Free Vastus Lateralis Functional Muscle Transfer: An Approach to Facial Reanimation and Reconstruction in Radical...

Area of Science:

• Plastic Surgery
• Oncology
• Neurosurgery

Background:

• Radical parotidectomy for malignant tumors can lead to facial nerve damage and soft tissue defects.
• Reconstruction of facial nerve and soft tissue is crucial for restoring function and aesthetics.

Purpose of the Study:

• To evaluate the efficacy of free vastus lateralis functional muscle transfer (FVL-FMT) for facial nerve reanimation and soft tissue reconstruction after parotidectomy.
• To assess functional outcomes using standardized facial nerve grading scales.

Main Methods:

• FVL-FMT is an immediate, single-stage reconstruction using vastus lateralis motor nerve branches (type 1 or 2).
• The descending branch of the vastus lateralis serves as a vascularized nerve graft for facial nerve repair.
• Facial function was assessed using modified House-Brackmann and Yanagihara facial nerve grading scales in patients with stage IVA parotid cancer.

Main Results:

• Seven patients underwent FVL-FMT with successful flap survival and no major complications.
• Three patients regained normal ocular function; four had moderate lower midface dysfunction.
• Facial nerve grading showed scores ranging from III to V, with 86% achieving acceptable resting tone and minimal synkinesis.

Conclusions:

• FVL-FMT is a reliable method for immediate facial nerve reconstruction and soft tissue restoration after parotidectomy.
• This technique effectively restores both function and appearance, significantly improving patients' quality of life.