Reanimation for facial palsy using gracilis muscle grafts

Twelve patients have been reviewed at least 2 years after gracilis muscle transfer, preceded by crossface nerve grafting, for complete unilateral facial palsy. Levels of satisfaction among the patients were good. Examination showed all had voluntary movement of the graft which could produce reasonable mouth symmetry in most patients. However, the involuntary spontaneity and expressive movements were not so satisfactory, though still worthwhile. The technique and some lessons learned from this experience are discussed. It appears from electromyographic studies that continuing innervation and activity can occur in these grafts for many years postoperatively.