Recent facial palsies are those in which fibrillations of the mimetic musculature remain detectable by electromyography (EMG). Such fibrillations generally cease 18–24 months after palsy onset. During this period, facial re-animation surgery seeks to supply new neural inputs to the facial nerve. Neural usable sources were divided into qualitative (contralateral facial nerve) and quantitative (hypoglossus and masseteric nerve), depending on the type of stimulus provided. To further improve the extent and quality of facial re-animation, we here describe a new surgical technique featuring triple neural inputs: the use of the masseteric nerve and 30% of the hypoglossus nerve fibres as quantitative sources was associated with the contralateral facial nerve (incorporated via two cross-face nerve grafts) as a qualitative source in order to restore facial movements in 24 consecutive patients. The use of two quantitative motor nerve sources together with a qualitative neural source appears to improve re-animation after facial paralysis, despite earlier doubts as to whether patients could use different nerves to produce facial movements. In fact, movement was much improved. Smiling according to emotions and blinking seem to be better assured if cross-face nerve grafting is performed in two steps rather than one.
Triple innervation for re-animation of recent facial paralysis / Biglioli, Federico; Allevi, Fabiana; Rabbiosi, Dimitri; Cupello, Silvia; Battista, Valeria Marinella August; Saibene, Alberto Maria; Colletti, Giacomo. - In: JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY. - ISSN 1010-5182. - 46:5(2018), pp. 851-857. [10.1016/j.jcms.2018.02.014]
Triple innervation for re-animation of recent facial paralysis
Colletti, Giacomo
2018
Abstract
Recent facial palsies are those in which fibrillations of the mimetic musculature remain detectable by electromyography (EMG). Such fibrillations generally cease 18–24 months after palsy onset. During this period, facial re-animation surgery seeks to supply new neural inputs to the facial nerve. Neural usable sources were divided into qualitative (contralateral facial nerve) and quantitative (hypoglossus and masseteric nerve), depending on the type of stimulus provided. To further improve the extent and quality of facial re-animation, we here describe a new surgical technique featuring triple neural inputs: the use of the masseteric nerve and 30% of the hypoglossus nerve fibres as quantitative sources was associated with the contralateral facial nerve (incorporated via two cross-face nerve grafts) as a qualitative source in order to restore facial movements in 24 consecutive patients. The use of two quantitative motor nerve sources together with a qualitative neural source appears to improve re-animation after facial paralysis, despite earlier doubts as to whether patients could use different nerves to produce facial movements. In fact, movement was much improved. Smiling according to emotions and blinking seem to be better assured if cross-face nerve grafting is performed in two steps rather than one.File | Dimensione | Formato | |
---|---|---|---|
triple innervation.pdf
Accesso riservato
Dimensione
1.88 MB
Formato
Adobe PDF
|
1.88 MB | Adobe PDF | Visualizza/Apri Richiedi una copia |
Pubblicazioni consigliate
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris