The evolution of facial reanimation techniques.

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2023-05

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Abstract

This review article provides an updated discussion on evidence-based practices related to the evaluation and management of facial paralysis. Ultimately, the goals of facial reanimation include obtaining facial symmetry at rest, providing corneal protection, restoring smile symmetry and facial movement for functional and aesthetic purposes. The treatment of facial nerve injury is highly individualized, especially given the wide heterogeneity regarding the degree of initial neuronal insult and eventual functional outcome. Recent advancements in facial reanimation techniques have better equipped clinicians to approach challenging patient scenarios with reliable, effective strategies. We discuss how technology such as machine learning software has revolutionized pre- and post-intervention assessments and provide an overview of current controversies including timing of intervention, choice of donor nerve, and management of nonflaccid facial palsy with synkinesis. We highlight novel considerations to mainstay conservative management strategies and examine innovations in modern surgical techniques with a focus on gracilis free muscle transfer. Innervation sources, procedural staging, coaptation patterns, and multi-vector and multi-muscle paddle design are modifications that have significantly evolved over the past decade.

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10.1016/j.amjoto.2023.103822

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Pan, Debbie R, Nicholas W Clark, Harry Chiang, Russel R Kahmke, Brett T Phillips and Dane M Barrett (2023). The evolution of facial reanimation techniques. American journal of otolaryngology, 44(3). p. 103822. 10.1016/j.amjoto.2023.103822 Retrieved from https://hdl.handle.net/10161/29298.

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Scholars@Duke

Pan

Debbie Pan

House Staff
Chiang

Harry Chiang

House Staff
Kahmke

Russel Roy Kahmke

Associate Professor of Head and Neck Surgery & Communication Sciences
Phillips

Brett Thomas Phillips

Assistant Professor of Surgery
Barrett

Dane Michael Barrett

Assistant Professor of Head and Neck Surgery & Communication Sciences

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