.1097/01.prs.0000232195.20293.bd
  33. Koshima I, Moriguchi T, Soeda S, Hamanaka T, Tanaka H, Ohta S. Free rectus femoris muscle transfer for one-stage reconstruction of established facial paralysis. Plast Reconstr Surg 1994;94:421-30.  https://doi.org/10.1097/00006534-199409000-00001
  34. Zuker RM, Goldberg CS, Manktelow RT. Facial animation in children with Mobius syndrome after segmental gracilis muscle transplant. Plast Reconstr Surg 2000;106:1-9.  https://doi.org/10.1097/00006534-200007000-00002
  35. Biglioli F, Colombo V, Tarabbia F, Pedrazzoli M, Battista V, Giovanditto F, et al. Double innervation in free-flap surgery for long-standing facial paralysis. J Plast Reconstr Aesthet Surg 2012;65:1343-9.  https://doi.org/10.1016/j.bjps.2012.04.030
  36. Kim MJ, Kim HB, Jeong WS, Choi JW, Kim YK, Oh TS. Comparative study of 2 different innervation techniques in facial reanimation: cross-face nerve graft-innervated versus double-innervated free gracilis muscle transfer. Ann Plast Surg 2020;84:188-95.  https://doi.org/10.1097/SAP.0000000000002034
  37. Oh TS, Kim HB, Choi JW, Jeong WS. Facial reanimation with masseter nerve-innervated free gracilis muscle transfer in established facial palsy patients. Arch Plast Surg 2019;46:122-8.  https://doi.org/10.5999/aps.2018.00717
  38. Gire A, Kwok A, Marx DP. PROSE treatment for lagophthalmos and exposure keratopathy. Ophthalmic Plast Reconstr Surg 2013;29:e38-40.  https://doi.org/10.1097/IOP.0b013e3182674069
  39. Kim MJ, Oh TS. Treatment for ophthalmic paralysis: functional and aesthetic optimization. Arch Craniofac Surg 2019;20:3-9.  https://doi.org/10.7181/acfs.2019.00066
  40. Oh TS, Min K, Song SY, Choi JW, Koh KS. Upper eyelid platinum weight placement for the treatment of paralytic lagophthalmos: a new plane between the inner septum and the levator aponeurosis. Arch Plast Surg 2018;45:222-8. https://doi.org/10.5999/aps.2017.01599