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Updated: Aug 18, 2026
Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
A comparison of surgical techniques used in dynamic reanimation of the paralyzed face
Tass H Malik1, Gerard Kelly, Aftab Ahmed
1University Department of Otorhinolaryngology-Head and Neck Surgery, Manchester Royal Infirmary, Oxford Road, Manchester, England, UK.
Objectives:
To compare the outcomes of three surgical techniques used in the rehabilitation of the paralyzed face.
Study Design:
Retrospective study.
Setting:
University-based tertiary referral center.
Patients:
Between 1976 and 2000, rehabilitative facial nerve surgery was performed on 70 adult patients with varying underlying diseases.
Intervention:
Three methods of facial nerve rehabilitative surgery were performed: end-to-end anastomosis, cable nerve graft interposition, and classic faciohypoglossal transposition.
Main Outcome Measures:
The House-Brackmann grade was scored at 6, 12, 24, and 36 months by the two senior authors. A favorable outcome was defined as House-Brackmann Grade
Results:
Data were available on 66 patients (94%), of whom 13 had an end-to-end anastomosis, 25 a cable nerve graft interposition, and 28 a classic faciohypoglossal transposition. At 24 months, a House-Brackmann Grade
Conclusion:
End-to-end anastomosis confers the best facial function, followed by cable nerve graft interposition and then classic faciohypoglossal transposition. Contrary to some previous opinions, improvement in facial function can still occur 2 years after surgical repair, particularly with classic faciohypoglossal transposition.
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