The evaluation of the effect of free gracilis muscle transfer on cheek tone and oral competence in long‐standing facial paralysis of patients by using Blasco index

Purpose Smile and eyelid reanimation are generally emphasized in facial reanimation, but the loss of cheek tone provided by the buccinator muscle is not adequately addressed. The use of free gracilis muscle flap for facial reanimation has become widespread since it was used in head and neck reconstr...

Full description

Saved in:
Bibliographic Details
Published in:Microsurgery 2023-05, Vol.43 (4), p.325-330
Main Authors: Bali, Zülfükar Ulaş, Tuluy, Yavuz, Özkaya Ünsal, Merve, Parspancı, Aziz, Yoleri, Levent, Keçeci, Yavuz
Format: Article
Language:English
Subjects:
Adult
Cheek
Cheek - surgery
Classification
Complications
Evaluation
Eyelid
Facial paralysis
Facial Paralysis - complications
Facial Paralysis - surgery
Female
Gracilis Muscle - transplantation
Humans
Lip
Male
Maxillofacial surgery
Middle Aged
Muscles
Nerve Transfer - methods
Nerves
Paralysis
Plastic Surgery Procedures
Restoration
Saliva
Smiling - physiology
Statistical analysis
Surgical Flaps - surgery
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose Smile and eyelid reanimation are generally emphasized in facial reanimation, but the loss of cheek tone provided by the buccinator muscle is not adequately addressed. The use of free gracilis muscle flap for facial reanimation has become widespread since it was used in head and neck reconstruction by Harii et al. The effect of free gracilis muscle transfer on drooling is not clearly defined in the literature. In our study, we aimed to evaluate the effect of free gracilis muscle transfer on drooling in patients with facial paralysis (FP) by using Blasco index. Smile function was overemphasized in the literature, but drooling was not evaluated. What happens to drooling after free functional muscle transfer was not clear, so this study was designed to evaluate improvement in drooling. Patients and Methods Drooling and smile were evaluated in 11 patients (4 male, 7 female) who underwent facial reanimation with a free functional gracilis muscle transfer (FFGMT), in long‐standing FP. The mean age was 39.9 years (range 22–56 years). Etiology was idiopathic in two patients, trauma in five patients, and intracranial tumor in four patients. Photographs and video recordings were taken preoperatively and at the first year postoperatively. The muscle was stitched to the upper lip, corner of the mouth, lower lip and the preauricular region. Masseteric nerve was preferred as donor nerve. Smile restoration was evaluated according to the five‐stage classification defined by Terzis and Noah. Results Flap dimensions differed from 12 cm× 5 cm to 15 cm× 6 cm. Oral intake was stopped for 5 days, and speaking was restricted postoperatively. Patients exercised for about 1 h starting from the postoperative third month. Patients were followed up for an average of 26.5 (14–48) months postoperatively. Postop courses were uneventful, and we did not observe any complications in these patients. Preoperative Blasco index score was 3 in 6 patients, 2 in 5 patients and the mean scores were 2.54 ± 0.52. Patients were followed for 1 year. No drooling was observed in the postoperative first year. The Blasco index score was 0 for all patients. The decrease in postoperative scores was found to be statistically significant (p 
ISSN:0738-1085
1098-2752
DOI:10.1002/micr.30976