Functional Serratus Anterior Muscle Transplantation to Improve Smile in Long-Standing Facial Paralysis

norosirurjiozel12-1-22kapak

Levent YOLERİa, Yavuz TULUYb
aManisa Celal Bayar University Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Manisa, Türkiye
bTurgutlu State Hospital, Clinic of Plastic, Reconstructive and Aesthetic Surgery, Manisa, Türkiye

Yoleri L, Tuluy Y. Functional serratus anterior muscle transplantation to improve smile in long-standing facial paralysis. In: Sanus GZ, Batıoğlu Karaaltın A, eds. Surgical Management of Facial Nerve Paralysis. 1st ed. Ankara: Türkiye Klinikleri; 2022. p.219-24.

Article Language: EN

ABSTRACT
The loss of cheek tonus, facial asymmetry at rest, drooling and inability to smile are problems that are needed to be solved in patients with facial paralysis. In long-standing facial paralysis, free functional muscle transfer with cross-facial nerve grafting is a preferred dynamic reconstructive procedure. Different types of muscles are used for this purpose. The senior author prefers to use the last three slips of serratus anterior muscle. Three slips can be inset in different vectors, so imitation of the facial muscles can be ensured. The distance between the root of the helix and modiolus is measured preoperatively on the healthy side. This distance is a reference for eighth slip. The other seventh and ninth slips are designed according to eight slip. The other muscle flaps need intramuscular dissection to inset at different vectors. Also thin serratus muscle slips with long and constant neurovascular pedicle can be better than the other donor muscles.

Keywords: Facial paralysis; cross-facial nerve grafting; serratus anterior muscle

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