A contribution to the treatment of permanent facial paralysis by free muscle grafting based on 21 cases

R. F. Mazzola, A. R. Antonelli

Research output: Contribution to journalArticle

Abstract

Twenty-one patients with unilateral permanent facial palsy were treated by free muscle grafting following Thompson's technique. Cases were divided into three groups according to the surgical procedure used and to the muscles transplanted. The muscle used was the extensor digitorum brevis of the foot for the 10 cases of group 1; the palmaris longus of the forearm for the 10 cases of group 2; the extensor digitorum brevis and the palmaris longus of the forearm for the case of group 3. In the patients of group 2 and 3 face-lifting was added to the standard Thompson procedure, in order to correct the relaxation of the soft tissue of the face on the paralysed side. In the subject of group 3, moreover, an upper based pedicle flap from the masseter muscle was rotated and fixed to the orbicularis oris muscle on the paralysed side, to improve smiling movements. Follow-up ranged from 6 months to 2 years. EMG activity of the grafts was recorded at 4, 6 and 12 months postoperatively. In 5 cases biopsy of the muscle grafts was taken 8 to 24 months after the transplants and histological as well as histochemical studies were carried out. Overall analysis of results leads the authors to point out that even though the muscle transplants survive, their function is mainly limited to the restoration of the sphincteric mechanisms of the eyelids and lips. On the other hand, the static as well as cosmetic appearance of the face is generally improved, especially when a face-lifting is added. Best results in the correction of unilateral permanent facial palsy may at present be achieved by combining face-lifting and rotation of a masseter muscle pedicle flap to the Thompson procedure.

Original languageEnglish
Pages (from-to)59-74
Number of pages16
JournalChirurgia Plastica
Volume3
Issue number2
DOIs
Publication statusPublished - 1975

Fingerprint

Facial Paralysis
Muscles
Transplants
Masseter Muscle
Forearm
Therapeutics
Smiling
Eyelids
Lip
Cosmetics
Foot
Biopsy

ASJC Scopus subject areas

  • Surgery

Cite this

A contribution to the treatment of permanent facial paralysis by free muscle grafting based on 21 cases. / Mazzola, R. F.; Antonelli, A. R.

In: Chirurgia Plastica, Vol. 3, No. 2, 1975, p. 59-74.

Research output: Contribution to journalArticle

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