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Related Concept Videos

Muscles for Facial Expressions01:14

Muscles for Facial Expressions

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The craniofacial muscles are a collection of approximately 20 thin skeletal muscles situated beneath the skin of the face and scalp. These muscles, primarily responsible for the vast array of human facial expressions, originate from the bones or fibrous structures of the skull and extend outwards to connect with the skin. While most skeletal muscles in the body are enveloped in thick fascia, facial muscles generally have a more delicate fascial covering, with the buccinator muscle being a...
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Related Experiment Video

Updated: Jul 11, 2025

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
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Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer

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Composite Sterno-Omohyoid Functional Muscle Transfer for Dual-Vector Smile Reanimation: A Case Series.

Marc H Hohman1, Joseph S Krivda1, Marc W Herr1

  • 1Otolaryngology-Head & Neck Surgery, Madigan Army Medical Center, Tacoma, Washington, USA.

Facial Plastic Surgery & Aesthetic Medicine
|November 10, 2023
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Summary

The sterno-omohyoid flap (SOHF) effectively restores dual-vector smile animation in patients with facial paralysis. This small flap offers significant improvements in oral commissure movement and dental show, providing a viable option for smile reanimation.

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Facial Nerve Surgery

Background:

  • Facial reanimation often involves bulky flaps or complex dissections.
  • Existing multivector flaps can be challenging to implement.
  • Need for effective dual-vector smile reanimation techniques.

Purpose of the Study:

  • To assess the efficacy of sterno-omohyoid flap (SOHF) transfer for dual-vector smile reanimation.
  • To quantify improvements in upper dental show and oral commissure movement post-SOHF transfer.

Main Methods:

  • Retrospective evaluation of SOHF transfers (2017-2020).
  • Utilized eFACE and Emotrics software for objective outcome measurement.
  • Analysis of oral commissure excursion, dental show, and eFACE scores.

Main Results:

  • Four flaccid and one nonflaccid facial paralysis cases treated.
  • Significant improvements observed in oral commissure excursion (7.6 mm) and dental exposure (2.9 mm).
  • Substantial gains in dynamic, smile, and midface-smile eFACE scores (20.3, 25.5, and 50.5 points, respectively).

Conclusions:

  • The sterno-omohyoid flap (SOHF) is a small, effective flap for dual-vector smile reanimation.
  • SOHF transfer demonstrates positive outcomes in both flaccid and nonflaccid facial paralysis.
  • This technique offers a valuable solution for improving smile aesthetics and function.