Muscular subunits transplantation for facial reanimation

Abstract

To present an alternative technique for reconstruction of musculocutaneous damages in the face transferring innervated subsegments (subunits) of the latissimus dorsi flap for replacement of various facial mimetic muscles. One clinical case of trauma with skin and mimetic muscles damage is described as an example of the technique. The treatment was performed with microsurgical transfer of latissimus dorsi muscle subunits. Each subunit present shape and dimensions of the respective mimetic muscles replaced. The origin, insertions and force vectors for the mimic muscle lost were considered. Each subsegment has its own arterial and venous supply with a motor nerve component for the muscular unit. Pre and one year postoperative photos registration of static and dynamic mimic aspects, as well as digital electromyography digital data of the patients were compared. The transplanted muscular units presented myoelectric activity, fulfilling both the functional and cosmetic aspect. This technique seems to be a promising way to deal with the complex musculocutaneous losses of the face as well as facial palsy.