Synkinetic Unilateral Lower Lip Palsy: Diagnosis and Technical Considerations for Facial Reanimation

The versatile melolabial flap

Otolaryngology ◽

10.1177/019459988910700602.1 ◽

1992 ◽

Vol 107 (6_part_1) ◽

pp. 721-726 ◽

Cited By ~ 13

Author(s):

R. A. L. Younger

Keyword(s):

Statistical Analysis ◽

Lower Lip ◽

Regional Anatomy ◽

Flap Viability ◽

History Of ◽

Versatile Technique ◽

Methods Of Reconstruction ◽

Technical Considerations

The melolabial flap Is a versatile technique for reconstruction of defects of the central face. Variations of this flap may be used to reconstruct the lower eyelids, the nose, the upper and lower lip, chin, and malar regions. Regional anatomy, Indications, technical considerations, and avoidance of complications are discussed on the basis of 10 bilateral cadaver dissections of the melolabial area, In conjunction with 70 reconstructive cases that used this flap. Statistical analysis of the results reveals that flap viability is compromised by previous radiation and smoking. Consequently, alternate methods of reconstruction of the central face should be used in patients who have a history of these problems.

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Pediatric facial reanimation: An algorithmic approach and systematic review

Archives of Plastic Surgery ◽

10.5999/aps.2020.00710 ◽

2020 ◽

Vol 47 (5) ◽

pp. 382-391

Author(s):

Paul J. Deramo ◽

Matthew R. Greives ◽

Phuong D. Nguyen

Keyword(s):

Facial Palsy ◽

Clinical Presentation ◽

Growth Potential ◽

Algorithmic Approach ◽

Facial Reanimation ◽

Surgical Options ◽

Tailored Approach ◽

And Function ◽

Technical Considerations ◽

Future Growth

Facial palsy has a broad clinical presentation and the effects on psychosocial interaction and facial functions can be devastating. Pediatric facial palsy, in particular, introduces unique familial and technical considerations as anatomy, future growth potential, and patient participation influence treatment planning. Though some etiologies of pediatric facial palsy are self-limiting, congenital and long-standing facial palsies pose difficult challenges that require a combination of surgical, adjunctive, and rehabilitative techniques to achieve facial reanimation. Given the spectrum of ages and symptom severity, as well as the various surgical options available for facial palsy, a tailored approach needs to be developed for each child to restore facial balance and function. Here, we review the etiologies, workup, and treatment of pediatric facial palsy and present our novel algorithmic approach to treatment.

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Simultaneous Reconstruction of the Lower Lip with Gracilis Functioning Free Muscle Transplantation for Facial Reanimation

Plastic & Reconstructive Surgery ◽

10.1097/prs.0000000000004849 ◽

2018 ◽

Vol 142 (5) ◽

pp. 1307-1317 ◽

Cited By ~ 5

Author(s):

Jerry Tsung-Kai Lin ◽

Johnny Chuieng-Yi Lu ◽

Tommy Nai-Jen Chang ◽

David Chwei-Chin Chuang

Keyword(s):

Lower Lip ◽

Muscle Transplantation ◽

Simultaneous Reconstruction ◽

Facial Reanimation ◽

Free Muscle Transplantation

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Technical considerations of the latissimus dorsi muscle flap: A segmentally innervated muscle transfer for facial reanimation

Microsurgery ◽

10.1002/micr.1920090112 ◽

1988 ◽

Vol 9 (1) ◽

pp. 36-45 ◽

Cited By ~ 29

Author(s):

Susan E. Mackinnon ◽

A. Lee Dellon

Keyword(s):

Latissimus Dorsi ◽

Muscle Flap ◽

Latissimus Dorsi Muscle ◽

Muscle Transfer ◽

Latissimus Dorsi Muscle Flap ◽

Dorsi Muscle ◽

Facial Reanimation ◽

Technical Considerations

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Dual-innervated multivector muscle transfer using two superficial subslips of the serratus anterior muscle for long-standing facial paralysis

Archives of Plastic Surgery ◽

10.5999/aps.2020.01599 ◽

2021 ◽

Vol 48 (3) ◽

pp. 282-286

Author(s):

Hisashi Sakuma ◽

Ichiro Tanaka ◽

Masaki Yazawa ◽

Anna Oh

Keyword(s):

Facial Paralysis ◽

Voluntary Contraction ◽

Serratus Anterior Muscle ◽

Upper Lip ◽

Muscle Transfer ◽

Serratus Anterior ◽

Lower Lip ◽

Fascia Lata Graft ◽

Facial Reanimation ◽

Double Muscle

Recent reports have described several cases of double muscle transfers to restore natural, symmetrical smiles in patients with long-standing facial paralysis. However, these complex procedures sometimes result in cheek bulkiness owing to the double muscle transfer. We present the case of a 67-year-old woman with long-standing facial paralysis, who underwent two-stage facial reanimation using two superficial subslips of the serratus anterior muscle innervated by the masseteric and contralateral facial nerves via a sural nerve graft. Each muscle subslip was transferred to the upper lip and oral commissures, which were oriented in different directions. Furthermore, a horizontal fascia lata graft was added at the lower lip to prevent deformities such as lower lip elongation and deviation. Voluntary contraction was noted at roughly 4 months, and a spontaneous smile without biting was noted 8 months postoperatively. At 18 months after surgery, the patient demonstrated a spontaneous symmetrical smile with adequate excursion of the lower lip, upper lip, and oral commissure, without cheek bulkiness. Dual-innervated muscle transfer using two multivector superficial subslips of the serratus anterior muscle may be a good option for long-standing facial paralysis, as it can achieve a symmetrical smile that can be performed voluntarily and spontaneously.

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