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Peripheral Facial Paralysis: Reanimation Techniques. An Overview

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03 October 2024

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04 October 2024

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Abstract
Peripheral facial paralysis represents a disabling condition with serious psychological and social impact. Patients with peripheral facial paralysis have a disfigurement of the face with loss of harmony and symmetry, and difficulties in everyday facial functions such as speaking, drinking, laughing, and closing their eyes, with impairment of their quality of life. This paralysis leads to impairment of facial expression that represents one of the first means of communication, an important aspect of human interaction. This review aims to explore the reanimation techniques for managing peripheral facial paralysis. An analysis of static and dynamic techniques for facial reanimation is provided, including muscle flaps, nerve grafting techniques, and bioengineering solutions. Dynamic techniques, when feasible, enable better outcomes in terms of facial motility, although the long-term rehabilitation and the long learning curve. Static techniques, while less invasive, provide limited functional recovery and should be combined with dynamic strategies for good results. Each technique showed its benefits and drawbacks; despite several options for facial reanimation, no technique has been detected as the gold standard. Therefore, each patient must be evaluated on an individual basis, considering his medical history, age, expectations, and treatment goals to find the best and most fitting treatment for him.
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Subject: Medicine and Pharmacology  -   Otolaryngology

1. Introduction

Peripheral facial paralysis (PFP) consists of the paralysis of one side of the face. Bell’s palsy represents the main cause of PFP [1]. Other causes may be infection, trauma, tumor, surgery [2].
It leads to a change in facial expression, that represents an important form of non-verbal communication. As stated by Rubin, facial expressions are the mirror of our inner emotions [3]. This concept could be summed up in the words of the founder of hand surgery, Sterling Bunnell (1927): “The delicate shades of continence are lost. Joy, happiness, sorrow, shock, surprise, all the emotions have for their common expression the same blank stare”.
Moreover, peripheral facial paralysis causes difficulties in swallowing, drinking and speech and may cause eye problems due to failure to close the eyelid. All these impairments result in a worsening of the quality of life [4]. Therefore, the main goals of facial reanimation surgery are to recover, as much as possible, facial symmetry and tone. So, over the years, different strategies and therapies were attempted and developed to deal with this disability and to try to revive the facial nerve. The first attempt was performed by Sir Balance in 1895. Then, other surgeons tried to develop new surgical strategies. Among the surgical techniques, some aimed to recover the motility of the lower third of the face, others the motility of the upper third of the face, by using local or free muscle flaps. In some cases, where conditions permit, the attempt was made directly on the facial nerve.
The techniques of facial nerve reanimation can be distinguished into static and dynamic. As well explained by McLaughlin (1949), both supports need: static one at rest and dynamic support during facial movement. Obviously, static techniques are easier to perform but cannot ensure the best facial recovery on their own. McLaughlin also suggested preferring static support for the forehead and eyelid and dynamic support for the lower third of face [5]. About dynamic techniques, whenever possible, nerve surgery provides the best results in comparison with muscle transplantation. As stated by Boahene [6], the more time that passes after denervation, the lower the chance of reinnervation and recovery.
This review attempts to summarize what has been studied and researched so far for facial reanimation, with a glance to the future.

2. Facial Nerve Grading System

Many facial nerve classifications could be used: House-Brackmann Grading System (HBGS) [7], the Sunnybrook Facial grading system (SFGS) [8], the Facial Clinimetric Evaluation (FaCE) scale [9], Facial Disability Index (FDI) [10].
HBGS was introduced in 1985 by the Facial Nerve Disorders Committee of the American Academy of Otolaryngology-Head and Neck Surgery. It is performed by the physician who assess facial appearance at rest, its residual movements and synkinesis, if present. Like HBGS, the SFGS, developed by Ross et al. in 1992 [11], evaluates the same parameters in terms of facial symmetry at rest and during movement and synkinesis. FaCE scale consists of 50 items administered to patients to measure the patient’s perception of his facial disability and impairment. Kahn et al. demonstrate that FaCe scale should be used along with physician-grade scales (e.g., HBSG or FGS) to achieve a complete analysis of PFP [9]. FDI is a self-administered test consisting of 10 items that evaluate facial disability and its impact in social life.
However, to date, there is not a gold standard classification. Indeed, the degree of movement impairment or asymmetry could be objectively evaluated, on the contrary the patient’s facial disability is very variable from patient to patient based on different factors, first due to different levels of facial expression. In this regard, in 1974, Rubin [3] stated that the existence of several facial muscles lead to different expressions and defined three main types of smiles: the “Mona Lisa” smile exposing the upper teeth, the “canine” smile showing the canine teeth, and the “full denture” smile showing both upper and lower teeth.

3. Reanimation of Lower Third of Face

Surgery for reanimation of the lower face aims to enable spontaneous smiling as well as volunteer mouth movements, correct swallowing and talking.

3.1. Fascia Lata Graft

As described by McLaughlin [5], the fascia lata graft can be used as a static technique of lower third face reanimation. He considered fascia lata, the iliotibial tract, as the best since it’s flattened and used to tension. The procedure consists of fastening the fascia lata at two points: corner of the mouth and temporal fascia or malar bone. The author suggested the overcorrection since it will disappear once the patient wakes up.

3.2. Lengthening Temporalis Myoplasty

This technique consists in the use of temporalis muscle as graft for the facial reanimation, both for buccal and orbital paralysis. The first surgeons who proposed this technique were Gillies (1934) who used a portion of temporalis muscle [12] and McLaughlin (1946) who suggested using the entire muscle [5], in both cases a fascia lata flap was also needed.
To restore smile, as reported by Labbè et al., the temporalis muscle tendon is transferred from its coronoid process attachment to the labial commissure and sutured to the upper lip levator muscles (e.g., levator labii superioris muscle, alae nasi muscle) [13,14,15]. As explained by Al Khabori et al. [16], attaching the tendon fibers (that correspond to the posterior part of temporalis muscle) to the commissure ensures a horizontal traction vector.
Post-operative complications may be hematoma, infection both on the surgical site and in the temporalis muscle tendon, tendon dehiscence [16]. Rehabilitation usually lasts one year; in the end the patient has a symmetric smile without effort and as well as spontaneous smile in some cases.

3.3. Latissimus Dorsi Muscle Flap

The technique consists of harvesting and splitting the latissimus dorsi muscle flap including the transverse and descendent branches of the thoracodorsal vessels and the thoracodorsal nerve. So, a skin incision is performed about 2 cm beyond the nasolabial fold of the paralyzed side, once the pocket is created, the muscle flaps are placed and anchored to the periosteum of the zygomatic bone. Nerve anastomoses are performed different between the two muscle flaps: the flap placed higher (allowing spontaneous smiling) will be innervated thanks to anastomosis between branch of thoracodorsal nerve and buccal branch of contralateral facial nerve, while the flap placed closer to the corner of the mouth (allowing voluntary smiling) will be innervated by the ipsilateral masseteric motor nerve. Flaps vascularization is achieved thanks to anastomosis between thoracodorsal vessels and facial vessels. This procedure has shown to achieve both spontaneous and voluntary smiling. The authors developed this technique based on previous similar surgeries: neurovascular latissimus dorsi flap innervated by the contralateral facial nerve [17], gracilis muscle flap innervated by the ipsilateral masseteric nerve [18] with or without a second innervation by contralateral facial nerve [19]. The first technique allowed only spontaneous smiling, while the second one allowed only voluntary smiling. the third technique reported by Biglioli et al. [19] resulted in recovery of both spontaneous and voluntary smiling as well as the technique by Okazaki et al. [20]. However, these last authors stated that their procedure has two main advantages: first, it doesn’t need nerve grafting (Biglioli used sural nerve graft) and results are more predictable. About this surgery, Takushima et al. suggest using the ipsilateral trigeminal nerve for the neuroanastomosis instead of contralateral facial nerve in order to reduce the risk of weak cheeks if they are fatty [21].

3.4. Sternohyoid Muscle Flap

First described by Alam et al. [22], the sternohyoid muscle flap represents a valid alternative to gracilis muscle flap in facial nerve reanimation. Indeed, its dimensions are like zygomatic muscle size in comparison with the gracilis that is bigger with consequent facial dysmorphism. Moreover, it has a single pedicle consisting of lingual or superior thyroid artery, branch of jugular vein and the most powerful branch of ansa cervicalis. This flap is sutured to the corner of the mouth and to the zygomatic periosteum and nerval anastomosis is performed with the masseteric nerve. Despite being a small scientific study, Suné et al. [23] demonstrated that this technique enables quite natural facial movement recovery and minimum morbidity to the donor site.

4. Reanimation of Upper Third of Face

Eyelid surgery should have these main goals: narrowing the palpebral fissure to reduce the lagophthalmos, and the risk of epiphora as well as conjunctivitis and corneal ulceration [24].

4.1. Masseter Muscle Flap

Masseter muscle is the main chewing muscle. It can be used for muscle transposition, both for the angle of the mouth and for the canthus of the eye [25,26]. In this latter case, the procedure consists of splitting the muscle belly leading to possible nerve injury. To prevent this complication, Shinohara et al. [27] proposed to elongate the muscle by using the fascia lata. The authors demonstrated the efficiency of this procedure with good outcome and patient satisfaction.

4.2. Lateral Tarsal Strip (LTS)

First described by Anderson et al. [28], the technique consists of a lateral canthotomy and cantholysis and the splitting of the eyelid into posterior and anterior lamellae. After removing a marginal triangular area from the anterior lamella, lateral tarsal strips (upper and lower) are created, sutured together, and anchored to the periosteum, close to the Whitnall tubercle.
This surgery provides many advantages such as: absence of sutures in the marginal lid, no risk of phimosis, reduced risk of laxity of canthal tendon over the time, quick surgery, the preservation of natural canthal angle.
However, in case of laxity of the upper eyelid, this procedure may cause the overlapping of the upper eyelid on the lower one. In this case, the combination with lateral tarsorrhaphy is suggested [29].

4.3. Lateral Tarsorrhaphy

This static procedure is performed to correct the ectropion. It consists of elevating the lower eyelid. However, as stated by Kwon et al., this procedure alone doesn’t ensure good cosmetic results, so the authors suggest performing also lateral tarsal strip [30]. So, after performing the LTS, a portion of the mucocutaneous junction in the upper eyelid is removed and a needle is passed from the tarsal strip to the lateral orbital rim (internal side), just above the canthal tendon insertion and, in the end, sutured to the lateral upper lid margin. This combined technique ensures the correction of ectropion as well as satisfying cosmetic results [31]. However, it may lead to complications such as infection, suture dehiscence, and few cases of phimosis [29].

4.4. Tessier’s Technique

Tessier’s technique (1969) should be performed for the correction of lagophthalmos [32]. The procedure consists in the elongation of the levator muscle of the upper eyelid by interposition of temporal aponeurotic graft to avoid upper eyelid levator muscle weakening [33]. Several studies demonstrated the efficacy of this surgical procedure to achieve the complete or near palpebral closure, in addition to ensure eyesight and good aesthetic results [34,35,36].

4.5. Conchal Cartilage Graft

In this case, under general anesthesia, a graft of conchal cartilage (preferably from the same side as the paralysis) is harvested and placed into the lower eyelid. The perichondrium on one side of the conchal cartilage must be preserved in order to ensure its vascular support. After shaping the graft, it is placed into a pocket created under the tarsus, without sutures. The use of autograft represents an advantage of this procedure as well as the easy harvesting of the graft, the good cosmetic result on the donor site, and the pliability of conchal cartilage compared to septal or costal cartilages. The authors reported only few post-operative complications such as haematoma and slight entropion. The main drawbacks are the possible visibility of the graft in case of thin skin and the need to bend the neck to look down [37].

4.6. Autologous Dermis Graft

A rectangular dermal graft is harvested from the supraclavicular area or iliac crest. The height of the graft must be twice that of retraction of the lower eyelid. The graft is placed and sutured in a pocket between the tarsus and the lower lid retractors.
A recent study compared the two types of autologous grafts: conchal cartilage and dermis [38]. The authors demonstrated that they are both efficient. However, the former is related to risk of donor site complications, e.g., haematoma and keloid. On the contrary, the dermal graft is stiffer and more available. Moreover, it could be harvested together with the fat to compensate for the lower lid lipoatrophy.

5. Nerve Reconstruction

5.1. Trifurcation Approach

Described by Beutner et al. [39], the so-called “trifurcation approach” consists of the use of two nerves: the greater auricular nerve (GAN) and the hypoglossal nerve. This technique is based on previous studies that demonstrated the benefits of GAN as graft in facial nerve reconstruction, sometimes used to cover a gap [40]. However, its enforcement is limited to only one neural branch defect [41]. In these cases, following the “combined approach” by Stennert [42], Beutner et al. suggest using the GAN graft to reanimate the upper face: the trunk of the GAN graft is sutured to the mastoid segment and its branches to temporal and zygomatic branches of facial nerve by end-to-end suture. The hypoglossal nerve is sutured to the marginal branch of the facial nerve by endo-to-side suture, while the descending branch of the hypoglossal nerve is sutured end-to-end to the facial buccal branch. The use of hypoglossal nerve has proven to allow better muscle tone and voluntary movement of the lower midface (e.g., spontaneous smile), without triggering involuntary tongue movements. First described by Korte et al. in 1903 [43], the original end-to-end hypoglossal-facial nerve transfer (HFNT) technique has been revised few times over the years with the suggestion of the partial end-to-end HFNT with or without the use of a bridge graft, the “jump” procedure [44] or the modified partial procedure, respectively [45]. Le Clerc et al. compared these three techniques finding good results in all cases, with the best outcomes in the modified partial procedure [46]. The same results were also found by Venail et al. [47], with only a few cases of tongue hemiparesis. In 2011, Volk et al. [48] attempted facial reconstruction by using the “jump” procedure along with facial nerve interpositional graft. Doing so, they demonstrated a lower incidence of hemitongue hypotrophy as well as lower cases of synkinesis between the lower and the upper face muscles, stressing the importance of the graft. However, regardless of the technique performed, to date the HFNT represents the most used technique.

5.2. Masseteric Nerve Transfer

To avoid the consequences on lingual motility due to HFNT, the masseteric-facial nerve anastomosis was proposed [45,49]. Masseteric nerve is a branch of the trigeminal nerve, and it is easily accessible during the procedure for facial nerve exposure. Once the nerves are accessed, the GAN graft is used to cover the gap between masseteric and facial nerves. Indeed, in case of complete PFP, the masseteric nerve is sutured to the facial nerve trunk by interpositioning of the graft [50,51]. In case of partial facial paralysis, the masseteric nerve could be anastomosed to the zygomatic branch of facial nerve [52]. However, this procedure doesn’t enable the spontaneous smile, but patients achieve facial symmetry and voluntary smile, with minimum donor site aesthetic impairment [53].

5.3. Cross-Face Nerve Grafting

It’s a two-step technique that includes the use of the contralateral facial nerve as donor nerve graft and the harvesting of free flaps (e.g., pectoralis minor, gracilis, latissimus dorsi) in paralyzed side of face [54,55]. This technique, first described by Scaramella et al. (1971) [56] with the use of sural nerve graft, was then modified by Harii et al. (1976) [57] by covering the sural nerve graft with the gracilis muscle. The surgery consists of harvesting the sural nerve graft that is sutured with the zygomatic branch of the contralateral healthy facial nerve and positioned into a pocket created in the gingivobuccal sulcus where the graft is anastomosed with the transected facial nerve. According to the technique described by Peng et al. [58], during the second-stage surgery (about after 6 months), the free edge of the sural nerve (in the gingivobuccal sulcus) is sutured with the obturator nerve of the gracilis free muscle. This procedure has many advantages such as good muscular contraction as well as coordination of oral movements (e.g., smiling) thanks to the control of the same functioning facial nerve. Moreover, it’is related to minor morbidity of the donor site and to a mild risk of lesion of healthy facial nerve during dissection. However, it requires a long learning curve to achieve good results.

5. Future Directions

In the last decades, bioengineering approaches have been proposed to facial nerve reanimation and preclinical studies on animal models have been carried out [59]. In particular, some authors described the use of a silicone conduit embedded with fibroblast growth factor (FGF-2) [60] or adipose stem cells [61] in a rat facial palsy demonstrating the potential regenerative role of the facial nerve. Also, biodegradable conduits (e.g., type I collagen, poly(glycolic acid)) embedded with bone marrow stem cells or adipocytes enable nerve regeneration, with similar results of autologous nerve grafting [62,63]. Three-dimensional (3D) technologies could also be used to customize a nerve guidance conduits (NGCs) [64,65] that integrated with growth factors and/or cells may help nerve repair and recovery.
In 2019, Jowett and his team [66] proposed a new technology consisting of a neuroprosthetic - biocompatible - device (NPD) implanted on the zygomatic region of paralyzed hemiface of the rat that evoke facial movements thank to electromyography signals from epimysial electrode arrays (EEAs) implemented on the contralateral health hemiface. This technology should enable symmetric facial movements and expressions as well as avoid involuntary neural activities that lead to undesirable facial contractions thanks to high frequency alternating current (HFAC).
Another promising device is the electronic pacing, much studied on animals in recent years [67,68]. In 2019, Makela et al. assessed the application of this device on humans [69]. The authors found that this device was able to simultaneously stimulate the frontalis, zygomaticus, orbicularis oculi and orbiculari oris muscles even if the paralysis had occurred several years earlier. Obviously, the muscles should not be completely denervated. The main limit of this device is the pain related to stimulation which was very variable from patient to patient.

6. Discussion

Peripheral facial palsy represents a social stigma. Indeed, PFP causes a disfigurement of the face with loss of harmony and symmetry as well as difficulty in performing daily facial movements and activities. Because of this, since 1895, surgeons attempted to find the best surgical technique that could reanimate the paralyzed facial side. Both static and dynamic strategies have been proposed and performed: the former are easier but with unsatisfactory results, the latter require a long learning curve and more invasive surgeries but the best facial recovery [5]. Reviewing the literature, several treatment options were performed over the years. McLaughlin [5] proposed the fascia lata graft because it’s flat and resistant to tension, however, for the reanimation of the lower third of the face, dynamic techniques are preferred. So, after McLaughlin, other myoplastic surgeries were performed by using temporalis muscle flap [12,13,14,15,16], latissimus dorsi muscle flap [17,18,19,20,21], and sternohyoid muscle flap [22,23]. The first two techniques have been found to be effective in achieving both spontaneous and voluntary smiling, after long rehabilitation (at least one year).
About the upper third of the face, other techniques are attempted: some using muscle flap [25,26,27], others acting on eyelid tarsal plate [28,29,30,31], others on autologous grafts (e.g., conchal cartilage, dermis) [37,38]. All these surgeries are static techniques and have proven effective in narrowing the palpebral fissure to treat the lagophthalmos, and so in avoiding complications such as epiphora, conjunctivitis and corneal ulceration. Obviously, many authors suggest combining static and dynamic techniques, to simultaneously treat both the upper and the lower part of the paralyzed side of the face [70].
In some cases, facial nerve reconstruction with local and/or free nerve graft has been performed. Some of these, more commonly used, are the trifurcation approach [39,40,41,42,43,44,45,46,47,48] which uses the GAN and the hypoglossal nerve, the masseteric nerve transfer [49,50,51,52,53] and the cross-face nerve grafting [54,55,56,57,58]. The first represents the most widely used technique, since it enables the best results with minimum comorbidity. On the contrary, the masseteric nerve transfer doesn’t enable the spontaneous smile, and the cross-face nerve grafting is related to risk of lesion of facial nerve on the healthy facial side.
The search for the best therapy is not over and further studies have been conducted by using the newborn bioengineering approaches. They include the use of conduit embedded with growth factors (e.g., FGF-2, bone marrow stem cells, adipocytes) [60,61,62,63], the NPD [66] or the electronic pacing implanted in the paralyzed facial side [67,68,69].

7. Conclusions

The management of PFP is an important clinical challenge, requiring a multidisciplinary approach and personalized assessment for each patient. Facial resuscitation techniques, both static and dynamic, have undergone developments over the decades. Dynamic techniques, such as muscle transfer and nerve grafting, demonstrate superior results in terms of restoring voluntary and spontaneous facial movement, giving patients greater expression and function. However, the static techniques remain useful where dynamic options are not applicable, ensuring a partial aesthetic improvement. The choice of technique depends on many factors, including the patient’s age, the duration of the paralysis and the availability of suitable tissues or muscles for transplantation as well as surgeon’ skill. Despite the progress made, no technique can be considered as the gold standard for all patients. Each case of PFP must be treated with an individualized approach. May the future of facial resuscitation be the innovative solutions, such as tissue engineering and stem cell therapies?

Author Contributions

Conceptualization, B.V.; methodology, C.S.; resources, B.V.; writing—original draft preparation, B.V; writing—review and editing, C.S.; supervision, C.S. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

Not applicable.

Acknowledgments

Not applicable.

Conflicts of Interest

The authors declare no conflicts of interest.

References

  1. Song K, Chang S, Lee J, Shin SA, Lee HY. Clinical Characteristics of Dizziness Associated with Acute Peripheral Facial Palsy. J Audiol Otol. 2018 Jul;22(3):148-153. Epub 2018 Apr 17. [CrossRef] [PubMed]
  2. Nakano H, Fujiwara T, Tsujimoto Y, Morishima N, Kasahara T, Ameya M, et al. Physical therapy for peripheral facial palsy: A systematic review and meta-analysis. Auris Nasus Larynx. 2024 Feb;51(1):154-160. Epub 2023 May 4. [CrossRef] [PubMed]
  3. Rubin, LR. The anatomy of a smile: its importance in the treatment of facial paralysis. Plast Reconstr Surg. 1974 Apr;53(4):384-7. [CrossRef] [PubMed]
  4. Luijmes RE, Pouwels S, Beurskens CH, Kleiss IJ, Siemann I, Ingels KJ. Quality of life before and after different treatment modalities in peripheral facial palsy: A systematic review. Laryngoscope. 2017 May;127(5):1044-1051. Epub 2016 Nov 12. [CrossRef] [PubMed]
  5. MCLAUGHLIN, CR. Surgical support in permanent facial paralysis. Plast Reconstr Surg (1946). 1953 Apr;11(4):302-14. [CrossRef] [PubMed]
  6. Boahene, K. Reanimating the paralyzed face. F1000Prime Rep. 2013 Nov 1;5:49. [CrossRef] [PubMed] [PubMed Central]
  7. House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg. 1985 Apr;93(2):146-7. [CrossRef] [PubMed]
  8. Kanerva M, Poussa T, Pitkäranta A. Sunnybrook and House-Brackmann Facial Grading Systems: intrarater repeatability and interrater agreement. Otolaryngol Head Neck Surg. 2006 Dec;135(6):865-71. [CrossRef] [PubMed]
  9. Kahn JB, Gliklich RE, Boyev KP, Stewart MG, Metson RB, McKenna MJ. Validation of a patient-graded instrument for facial nerve paralysis: the FaCE scale. Laryngoscope. 2001 Mar;111(3):387-98. [CrossRef] [PubMed]
  10. VanSwearingen JM, Brach JS. The Facial Disability Index: reliability and validity of a disability assessment instrument for disorders of the facial neuromuscular system. Phys Ther. 1996 Dec;76(12):1288-98; discussion 1298-300. [CrossRef] [PubMed]
  11. Ross BG, Fradet G, Nedzelski JM. Development of a sensitive clinical facial grading system. Otolaryngol Head Neck Surg. 1996 Mar;114(3):380-6. [CrossRef] [PubMed]
  12. Gillies, H. Experiences with Fascia Lata Grafts in the Operative Treatment of Facial Paralysis: (Section of Otology and Section of Laryngology). Proc R Soc Med. 1934 Aug;27(10):1372-82. [PubMed] [PubMed Central]
  13. Labbé D, Huault M. Lengthening temporalis myoplasty and lip reanimation. Plast Reconstr Surg. 2000 Apr;105(4):1289-97; discussion 1298. [PubMed]
  14. Labbé, D. Myoplastie d’allongement du temporal et réanimation des lèvres. Note technique [Lengthening of temporalis myoplasty and reanimation of lips. Technical notes]. Ann Chir Plast Esthet. 1997 Feb;42(1):44-7. French. [PubMed]
  15. Labbé, D. Myoplastie d’allongement du temporal V.2. et réanimation des lèvres [Lenghtening temporalis myoplasty V.2. and lip reanimation]. Ann Chir Plast Esthet. 2009 Dec;54(6):571-6. French. Epub 2009 Jul 25. [CrossRef] [PubMed]
  16. Al Khabori MS, Oubari H, Guerreschi P, Labbé D. Lengthening Temporalis Myoplasty: A Surgical Guide to Labbé’s Technique. Atlas Oral Maxillofac Surg Clin North Am. 2023 Mar;31(1):43-55. [CrossRef] [PubMed]
  17. Watanabe Y, Yamamoto T, Hirai R, Sasaki R, Agawa K, Akizuki T. One-stage free transfer of latissimus dorsi-serratus anterior combined muscle flap with dual innervation for smile reanimation in established facial paralysis. J Plast Reconstr Aesthet Surg. 2020 Jun;73(6):1107-1115. Epub 2020 Jan 31. [CrossRef] [PubMed]
  18. Lifchez SD, Matloub HS, Gosain AK. Cortical adaptation to restoration of smiling after free muscle transfer innervated by the nerve to the masseter. Plast Reconstr Surg. 2005 May;115(6):1472-9; discussion 1480-2. [CrossRef] [PubMed]
  19. Biglioli F, Colombo V, Tarabbia F, Pedrazzoli M, Battista V, Giovanditto F, et al. Double innervation in free-flap surgery for long-standing facial paralysis. J Plast Reconstr Aesthet Surg. 2012 Oct;65(10):1343-9. Epub 2012 Jun 23. [CrossRef] [PubMed]
  20. Okazaki M, Kentaro T, Noriko U, Satoshi U, Tsutomu H, Alisa O, et al. One-stage dual latissimus dorsi muscle flap transfer with a pair of vascular anastomoses and double nerve suturing for long-standing facial paralysis. J Plast Reconstr Aesthet Surg. 2015 Jun;68(6):e113-9. Epub 2015 Feb 21. Erratum in: J Plast Reconstr Aesthet Surg. 2016 Apr;69(4):e96. Mutsumi, Okazaki [corrected to Okazaki, Mutsumi]. [CrossRef] [PubMed]
  21. Takushima A, Harii K, Asato H, Kurita M, Shiraishi T. Fifteen-year survey of one-stage latissimus dorsi muscle transfer for treatment of longstanding facial paralysis. J Plast Reconstr Aesthet Surg. 2013 Jan;66(1):29-36. Epub 2012 Sep 7. [CrossRef] [PubMed]
  22. Alam, DS. The Sternohyoid Flap for Facial Reanimation. Facial Plast Surg Clin North Am. 2016 Feb;24(1):61-9. [CrossRef] [PubMed]
  23. Suñé CH, López CC, López PM, Senosiain OG, Escribano MDR, Poyatos JV, et al. The sternohyoid muscle flap for new dynamic facial reanimation technique: Anatomical study and clinical results. J Plast Reconstr Aesthet Surg. 2021 Nov;74(11):3040-3047. Epub 2021 Apr 20. [CrossRef] [PubMed]
  24. Moncaliano MC, Ding P, Goshe JM, Genther DJ, Ciolek PJ, Byrne PJ. Clinical features, evaluation, and management of ophthalmic complications of facial paralysis: A review. J Plast Reconstr Aesthet Surg. 2023 Dec;87:361-368. Epub 2023 Oct 20. [CrossRef] [PubMed]
  25. De Castro Correia P, Zani R. Masseter muscle rotation in the treatment of inferior facial paralysis. Anatomical and clinical observations. Plast Reconstr Surg. 1973 Oct;52(4):370-3. [PubMed]
  26. Romeo M, Lim YJ, Fogg Q, Morley S. Segmental masseteric flap for dynamic reanimation of facial palsy. J Craniofac Surg. 2014 Mar;25(2):630-2. [CrossRef] [PubMed]
  27. Shinohara H, Matsuo K, Osada Y, Kawamura T, Tanaka Y. Facial reanimation by transposition of the masseter muscle combined with tensor fascia lata, using the zygomatic arch as a pulley. Scand J Plast Reconstr Surg Hand Surg. 2008;42(1):17-22. [CrossRef] [PubMed]
  28. Anderson RL, Gordy DD. The tarsal strip procedure. Arch Ophthalmol. 1979 Nov;97(11):2192-6. [CrossRef] [PubMed]
  29. Vagefi MR, Anderson RL. The lateral tarsal strip mini-tarsorrhaphy procedure. Arch Facial Plast Surg. 2009 Mar-Apr;11(2):136-9. [CrossRef] [PubMed]
  30. Kwon KY, Jang SY, Yoon JS. Long-Term Outcome of Combined Lateral Tarsal Strip With Temporal Permanent Tarsorrhaphy for Correction of Paralytic Ectropion Caused By Facial Nerve Palsy. J Craniofac Surg. 2015 Jul;26(5):e409-12. [CrossRef] [PubMed]
  31. de Silva DJ, Ramkissoon YD, Ismail AR, Beaconsfield M. Surgical technique: modified lateral tarsorrhaphy. Ophthalmic Plast Reconstr Surg. 2011 May-Jun;27(3):216-8. [CrossRef] [PubMed]
  32. Tessier P, Delbet JP, Pastoriza J, Lekiefre M. Les paupières paralysées [Paralized eyelids]. Ann Chir Plast. 1969;14(3):215-23. French. [PubMed]
  33. Basiony Dawood, Ahmed; Alshahat, Osama; Al-Deeb, Fayez; and Salem, Ahmed (2022) “A Prospective Study of Paul Tessier’s Technique in Paralytic Lagophthalmos Management,” Al-Azhar International Medical Journal: Vol. 3: Iss. 3, Article 1. [CrossRef]
  34. Pirrello R, D’Arpa S, Moschella F. Static treatment of paralytic lagophthalmos with autogenous tissues. Aesthetic Plast Surg. 2007 Nov-Dec;31(6):725-31. Epub 2007 Aug 10. [CrossRef] [PubMed]
  35. Guillou-Jamard MR, Labbé D, Bardot J, Benateau H. Paul Tessier’s technique in the treatment of paralytic lagophthalmos by lengthening of the levator muscle: evaluation of 29 cases. Ann Plast Surg. 2011 Dec;67(6):S31-5. [CrossRef] [PubMed]
  36. Hayashi A, Yoshizawa H, Natori Y, Senda D, Tanaka R, Mizuno H. Levator lengthening technique using cartilage or fascia graft for paralytic lagophthalmos in facial paralysis. J Plast Reconstr Aesthet Surg. 2016 May;69(5):679-86. Epub 2016 Feb 2. [CrossRef] [PubMed]
  37. Krastinova D, Franchi G, Kelly MB, Chabolle F. Rehabilitation of the paralysed or lax lower eyelid using a graft of conchal cartilage. Br J Plast Surg. 2002 Jan;55(1):12-9. [CrossRef] [PubMed]
  38. Martel A, Farah E, Zmuda M, Almairac F, Jacomet PV, Galatoire O. Autologous dermis graft versus conchal cartilage graft for managing lower eyelid retraction: A comparative study. Eur J Ophthalmol. 2021 Jul;31(4):1733-1740. Epub 2020 Jun 12. [CrossRef] [PubMed]
  39. Beutner D, Grosheva M. Reconstruction of complex defects of the extracranial facial nerve: technique of “the trifurcation approach”. Eur Arch Otorhinolaryngol. 2019 Jun;276(6):1793-1798. Epub 2019 Apr 4. [CrossRef] [PubMed]
  40. Lu L, Ding Y, Lin Y, Xu Z, Li Z, Qu J, He Y, Dai Y, Chen Y, Qiu J. [Greater auricular nerve graft for repair of facial nerve defects]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2010 Apr;24(7):293-6. Chinese. [PubMed]
  41. Humphrey CD, Kriet JD. Nerve repair and cable grafting for facial paralysis. Facial Plast Surg. 2008 May;24(2):170-6. [CrossRef] [PubMed]
  42. Stennert E. I. Hypoglossal facial anastomosis: its significance for modern facial surgery. II. Combined approach in extratemporal facial nerve reconstruction. Clin Plast Surg. 1979 Jul;6(3):471-86. [PubMed]
  43. Ko ̈rte, W. Ein fall von nervenpfropfung des nervus facialais auf den nervus hypoglossus.
  44. May M, Sobol SM, Mester SJ. Hypoglossal-facial nerve interpositional-jump graft for facial reanimation without tongue atrophy. Otolaryngol Head Neck Surg. 1991 Jun;104(6):818-25. [CrossRef] [PubMed]
  45. Urban MJ, Eggerstedt M, Varelas E, Epsten MJ, Beer AJ, Smith RM, et al. Hypoglossal and Masseteric Nerve Transfer for Facial Reanimation: A Systematic Review and Meta-Analysis. Facial Plast Surg Aesthet Med. 2022 Jan-Feb;24(1):10-17. Epub 2021 Feb 26. [CrossRef] [PubMed]
  46. Le Clerc N, Herman P, Kania R, Tran H, Altabaa K, Tran Ba Huy P, et al. Comparison of 3 procedures for hypoglossal-facial anastomosis. Otol Neurotol. 2013 Oct;34(8):1483-8. [CrossRef] [PubMed]
  47. Venail F, Sabatier P, Mondain M, Segniarbieux F, Leipp C, Uziel A. Outcomes and complications of direct end-to-side facial-hypoglossal nerve anastomosis according to the modified May technique. J Neurosurg. 2009 Apr;110(4):786-91. [CrossRef] [PubMed]
  48. Volk GF, Pantel M, Streppel M, Guntinas-Lichius O. Reconstruction of complex peripheral facial nerve defects by a combined approach using facial nerve interpositional graft and hypoglossal-facial jump nerve suture. Laryngoscope. 2011 Nov;121(11):2402-5. [CrossRef] [PubMed]
  49. Hontanilla B, Marre D. Masseteric-facial nerve transposition for reanimation of the smile in incomplete facial paralysis. Br J Oral Maxillofac Surg. 2015 Dec;53(10):943-8. Epub 2015 Jul 2. [CrossRef] [PubMed]
  50. Biglioli F, Frigerio A, Colombo V, Colletti G, Rabbiosi D, Mortini P, et al. Masseteric-facial nerve anastomosis for early facial reanimation. J Craniomaxillofac Surg. 2012 Feb;40(2):149-55. Epub 2011 Apr 3. [CrossRef] [PubMed]
  51. Sakthivel P, Singh CA, Thakar A, Thirumeni G, Raveendran S, Sharma SC. Masseteric-Facial Nerve Anastomosis: Surgical Techniques and Outcomes-A Pilot Indian study. Indian J Otolaryngol Head Neck Surg. 2020 Mar;72(1):92-97. Epub 2019 Nov 6. [CrossRef] [PubMed] [PubMed Central]
  52. Bermudez LE, Nieto LE. Masseteric-facial nerve anastomosis: case report. J Reconstr Microsurg. 2004 Jan;20(1):25-30. [CrossRef] [PubMed]
  53. Cassoni A, Catalano C, Di Giorgio D, Raponi I, Di Brino M, Perotti S, et al. Masseter-facial neurorrhaphy for facial palsy reanimation: What happens after masseter denervation? Histomorphometric and stomatognathic functional analysis. J Craniomaxillofac Surg. 2020 Jul;48(7):680-684. Epub 2020 Jun 2. [CrossRef] [PubMed]
  54. O’Brien BM, Franklin JD, Morrison WA. Cross-facial nerve grafts and microneurovascular free muscle transfer for long established facial palsy. Br J Plast Surg. 1980 Apr;33(2):202-15. [CrossRef] [PubMed]
  55. Kumar PA, Hassan KM. Cross-face nerve graft with free-muscle transfer for reanimation of the paralyzed face: a comparative study of the single-stage and two-stage procedures. Plast Reconstr Surg. 2002 Feb;109(2):451-62; discussion 463-4. [CrossRef] [PubMed]
  56. Scaramella, LF. Cross-face facial nerve anastomosis: historical notes. Ear Nose Throat J. 1996 Jun;75(6):343, 347-52, 354. [PubMed]
  57. Harii K, Ohmori K, Torii S. Free gracilis muscle transplantation, with microneurovascular anastomoses for the treatment of facial paralysis. A preliminary report. Plast Reconstr Surg. 1976 Feb;57(2):133-43. [CrossRef] [PubMed]
  58. Peng GL, Azizzadeh B. Cross-facial nerve grafting for facial reanimation. Facial Plast Surg. 2015 Apr;31(2):128-33. Epub 2015 May 8. [CrossRef] [PubMed]
  59. Bengur FB, Stoy C, Binko MA, Nerone WV, Fedor CN, Solari MG, et al. Facial Nerve Repair: Bioengineering Approaches in Preclinical Models. Tissue Eng Part B Rev. 2022 Apr;28(2):364-378. Epub 2021 Apr 13. [CrossRef] [PubMed] [PubMed Central]
  60. Matsumine H, Sasaki R, Tabata Y, Matsui M, Yamato M, Okano T, et al. Facial nerve regeneration using basic fibroblast growth factor-impregnated gelatin microspheres in a rat model. J Tissue Eng Regen Med. 2016 Oct;10(10):E559-E567. Epub 2014 Apr 16. [CrossRef] [PubMed]
  61. Watanabe Y, Sasaki R, Matsumine H, Yamato M, Okano T. Undifferentiated and differentiated adipose-derived stem cells improve nerve regeneration in a rat model of facial nerve defect. J Tissue Eng Regen Med. 2017 Feb;11(2):362-374. Epub 2014 Jun 1. [CrossRef] [PubMed]
  62. Fujimaki H, Matsumine H, Osaki H, Ueta Y, Kamei W, Shimizu M, et al. Dedifferentiated fat cells in polyglycolic acid-collagen nerve conduits promote rat facial nerve regeneration. Regen Ther. 2019 Sep 12;11:240-248. Erratum in: Regen Ther. 2020 Jun 10;15:35-43. doi: 10.1016/j.reth.2020.05.002. [CrossRef] [PubMed] [PubMed Central]
  63. Costa HJ, Bento RF, Salomone R, Azzi-Nogueira D, Zanatta DB, Paulino Costa M, et al. Mesenchymal bone marrow stem cells within polyglycolic acid tube observed in vivo after six weeks enhance facial nerve regeneration. Brain Res. 2013 May 13;1510:10-21. Epub 2013 Mar 28. [CrossRef] [PubMed]
  64. Zhu W, Tringale KR, Woller SA, You S, Johnson S, Shen H, et al. Rapid continuous 3D printing of customizable peripheral nerve guidance conduits. Mater Today (Kidlington). 2018 Nov;21(9):951-959. Epub 2018 Apr 27. [CrossRef] [PubMed] [PubMed Central]
  65. Petcu EB, Midha R, McColl E, Popa-Wagner A, Chirila TV, Dalton PD. 3D printing strategies for peripheral nerve regeneration. Biofabrication. 2018 Mar 23;10(3):032001. [CrossRef] [PubMed]
  66. Jowett N, Kearney RE, Knox CJ, Hadlock TA. Toward the Bionic Face: A Novel Neuroprosthetic Device Paradigm for Facial Reanimation Consisting of Neural Blockade and Functional Electrical Stimulation. Plast Reconstr Surg. 2019 Jan;143(1):62e-76e. [CrossRef] [PubMed] [PubMed Central]
  67. Attiah MA, de Vries J, Richardson AG, Lucas TH. A Rodent Model of Dynamic Facial Reanimation Using Functional Electrical Stimulation. Front Neurosci. 2017 Apr 5;11:193. [CrossRef] [PubMed] [PubMed Central]
  68. Jowett N, Kearney RE, Knox CJ, Hadlock TA. Toward the Bionic Face: A Novel Neuroprosthetic Device Paradigm for Facial Reanimation Consisting of Neural Blockade and Functional Electrical Stimulation. Plast Reconstr Surg. 2019 Jan;143(1):62e-76e. [CrossRef] [PubMed] [PubMed Central]
  69. Mäkelä E, Venesvirta H, Ilves M, Lylykangas J, Rantanen V, Ylä-Kotola T, et al. Facial muscle reanimation by transcutaneous electrical stimulation for peripheral facial nerve palsy. J Med Eng Technol. 2019 Apr;43(3):155-164. Epub 2019 Jul 15. [CrossRef] [PubMed]
  70. Labbè D, Bussu F, Iodice A. A comprehensive approach to long-standing facial paralysis based on lengthening temporalis myoplasty. Acta Otorhinolaryngol Ital. 2012 Jun;32(3):145-53. PMCID: PMC3385063. [PubMed]
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