The evaluation of the effect of free gracilis muscle transfer on cheek tone and oral competence in long-standing facial paralysis of patients by using Blasco index

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dc.contributor.authorBali Z.U.
dc.contributor.authorTuluy Y.
dc.contributor.authorÖzkaya Ünsal M.
dc.contributor.authorParspancı A.
dc.contributor.authorYoleri L.
dc.contributor.authorKeçeci Y.
dc.date.accessioned2024-07-22T08:02:47Z
dc.date.available2024-07-22T08:02:47Z
dc.date.issued2023
dc.description.abstractPurpose: Smile and eyelid reanimation are generally emphasized in facial reanimation, but the loss of cheek tone provided by the buccinator muscle is not adequately addressed. The use of free gracilis muscle flap for facial reanimation has become widespread since it was used in head and neck reconstruction by Harii et al. The effect of free gracilis muscle transfer on drooling is not clearly defined in the literature. In our study, we aimed to evaluate the effect of free gracilis muscle transfer on drooling in patients with facial paralysis (FP) by using Blasco index. Smile function was overemphasized in the literature, but drooling was not evaluated. What happens to drooling after free functional muscle transfer was not clear, so this study was designed to evaluate improvement in drooling. Patients and Methods: Drooling and smile were evaluated in 11 patients (4 male, 7 female) who underwent facial reanimation with a free functional gracilis muscle transfer (FFGMT), in long-standing FP. The mean age was 39.9 years (range 22–56 years). Etiology was idiopathic in two patients, trauma in five patients, and intracranial tumor in four patients. Photographs and video recordings were taken preoperatively and at the first year postoperatively. The muscle was stitched to the upper lip, corner of the mouth, lower lip and the preauricular region. Masseteric nerve was preferred as donor nerve. Smile restoration was evaluated according to the five-stage classification defined by Terzis and Noah. Results: Flap dimensions differed from 12 cm× 5 cm to 15 cm× 6 cm. Oral intake was stopped for 5 days, and speaking was restricted postoperatively. Patients exercised for about 1 h starting from the postoperative third month. Patients were followed up for an average of 26.5 (14–48) months postoperatively. Postop courses were uneventful, and we did not observe any complications in these patients. Preoperative Blasco index score was 3 in 6 patients, 2 in 5 patients and the mean scores were 2.54 ± 0.52. Patients were followed for 1 year. No drooling was observed in the postoperative first year. The Blasco index score was 0 for all patients. The decrease in postoperative scores was found to be statistically significant (p <.01). Smile restoration was evaluated according to the five-stage classification defined by Terzis and Noah for facial reanimation after muscle transfer. Excellent results (grade 5) were obtained in 6 patients, good results (grade 4) in 4 patients and moderate results (grade 3) in 1 patient. Conclusion: Free functional gracilis muscle transfer improves chewing functions and prevents drooling. This case series reveals that FFGMT can be a good option to enable cheek tone in long-standing FP of patients. © 2022 Wiley Periodicals LLC.
dc.identifier.DOI-ID10.1002/micr.30976
dc.identifier.issn07381085
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/11980
dc.language.isoEnglish
dc.publisherJohn Wiley and Sons Inc
dc.subjectAdult
dc.subjectCheek
dc.subjectFacial Paralysis
dc.subjectFemale
dc.subjectGracilis Muscle
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectNerve Transfer
dc.subjectPlastic Surgery Procedures
dc.subjectSmiling
dc.subjectSurgical Flaps
dc.subjectYoung Adult
dc.subjectadult
dc.subjectArticle
dc.subjectcancer staging
dc.subjectclinical article
dc.subjectcompetence
dc.subjectfacial nerve paralysis
dc.subjectfemale
dc.subjectgracilis muscle
dc.subjecthuman
dc.subjecthypersalivation
dc.subjectintracranial tumor
dc.subjectlower lip
dc.subjectmale
dc.subjectmedical photography
dc.subjectmuscle transplantation
dc.subjectneurologic disease assessment
dc.subjectstanding
dc.subjectvideorecording
dc.subjectcase report
dc.subjectcheek
dc.subjectcomplication
dc.subjectfacial expression
dc.subjectmiddle aged
dc.subjectnerve transplantation
dc.subjectphysiology
dc.subjectplastic surgery
dc.subjectprocedures
dc.subjectsurgical flaps
dc.subjecttransplantation
dc.subjectyoung adult
dc.titleThe evaluation of the effect of free gracilis muscle transfer on cheek tone and oral competence in long-standing facial paralysis of patients by using Blasco index
dc.typeArticle

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