Free transfer of abductor hallucis combined with anastomosis of blood vessels and nerves for established facial paralysis:assessment of long term effectiveness

Abstract

Objective:To evaluate the long-term effectiveness of free transfer of Abductor hallucis muscle plus anastomosis of blood vessels and nerves for dynamic reanimation of the established facial paralysis.Methods: Twenty-eight patients who received the above-mentioned treatment during March 1999 to November 2006 were followed up.The follow-up period was 1 to 16 years,with a median period of 4 years.The facial pictures of frontal view were analyzed before and after operation.T-FGS and facial nerve function index(FNFI) were used to evaluate the facial nerve function before and after operation.Meanwhile,the survival of the graft,the width of the face,the scar,and the function of the foot were analyzed and compared.Results: All patients obtained satisfactory symmetric faces in static state and voluntary contraction of the transferred muscles.Twenty-two patients obtained ideal smiling faces.The T-FGS score increased by(27±7.2) points and the score of FNFI increased by(57±10.7)% after transplantation(P0.05).Furthermore,the scars on the face were well concealed and there was no functional impairment in the donor foots.Conclusion: Free transfer of abductor hallucis muscle plus anastomosis of blood vessels and nerves has satisfactory long term outcome in dynamic reanimation of established facial paralysis,without functional impairment to the donor foot and is worth of popularizing.