The Sternohyoid Muscle Flap for New Dynamic Facial Reanimation Technique: Anatomical Study and Clinical Results

2021 ◽  
Author(s):  
Carmen Higueras Suñé ◽  
Cristian Carrasco López ◽  
Paloma Malagón López ◽  
Oihane García Senosiain ◽  
María Del Río Escribano ◽  
...  
Keyword(s):  
Muscle Flap ◽  
Anatomical Study ◽  
Clinical Results ◽  
Facial Reanimation

scholarly journals First Lumbrical Muscle Flap for Recurrence of Carpal Tunnel Syndrome: Anatomical Study and Surgical Technique

2021 ◽  
Vol 49 (01) ◽  
pp. 079-087
Author(s):  
Esther Fernández Tormos ◽  
Fernando Corella Montoya ◽  
Blanca Del Campo Cereceda ◽  
Montserrat Ocampos Hernández ◽  
Teresa Vázquez Osorio ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Revision Surgery ◽  
Muscle Flap ◽  
Anatomical Study ◽  
Physical Barrier ◽  
Adjacent Structures ◽  
Tunnel Syndrome ◽  
Lumbrical Muscle

AbstractRecurrence of carpal tunnel syndrome implies the reappearance of symptoms after release surgery. If the cause of recurrence is not an incomplete release, but a traction neuritis, the tendency is to add to the revision surgery of the carpal tunnel the use of flaps to cover the median nerve. These flaps establish a physical barrier between the nerve and the rest of the adjacent structures, preventing adhesions, and providing neovascularization and better nerve sliding.In the present work, we detail a revision surgery in which the first lumbrical muscle is used as a covering flap. This flap has two benefits. Firstly, it acts as a vascularized coverage for the median nerve (avoiding the formation of fibrosis and favoring its sliding); secondly, a structure that takes up space is removed from the carpal tunnel, thus reducing the pressure within it.Along with the explanation of the technique, the present article provides a detailed description of the anatomical variability of the first lumbrical muscle and its vascularization, as well as the results of a cadaveric study on the location of the vascular pedicle of the first lumbrical muscle.

Anatomical study of the zygomatic and buccal branches of the facial nerve: Application to facial reanimation procedures

2019 ◽  
Vol 32 (4) ◽  
pp. 480-488 ◽  
Author(s):  
Andreas Kehrer ◽  
Simon Engelmann ◽  
Marc Ruewe ◽  
Sebastian Geis ◽  
Christian Taeger ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Anatomical Study ◽  
Facial Reanimation ◽  
Buccal Branches

scholarly journals The Vascular Basis of the Pronator Quadratus Muscle Flap and Its Use in Clinical Cases

2020 ◽  
Author(s):  
Binu P. Thomas ◽  
Sasi P. Kiran ◽  
Maolin Tang ◽  
Christopher R. Geddes ◽  
Steven F. Morris
Keyword(s):  
Muscle Flap ◽  
Anatomical Study ◽  
Vascular Supply ◽  
Soft Tissue Reconstruction ◽  
Pronator Quadratus ◽  
India Ink ◽  
Pedicle Length ◽  
Human Cadavers ◽  
The Mean ◽  
Pronator Quadratus Muscle

AbstractBackground Pronator quadratus (PQ) is a deeply situated muscle in the forearm which may occasionally be utilized for soft-tissue reconstruction. The purpose of this anatomical and clinical study was to confirm vascular supply of PQ muscle (PQM) in order to optimize its transfer and confirm its utility in clinical situations. Methods In Part A of the anatomical study, fresh human cadavers (n = 7) were prepared with an intra-arterial injection of lead oxide and gelatin solution, and PQM and neurovascular pedicle were dissected (n = 14). In the anatomical study Part B, isolated limbs of embalmed human cadavers (n = 12) were injected with India ink-gelatin mixture and PQ were dissected.Results PQ is a type II muscle flap, with one major pedicle, the anterior interosseous (AI) vessels and two minor pedicles from the radial and ulnar vessels. The mean dimensions of the muscle were 5.5 × 5.0 × 1.0 cm3, mean pedicle length was 9.6 cm, and the mean diameter of the artery and the vein was 2.3 mm and 2.8 mm, respectively. The dorsal cutaneous perforating branch (DPB) of the artery supplied the skin over the dorsal forearm and wrist. This branch also anastomosed with the 1, 2 intercompartmental supraretinacular artery (ICSRA). Conclusion This study confirms the potential utility and vascular basis of the PQM flap and its associated cutaneous paddle.In the clinical part, two patients with nonhealing wounds exposing the median nerve and flexor tendons in the distal forearm were treated using the PQM flap with good results.

scholarly journals An Anatomical study for localisation of Zygomatic branch of Facial nerve and Masseteric nerve – An aid to nerve coaptation for facial reanimation surgery: A cadaver based study in Eastern India

2017 ◽  
Vol 50 (01) ◽  
pp. 074-078
Author(s):  
Ratnadeep Poddar ◽  
Alipta Bhattacharya ◽  
Iman Sinha ◽  
Asis Kumar Ghosal
Keyword(s):  
Facial Nerve ◽  
Reference Point ◽  
Copper Wire ◽  
Anatomical Study ◽  
Cross Sectional Study ◽  
Reference Points ◽  
Circular Area ◽  
Cross Sectional ◽  
Facial Reanimation ◽  
Masseteric Nerve

ABSTRACT Context: In cases of chronic facial palsy, where direct neurotisation is possible, ipsilateral masseteric nerve is a very suitable motor donor. We have tried to specifically locate the masseteric nerve for this purpose. Aims: Describing an approach of localisation and exposure of both the zygomatic branch of Facial nerve and the nerve to masseter, with respect to a soft tissue reference point over face. Settings and Design: Observational cross sectional study, conducted on 12 fresh cadavers. Subjects and Methods: A curved incision was given, passing about 0.5cms in front of the tragal cartilage. A reference point “R” was pointed out. The zygomatic branch of facial nerve and masseteric nerve were dissected out and their specific locations were recorded from fixed reference points with help of copper wire and slide callipers. Statistical Analysis Used: Central Tendency measurements and Unpaired “t” test. Results: Zygomatic branch of the Facial nerve was located within a small circular area of radius 1 cm, the centre of which lies at a distance of 1.1 cms (±0.4cm) in males and 0.2cm (±0.1cm) in females from the point, ‘R’, in a vertical (coronal) plane. The nerve to masseter was noted to lie within a circular area of 1 cm radius, the centre of which was at a distance of 2.5cms (±0.4cm) and 1.7cms (±0.2cm) from R, in male and female cadavers, respectively. Finally, Masseteric nerve's depth, from the masseteric surface was found to be 1cm (±0.1cm; male) and 0.8cm (±0.1cm; female). Conclusions: This novel approach can reduce the post operative cosmetic morbidity and per-operative complications of facial reanimation surgery.

scholarly journals Distally Based Pedicled Flexor Carpi Ulnaris Muscle Flap: An Anatomical Study and Clinical Application

Hand ◽  
2018 ◽  
Vol 14 (1) ◽  
pp. 121-126
Author(s):  
Kai Yang ◽  
David Rivedal ◽  
Lucas Boehm ◽  
Ji-Geng Yan ◽  
James Sanger ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Median Nerve ◽  
Average Distance ◽  
Muscle Flap ◽  
Anatomical Study ◽  
Ulnar Artery ◽  
Soft Tissue Coverage ◽  
Ulnar Styloid ◽  
Flexor Carpi Ulnaris ◽  
Distally Based

Background: Proximally based, pedicled flexor carpi ulnaris (FCU) muscle flap has been described previously for soft tissue coverage of the proximal forearm and elbow. No studies have been done on the distal muscular perforators and its use as a distally based flap. Methods: Ten fresh-frozen cadaveric dissections were done. Specimens were injected with latex to facilitate identification of the perforators. Distal muscular perforators were dissected and distances of the pedicles from the distal wrist crease and ulnar styloid were measured and recorded. A clinical case is also presented where a distally based FCU muscle flap was used for coverage in a patient with median nerve neuroma. Results: A distal muscular perforator and a second more proximal perforator were identified in all specimens. The average distance from the most distal muscular perforator to the ulnar styloid was 3.0 cm. The average distance to the wrist crease was 4.6 cm. The more proximal perforators had an average distance to the ulnar styloid and wrist crease of 7.3 cm and 8.8 cm, respectively. At 7 months post-op, the patient who underwent median nerve neurolysis and coverage with pedicled FCU flap had much improved sensation, with complete resolution of pain and tingling, and without any functional deficits. Conclusions: The use of a distally based FCU muscle flap is a good option for soft tissue coverage of the distal forearm, wrist, and hand. The distal muscular perforators from the ulnar artery exhibit a relatively consistent anatomy.

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