Wenjin Wang1, Yizuo Cai1, Carlo M Oranges2, Daniel F Kalbermatten2, Dirk J Schaefer3, Chuan Yang4, Wei Li4. 1. Plastic and Reconstructive Surgery Department, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China. 2. Department of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, University of Geneva, Geneva, Switzerland. 3. Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, Basel University Hospital, University of Basel, Basel, Switzerland. 4. Plastic and Reconstructive Surgery Department, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China; liweiboshi@163.com Patrick-wt@outlook.com.
Abstract
BACKGROUND/AIM: The use of sternocleidomastoid muscle (SCM) flap for facial reanimation was established in the 1980s by the senior author of this paper. We aimed to analyze long-term outcome and complications of this procedure. PATIENTS AND METHODS: We conducted a retrospective chart review of all patients undergoing SCM reanimation for longstanding facial palsy between January 2009 and December 2015. Patients with follow-up longer than 12 months (range=12-96) were included in the study. Facial muscle function was evaluated before and at each follow-up after the surgery with the House-Brackmann (HB) scale-facial nerve grading system and Facegram analysis. Donor site morbidity and overall complication rates were documented and analyzed. RESULTS: Forty-two patients aged 18-66 years (mean age=37) with a mean duration of facial palsy of 5 years (range=2-48) met the inclusion criteria. The HB score 2 years after surgery improved significantly (p<0.05) in comparison to the pre-operative condition (3.6 vs. 4.7). Twelve months after surgery, oral commissure excursion improved by mean 8.95 mm. No flap necrosis occurred, nor compromise of neck and shoulder function despite an obvious contour defect in the SCM donor site. None of the patients presented head posture or movement issues. CONCLUSION: The SCM flap transfer is a reliable and effective procedure to achieve moderate improvement of the oral commissure excursion using a local method with moderate donor site morbidity. It can be regarded as a valuable option for dynamic facial reanimation in case of longstanding facial palsy.
BACKGROUND/AIM: The use of sternocleidomastoid muscle (SCM) flap for facial reanimation was established in the 1980s by the senior author of this paper. We aimed to analyze long-term outcome and complications of this procedure. PATIENTS AND METHODS: We conducted a retrospective chart review of all patients undergoing SCM reanimation for longstanding facial palsy between January 2009 and December 2015. Patients with follow-up longer than 12 months (range=12-96) were included in the study. Facial muscle function was evaluated before and at each follow-up after the surgery with the House-Brackmann (HB) scale-facial nerve grading system and Facegram analysis. Donor site morbidity and overall complication rates were documented and analyzed. RESULTS: Forty-two patients aged 18-66 years (mean age=37) with a mean duration of facial palsy of 5 years (range=2-48) met the inclusion criteria. The HB score 2 years after surgery improved significantly (p<0.05) in comparison to the pre-operative condition (3.6 vs. 4.7). Twelve months after surgery, oral commissure excursion improved by mean 8.95 mm. No flap necrosis occurred, nor compromise of neck and shoulder function despite an obvious contour defect in the SCM donor site. None of the patients presented head posture or movement issues. CONCLUSION: The SCM flap transfer is a reliable and effective procedure to achieve moderate improvement of the oral commissure excursion using a local method with moderate donor site morbidity. It can be regarded as a valuable option for dynamic facial reanimation in case of longstanding facial palsy.
Authors: Alvaro Sanabria; Luiz P Kowalski; Patrick J Bradley; Dana M Hartl; Carol R Bradford; Remco de Bree; Alessandra Rinaldo; Alfio Ferlito Journal: Head Neck Date: 2011-04-05 Impact factor: 3.147
Authors: Jennifer B Goines; Lisa E Ishii; Jacob K Dey; Maria Phillis; Patrick J Byrne; Kofi D O Boahene; Masaru Ishii Journal: JAMA Facial Plast Surg Date: 2016-09-01 Impact factor: 4.611