Microneurovascular Reconstruction for Facial Reanimation

2019 ◽  
pp. 393-402
Author(s):  
Michael Klebuc
Keyword(s):  
Sural Nerve ◽  
Motor Nerve ◽  
Muscle Flap ◽  
Nerve Graft ◽  
Muscle Flaps ◽  
Nerve Grafts ◽  
Free Muscle Flap ◽  
Graft Harvest ◽  
Facial Reanimation ◽  
Sural Nerve Graft

Microneurovascular muscle flaps can be effectively employed to reanimate the paralyzed mid-face. This chapter explores the indications and contraindications for free muscle flap smile restoration. Various sources of innervation are examined including the motor nerve to masseter and cross-face nerve grafts, as are different muscle flap donor sites. A detailed description of facial nerve exploration, sural nerve graft harvest, and the cross-face nerve graft procedure are provided. Single and two-staged facial reanimation procedures utilizing free gracilis muscle flaps are also described in detail, including technical nuances, postoperative care, and physical therapy. The technique is well suited for individuals whose native muscles of facial expression have failed to develop in utero, undergone irreversible atrophy, sustained significant trauma, or have been sacrificed during oncologic resection.

scholarly journals Per-oral cross-facial sural nerve graft for facial reanimation

2018 ◽  
Vol 40 (1) ◽  
Author(s):  
Joohee Jeong ◽  
Akram Abdo Almansoori ◽  
Hyun-Soo Park ◽  
Soo-Hwan Byun ◽  
Seung-Ki Min ◽  
...  
Keyword(s):  
Sural Nerve ◽  
Nerve Graft ◽  
Facial Reanimation ◽  
Per Oral ◽  
Sural Nerve Graft

scholarly journals Reconstruction of Sciatic Nerve Using Bilateral Vascularized Sural Nerve Grafts: A Case Report

2021 ◽  
Author(s):  
Si-Gyun Roh ◽  
Jae Young Chun ◽  
Nae-Ho Lee ◽  
Jin Yong Shin ◽  
Jong-Lim Kim
Keyword(s):  
Case Report ◽  
Sciatic Nerve ◽  
Peripheral Nerve ◽  
Sural Nerve ◽  
Tumor Resection ◽  
Nerve Graft ◽  
Sensory Function ◽  
Nerve Grafts ◽  
Function Recovery ◽  
Sural Nerve Graft

Injury of peripheral nerve may require reconstruction for motor and sensory function recovery. However, when the nerve defect is long, especially in the lower extremities, reconstruction with successful function recovery proved to be difficult. We documented a case of bilateral vascularized sural nerve graft repair of a large and long sciatic nerve defect following malignant tumor resection on posterior thigh. Although we were unable to achieve satisfactory outcomes in motor function recovery, we did accomplish some sensory function recovery.

Peroneal nerve lesion after sural nerve graft harvest: An unusual complication?case report

Microsurgery ◽  
2005 ◽  
Vol 25 (1) ◽  
pp. 54-56 ◽  
Author(s):  
Heinrich M. Schubert ◽  
Gottfried Wechselberger ◽  
Heribert Hussl ◽  
Thomas Schoeller
Keyword(s):  
Case Report ◽  
Sural Nerve ◽  
Peroneal Nerve ◽  
Nerve Graft ◽  
Unusual Complication ◽  
Nerve Lesion ◽  
Graft Harvest ◽  
Sural Nerve Graft

A randomised comparison of neurotmesis using scissors or a razor blade for sural nerve graft harvest

2016 ◽  
Vol 69 (12) ◽  
pp. 1711-1713
Author(s):  
P.R. Sharma ◽  
A. Rosich-Medina ◽  
M.C. Swan ◽  
P.H. Gillespie ◽  
J.N. Skepper ◽  
...  
Keyword(s):  
Sural Nerve ◽  
Nerve Graft ◽  
Razor Blade ◽  
Graft Harvest ◽  
Sural Nerve Graft

scholarly journals Partial epineural burying of nerve grafts with different sizes next to or distant from neurorrhaphy’s site: histological and electrophysiological studies in rat sciatic nerves

2001 ◽  
Vol 16 (4) ◽  
pp. 187-194
Author(s):  
Marco Túlio Rodrigues da Cunha ◽  
Alcino Lázaro da Silva ◽  
Maria das Graças Reis ◽  
Valdo José Dias da Silva
Keyword(s):  
Nerve Fiber ◽  
Sural Nerve ◽  
Electrophysiological Study ◽  
Nerve Fibers ◽  
Nerve Graft ◽  
Nerve Grafts ◽  
Group 3 ◽  
Sciatic Nerves ◽  
Sural Nerve Graft ◽  
Group 1

The aim of the present study was to compare and correlate histologically and electromyographically the effects of partial epineural burying of sural nerve segments in sectioned and sutured rat sciatic nerves. Sixty adult male Wistar rats were operated on 3 groups: Group 1, sural nerve graft, 9mm long, placed next to neurorrhaphy; Group 2, sural nerve graft, 9mm long, buryied 10mm distant from neurorrhaphy; Group 3, sural nerve graft, 18mm long, set next to neurorrhaphy. The morphological features were examined at light microscope after 3 months in 45 rats. The elements observed were: vascularization, vacuoles in nerve fibers, mastocytes and inflammatory infiltrate. The morphometry was made after 6 months in 15 rats from Group 1, 2 and 3, measuring external nerve fiber diameters and counting myelinated nerve fibers/mm². The electrophysiological study was perfomed after 6 months, registering maximum amplitude and frequency of EMG pontentials, at rest, in extensor digitorum longus muscle. Group 3 rats presented sciatic nerves better conserved morphologically and mean external nerve fiber diameters greater than those from Groups 1 and 2. There were no significant differences in density of nerve fibers/mm², and in the electrophysiological study in rats from Group 1, 2 and 3. The epineural burying of sural nerve grafts with greater length and placed next to the neurorrhaphy’s site had a significantly better regeneration of the histological features than the smaller ones distant from neurorrhaphy.

scholarly journals Long-Term Follow-Up after the Sural Nerve Graft on the Injured Temporal Branch of the Facial Nerve: A Case Report

2018 ◽  
Vol 23 (4) ◽  
pp. 306
Author(s):  
Jeong-Hyun Cheon ◽  
Jae-Ho Chung ◽  
Eul-Sik Yoon ◽  
Byung-Il Lee ◽  
Seung-Ha Park
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Sural Nerve ◽  
Nerve Graft ◽  
Long Term Follow Up ◽  
Sural Nerve Graft

scholarly journals Management of Radial Nerve Lesions after Trauma or Iatrogenic Nerve Injury: Autologous Grafts and Neurolysis

2020 ◽  
Vol 9 (12) ◽  
pp. 3823
Author(s):  
Karl Schwaiger ◽  
Selim Abed ◽  
Elisabeth Russe ◽  
Fabian Koeninger ◽  
Julia Wimbauer ◽  
...  
Keyword(s):  
Radial Nerve ◽  
Sural Nerve ◽  
Nerve Graft ◽  
Nerve Lesion ◽  
Severe Injuries ◽  
Nerve Lesions ◽  
Significant Difference ◽  
Radial Nerve Lesion ◽  
Graft Interposition ◽  
Sural Nerve Graft

Background: Proximal radial nerve lesions located between the brachial plexus and its division into the superficial and deep branches are rare but severe injuries. The majority of these lesions occur in association with humerus fractures, directly during trauma or later during osteosynthesis for fracture treatment. Diagnostics and surgical interventions are often delayed. The best type of surgical treatment and the outcome to be expected often is uncertain. Methods: Twelve patients with proximal radial nerve lesions due to trauma or prior surgery were included in this study and underwent neurolysis (n = 6) and sural nerve graft interposition (n = 6). Retrospective analysis of the collected patient data was performed and the postoperative course was systematically evaluated. The Disabilities of the Arm, Shoulder, and Hand (DASH) and the LSUHS (Louisiana State University Health Sciences) scores were used to determine regeneration after surgery. Comparison between the patients’ and calculated normative DASH scores was performed. Results: All patients had a traumatically or iatrogenically induced proximal radial nerve lesion and underwent secondary treatments. The average time from radial nerve lesion occurrence to surgical intervention was approximately four months (1.5–10 months). Eight patients (66.67%) had a humeral fracture. During follow up, no statistically significant difference between the calculated normative and the patients’ DASH scores was observed. The LSUHS scores were at least satisfactory. Conclusions: Neurolysis or sural nerve graft interposition performed within a specific period of time are the primary treatment options for radial nerve lesions. They should be performed depending on the lesion type. Regeneration to a satisfactory degree was observed in all patients, and the majority achieved full recovery of sensory and motor functions. This was the first study to highlight the efficiency of neurolysis and sural nerve graft interposition as secondary treatment interventions, especially for radial nerve lesions.

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