One-stage microneurovascular free abductor hallucis muscle transplantation for reanimation of facial paralysis.

We introduce a new method using abductor hallucis muscle free transplantation for reanimation of the cheek with long-standing facial palsy in six young patients. The muscle is used to reanimate facial palsy because it has many unique advantages: (1) appropriate size and shape of the muscle and adequate bulk, (2) closely parallel alignment and unvaried anatomy of the main vessels and nerve distribution to the muscle, (3) a long neurovascular pedicle, (4) easy surgical isolation of the muscle and its neurovascular pedicle, and (5) no functional deficit after muscle removal. The nerve and muscle grafts can be performed by microneurovascular anastomosis in one surgical procedure. The follow-up period was over 1 year. A satisfactory result was obtained in five of six patients.