The Dynamic Lip Reconstruction with Variable Free Neuromuscular Transfers in Chronic Facial Palsy.

Lee, Seung Hwan; Ahn, Ki Young; Woo, Ji Won; Park, Mee Young

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2003;30(2):114-119.
Published online March 1, 2003.

The Dynamic Lip Reconstruction with Variable Free Neuromuscular Transfers in Chronic Facial Palsy.

Seung Hwan Lee, Ki Young Ahn, Ji Won Woo, Mee Young Park

¹Department of Plastic and Reconstructive Surgery, College of Medicine, Catholic University of Daegu, Korea. kyahn@ cuth.cataegu.ac.kr
²Department of Neurology, College of Medicine, Yeung Nam University, Daegu, Korea.

Abstract

The goals of ideal lip reconstruction in chronic facial palsy include recovery of sphincteric function of the lip and symmetry of mouth during facial expression and the resting state. The lip reconstruction in chronic facial palsy can be mainly divided into dynamic and static method. Recently, the dynamic lip reconstruction tend to be reported more frequently with the development of microsurgery. From December of 1994 to August of 2001, We had 6 dynamic lip reconstruction by one or two staged free neurovascular flap, and followed up from 1 to 4 years and 4 months (mean 36 months). One case was two-staged free rectus abdominis flap after cross-face nerve graft with sural nerve. Another case was one- staged free gracilis muscle flap anastmosised with one of the buccal branch of facial nerve in the affected side, which had relatively good function. The other 4 cases were one-staged free neurovascular latissimus dorsi flaps. We also combined other procedures such as gold implant for lagophthalmos, temporalis muscle transfer on ectropion of the lower eyelid, and the excisional eyebrow lift on the affected side. We got relatively satisfactory results except 1 case.

Keywords: Chronic facial palsy; Dynamic lip reconstruction; Free neurovascular flap