Gracilis Muscle-Free Flap Objective Improvement of Oral Commissure Excursion in Facial Palsy Reanimation Surgery: Systematic Review and Meta-Analysis.
Isabel Fernández-Carrera GonzálezJavier Gavilanes PlasenciaNieves Mata CastroPublished in: Facial plastic surgery & aesthetic medicine (2023)
Background: Facial palsy patients face significant challenges. Gracilis free flap transfer is a key procedure in facial reanimation. Objective: This study aims to analyze oral commissure excursion improvement after gracilis free flap transfer and the differences regarding donor nerve: cross-facial nerve graft (CFNG), hypoglossal or spinal accessory nerves, motor nerve to masseteric (MNTM), and most recently, double anastomosis using both the MNTM and CFNG. Methods: A systematic review and meta-analysis were conducted of studies reporting oral commissure excursion improvement after free gracilis muscle transfer. Pooled proportions were calculated using a random-effects model. Results: Eighteen studies, 453 patients, and 488 free gracilis flaps were included. The mean change in perioperative oral commissure excursion was 7.0 mm, for CFNG 7.2 mm, for MNTM 7.7, and for double anastomoses 5.5 mm. Conclusions: There is a significant improvement in oral commissure excursion after gracilis muscle-free flap. Unfortunately, we could not make definitive conclusions regarding the optimal choice of donor nerve.
Keyphrases
- end stage renal disease
- newly diagnosed
- ejection fraction
- skeletal muscle
- minimally invasive
- peritoneal dialysis
- spinal cord
- randomized controlled trial
- emergency department
- coronary artery disease
- patients undergoing
- spinal cord injury
- acute kidney injury
- study protocol
- atrial fibrillation
- decision making
- adverse drug