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Updated: Aug 13, 2026
Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Postoperative functional evaluation of different reanimation techniques for facial nerve repair
Orlando Guntinas-Lichius1, Michael Streppel, Eberhard Stennert
1Clinic of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, D-50924 Koeln, Cologne, Germany.
Background:
The facial nerve function after facial-facial nerve anastomosis, grafting, hypoglossal-facial nerve anastomosis, hypoglossal-facial interpositional jump nerve anastomosis, or a combined approach was analyzed.
Methods:
Facial function was assessed after operation using a 7-point visual analog scale (VAS) and by electromyography (EMG) in 53 patients. The final result was judged by May's facial nerve grading system.
Results:
Voluntary EMG activity occurred on average 4.52 +/- 1.31 months after operation. Initial facial movements were visible after 5.41 +/- 1.80 months. Facial function related to the VAS finally reached 44% of normal value. The result was judged May's grade I in 13%, grade II in 34%, grade III in 28%, and grade IV in 25% of patients. A significant difference in outcome between different reconstruction types was not seen. Age over 60 years was related to worse outcome.
Conclusions:
A correct selection of the best method in the individual situation presumed, all analyzed facial reanimation techniques seem to lead nearly similar and satisfactory results.
