[Prospective study on the treatment of facial palsy with dynamic free muscle transplantation]

Abstract

In this prospective study, patients were randomly divided into 3 groups according to 3 different operation procedures used to correct facial palsy with microneurovascular anastomosed muscle transplantation: In group 1, 9 patients accepted cross face transplantation of segmental latissimus dorsi muscle flap with super-long neurovascular pedicle, through upper labial tunnel, anastomosed in normal face (one stage method); In group 2, 7 patients accepted cross face nerve graft and secondary free muscle transplantation by neurovascular anastomoses in paralyzed face (two stage method); In group 3, 5 patients, free muscle transplantation by microneurovascular anastomosis in paralyzed face. The appreciation for the results was carried out in 16 patients who had been followed-up more than 1 year. In terms of functional recovery, the success rate ranged in excellent and good reached 93.8%. There were not significant differences among groups. The patients of less than 40-year-old got better results and the correlation between operative effects and both cause and course of disease could not be found. It was considered that the nerve regeneration speed and quality in one stage method were better than sural nerve graft with small saphenous vein anastomosis, because physiological blood supply was kept well along the nerve pedicle and regenerating nerve fibers need not pass through two suture sites. Patients satisfied the results after the swelling was gone because one stage method had the advantages of face lift and selective neurotomy at the same time. The course of treatment was shortened significantly as well.