Anatomical features of the extensor digitorum brevis muscle as a plastic material in reconstructive surgery of facial paralysis

Relevance. Facial paralysis is a common neurological illnesses of the maxillofacial region. Gold standard of dynamic correction of permanent facial paralysis is gracilis muscle transfer. However, using this flap is impractical or impossible in some cases. There are few domestic and international publications about extensor digitorum brevis muscle for facial reanimation surgery.Purpose. Assessment of muscle variability on the dorsum of the foot; analysis of blood supply and innervation of the extensor digitorum brevis muscle.Materials and methods. Operations performed on 10 unclaimed corpses: dissection of the extensor digitorum brevis muscle, as well as the blood vessels and nerves of the dorsum of the foot. The legal and ethical requirements for such studies were observed planning the design of the study and during work.Results. As a result, in 80% of cases, was found a typical anatomy of muscles, blood vessels, and nerves in the dorsum of the foot. In 10% was found a typical anatomy of muscles and nerves, but there was no lateral tarsal artery – the branch of the dorsal artery of the foot. Blood supply to the extensor digitorum brevis muscle performed by perforating branches of the peroneal artery. In 10% was found subtotal atrophy and fibrous degeneration of the extensor digitorum brevis muscle.Conclusions. The use of the extensor digitorum brevis muscle is a perspective method for the treatment of facial paralysis. Harvesting of this flap is complicated.

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Neuroanatomy of Extensor Digitorum Brevis Muscle for Reanimation of Facial Paralysis

Journal of Craniofacial Surgery ◽

10.1097/scs.0b013e318232a806 ◽

2011 ◽

Vol 22 (6) ◽

pp. 2308-2311 ◽

Cited By ~ 3

Author(s):

Murat Şahin Alagöz ◽

Aybala Neslihan Alagöz ◽

Ayhan Comert

Keyword(s):

Facial Paralysis ◽

Extensor Digitorum ◽

Extensor Digitorum Brevis

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Innervation of endoneurial microvessels in human sural nerve

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100125002 ◽

1992 ◽

Vol 50 (1) ◽

pp. 920-921

Author(s):

John L. Beggs ◽

Peter C. Johnson ◽

Astrid G. Olafsen ◽

C. Jane Watkins

Keyword(s):

Blood Flow ◽

Blood Vessels ◽

Blood Supply ◽

Peripheral Nerves ◽

Sural Nerve ◽

Nerve Fibers ◽

Arterial Supply ◽

Autonomic Nerve ◽

Vasa Nervorum ◽

Endoneurial Blood Flow

The blood supply (vasa nervorum) to peripheral nerves is composed of an interconnected dual circulation. The endoneurium of nerve fascicles is maintained by the intrinsic circulation which is composed of microvessels primarily of capillary caliber. Transperineurial arterioles link the intrinsic circulation with the extrinsic arterial supply located in the epineurium. Blood flow in the vasa nervorum is neurogenically influenced (1,2). Although a recent hypothesis proposes that endoneurial blood flow is controlled by the action of autonomic nerve fibers associated with epineurial arterioles (2), our recent studies (3) show that in addition to epineurial arterioles other segments of the vasa nervorum are also innervated. In this study, we examine blood vessels of the endoneurium for possible innervation.

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Pseudohypertrophy of the Extensor Digitorum Brevis in diabetic polyneuropathy

Muscle & Nerve ◽

10.1002/mus.27377 ◽

2021 ◽

Author(s):

Pierre R. Bourque ◽

Kawan S. Rakhra ◽

Jocelyn Zwicker ◽

Catherine E. Pringle ◽

Jodi Warman‐Chardon

Keyword(s):

Diabetic Polyneuropathy ◽

Extensor Digitorum ◽

Extensor Digitorum Brevis

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Facial Reanimation of Patients With Neurofibromatosis Type 2

Operative Neurosurgery ◽

10.1227/neu.0b013e31823a819f ◽

2011 ◽

Vol 70 (suppl_2) ◽

pp. ons237-ons243 ◽

Cited By ~ 2

Author(s):

Kalpesh T. Vakharia ◽

Doug Henstrom ◽

Scott R. Plotkin ◽

Mack Cheney ◽

Tessa A. Hadlock

Keyword(s):

Facial Paralysis ◽

Neurofibromatosis Type ◽

Neurofibromatosis Type 2 ◽

Gracilis Muscle ◽

Single Stage ◽

Care Plan ◽

Muscle Transfer ◽

Facial Reanimation ◽

Oral Commissure

ABSTRACT BACKGROUND: Neurofibromatosis type 2 (NF2) is a tumor suppressor syndrome defined by bilateral vestibular schwannomas. Facial paralysis, from either tumor growth or surgical intervention, is a devastating complication of this disorder and can contribute to disfigurement and corneal keratopathy. Historically, physicians have not attempted to treat facial paralysis in these patients. OBJECTIVE: To review our clinical experience with free gracilis muscle transfer for the purpose of facial reanimation in patients with NF2. METHODS: Five patients with NF2 and complete unilateral facial paralysis were referred to the facial nerve center at our institution. Charts and operative reports were reviewed; treatment details and functional outcomes are reported. RESULTS: Patients were treated between 2006 and 2009. Three patients were men and 2 were women. The age of presentation of debilitating facial paralysis ranged from 12 to 50 years. All patients were treated with a single-stage free gracilis muscle transfer for smile reanimation. Each obturator nerve of the gracilis was coapted to the masseteric branch of the trigeminal nerve. Measurement of oral commissure excursions at rest and with smile preoperatively and postoperatively revealed an improved and nearly symmetric smile in all cases. CONCLUSION: Management of facial paralysis is oftentimes overlooked when defining a care plan for NF2 patients who typically have multiple brain and spine tumors. The paralyzed smile may be treated successfully with single-stage free gracilis muscle transfer in the motivated patient.

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Painful extensor digitorum brevis manus muscle

The Journal Of Hand Surgery ◽

10.1016/0363-5023(89)90190-1 ◽

1989 ◽

Vol 14 (4) ◽

pp. 674-678 ◽

Cited By ~ 10

Author(s):

Mukund R. Patel ◽

Shekhar S. Desai ◽

Lynn Bassini-Lipson ◽

Tatsuji Namba ◽

J. Sahoo

Keyword(s):

Extensor Digitorum ◽

Extensor Digitorum Brevis

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Isolated flexor muscles of the little toe in the feet of an individual with atrophied or lacking 4th head of the M. extensor digitorum brevis and lacking the 4th tendon of the M. extensor digitorum longus

Annals of Anatomy - Anatomischer Anzeiger ◽

10.1016/s0940-9602(03)80017-1 ◽

2003 ◽

Vol 185 (1) ◽

pp. 81-84 ◽

Cited By ~ 6

Author(s):

Horst Claassen ◽

Andreas Wree

Keyword(s):

Extensor Digitorum Longus ◽

Extensor Digitorum ◽

Flexor Muscles ◽

Extensor Digitorum Brevis

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20 The Extensor Digitorum Brevis Manus Muscle

Clinical Orthopaedics and Related Research ◽

10.1097/00003086-196300280-00021 ◽

1963 ◽

Vol &NA; (28) ◽

pp. 210???212 ◽

Cited By ~ 1

Author(s):

CAPTAIN ADOLPHUS W. DUNN ◽

LIEUTENANT CHARLES M. EVARTS

Keyword(s):

Extensor Digitorum ◽

Extensor Digitorum Brevis

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A Critical Assessment and Review of Artificial Intelligence in Facial Paralysis Analysis: Uncovering the Truth

FACE ◽

10.1177/27325016211022805 ◽

2021 ◽

pp. 273250162110228

Author(s):

David T. Mitchell ◽

David Z. Allen ◽

Matthew R. Greives ◽

Phuong D. Nguyen

Keyword(s):

Artificial Intelligence ◽

Facial Paralysis ◽

Critical Assessment ◽

Facial Emotion ◽

Data Systems ◽

Computer Algorithms ◽

Future Directions ◽

Sample Data ◽

Before And After ◽

Facial Reanimation

Machine learning is a rapidly growing subset of artificial intelligence (AI) which involves computer algorithms that automatically build mathematical models based on sample data. Systems can be taught to learn from patterns in existing data in order to make similar conclusions from new data. The use of AI in facial emotion recognition (FER) has become an area of increasing interest for providers who wish to quantify facial emotion before and after interventions such as facial reanimation surgery. While FER deep learning algorithms are less subjective when compared to layperson assessments, the databases used to train them can greatly alter their outputs. There are currently many well-established modalities for assessing facial paralysis, but there is also increasing interest in a more objective and universal measurement system to allow for consistent assessments between practitioners. The purpose of this article is to review the development of AI, examine its existing uses in facial paralysis assessment, and discuss the future directions of its implications.

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