Faris Callum, Heiser Alyssa, Hadlock Tessa, Jowett Nate
Department of Facial Plastic Reconstructive Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
Head Neck. 2018 Mar;40(3):561-568. doi: 10.1002/hed.25022. Epub 2017 Nov 20.
The purpose of this study was to characterize the outcomes of free gracilis muscle transfer for delayed smile reanimation after radical parotidectomy.
A retrospective chart review of patients who underwent free gracilis muscle transfer for smile reanimation after radical parotidectomy between 2003 and 2016 was performed. Patient-reported quality of life (Facial Clinimetric Evaluation Scale [FaCE]), physician-reported facial function ("eFACE" facial grading scale), and oral commissure excursion were compared preoperatively and postoperatively.
Twelve patients were identified with prior surgery and adjuvant therapy (radiotherapy in 6 cases and chemoradiotherapy in 6 cases). Significant postoperative improvements were demonstrated for ipsilateral commissure excursion with smile (preoperatively: -2.2 mm [SD 2.3 mm] vs postoperatively: 7.9 mm [SD 2.5 mm]; P = .002), with meaningful smile achieved in 11 of 12 cases (91.7%). The average duration of facial paralysis before intervention was 72 months (range 12-204 months).
Free gracilis muscle transfer is an option for dynamic smile reanimation in select patients who have undergone treatment for advanced parotid malignancy.
本研究旨在描述在根治性腮腺切除术后进行游离股薄肌转移以延迟微笑重建的效果。
对2003年至2016年间因根治性腮腺切除术后进行微笑重建而接受游离股薄肌转移的患者进行回顾性病历审查。比较术前和术后患者报告的生活质量（面部临床测量评估量表[FaCE]）、医生报告的面部功能（“eFACE”面部分级量表）和口角偏移情况。
确定了12例曾接受过手术和辅助治疗的患者（6例接受放疗，6例接受放化疗）。术后同侧微笑时口角偏移有显著改善（术前：-2.2毫米[标准差2.3毫米]，术后：7.9毫米[标准差2.5毫米]；P = 0.002），12例中有11例（91.7%）实现了有意义的微笑。干预前面瘫的平均持续时间为72个月（范围12 - 204个月）。
对于接受过晚期腮腺恶性肿瘤治疗的特定患者，游离股薄肌转移是动态微笑重建的一种选择。
