Department of Plastic and Reconstructive Surgery, Clínica Universidad de Navarra, C/ Pío XII 36, 31008 Pamplona, Spain.
Department of Plastic and Reconstructive Surgery, Clínica Universidad de Navarra, C/ Pío XII 36, 31008 Pamplona, Spain.
J Plast Reconstr Aesthet Surg. 2022 Feb;75(2):767-772. doi: 10.1016/j.bjps.2021.09.046. Epub 2021 Oct 22.
Masseteric nerve transposition has shown to be an effective technique for the treatment of facial paralysis. Due to its low morbidity at the donor site, its consistent anatomy, and one-stage operation, it constitutes a reliable option for both complete and incomplete facial paralysis. Masseteric nerve transference has proven to achieve good commissural excursion and dynamic symmetry. However, some patients with heavy faces and complete facial paralysis recover incompletely after surgery characterized by an asymmetrical smile with asymmetry at rest, affecting the cosmetic appearance. For these patients, we propose a novel combination of masseteric nerve transposition for the dynamic rehabilitation of the smile with a tendon sling suspension to create symmetry at rest. A detailed description of the surgical technique is given and results after using it with eight patients show good functional and aesthetic satisfaction. A combination of both dynamic and static techniques for complete facial paralysis rehabilitation may provide adequate symmetry with the contralateral healthy side both at rest and when smiling.
咬肌神经移位已被证明是治疗面瘫的有效技术。由于供体部位的发病率低、解剖结构一致且为一次性手术，因此对于完全性和不完全性面瘫都是可靠的选择。咬肌神经转移已被证明可实现良好的口角偏移和动态对称。然而，一些面部较宽和完全面瘫的患者手术后恢复不完全，表现为不对称的微笑，休息时不对称，影响美观。对于这些患者，我们提出了一种新的组合方案，即通过咬肌神经移位进行动态微笑康复，并使用腱索悬吊来实现休息时的对称。本文详细描述了该手术技术，并用 8 例患者的结果表明，该技术具有良好的功能和美学满意度。对于完全性面瘫的康复，将动态和静态技术相结合，可能会使患侧在休息和微笑时与健侧达到足够的对称。
