Facial Reanimation Surgery With Micro-vascular Gracilis Free Flap for Unilateral Facial Palsy

Abstract

Introduction and objectivesMicro-neurovascular free muscle flap transfer is currently the procedure of choice for long-standing facial paralysis. We present a case series of patients treated with gracilis muscle free flap with motor innervation by the masseteric nerve. We discuss the surgical technique and quantify the movement granted by the muscle, the improvement in quality of life and aesthetic results. Materials and methodsWe report ten patients with unilateral facial paralysis who underwent free gracilis muscle flap, between the years 2010 and 2012 in two tertiary hospitals. ResultsAny failure of the microsuture with survival of all flaps is not reported. The muscle movement was quantified by vectors at rest and contraction with an average of 1.7cm that initiated around the fourth month after surgery. Patients also reported a significant improvement in symmetry at rest as well as oral and ocular competition. ConclusionAs currently presented in literature, microvascular free flaps are the technique of choice for facial reanimation. In our experience, we believe that gracilis muscle flap innervated by the masseteric nerve is a reliable and secure technique that provides adequate functional and aesthetic results.