Facial Reanimation

Facial reanimation is another reconstructive challenge where there is cautious optimism about the use of microvascular surgery for the transfer of nerve-muscle units that are neuro-logically connected to crossover nerve grafts with the ultimate goal of reestablishing movement in the paralyzed face. An advantage of providing viable motor end plates and a vascularized donor nerve is the restoration of facial movement in patients with longstanding paralysis. This type of work is being done for the rehabilitation of facial paralysis that cannot be resolved with the other reanimation techniques.43'44 The results are still far from ideal.

There are those who have described using free flaps for the closure of cranial base defects.45-47 However, we have rarely found it necessary to use free flaps for this particular reconstructive task.48

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