Facial Nerve Reconstruction...Facial Plastic and Reconstructive Surgery Aesthetic and functional...
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Transcript of Facial Nerve Reconstruction...Facial Plastic and Reconstructive Surgery Aesthetic and functional...
Facial Nerve ReconstructionParadigm for Contour and Color Match
No Disclosures
Newest Developments and Pearls
Contour Restoration
SCM flap1
SMAS interposition flap2,3
Temporoparietal fascial flap4
Implants5
Autogenous fat grafts6,7
Free tissue transfer8-11
Contour Restoration
Submental Island Flap
Reconstructive Ladder- Assumptions
Muscle Volume Changes
Yamaguchi K, et al. Quantative analysis of free flap volume changes in head and neck reconstruction, Head Neck, 2012.
Parotid Contour
Cannady SB, Seth R, Fritz MA, Alam DS, Wax MK. Total parotidectomy defect reconstruction using the buried free flap,Otolaryngol Head Neck Surg. 2010 Nov;143(5):637-43
Durability of Vascularized Fat?
Radical Parotidectomy
A
CB
Vascularized Fat Following Radical Parotid
6 months1 month
Vascularized Fat following Radical Parotid
2 years1 month
Methods
Days Post-OpSurgery
7 Day Survey 30 Day Survey
1. Gabel, et al. Physical Therapy, (2012)2. Van der Wal, et al. Quality of Life Research (2012).
Results
Nerve Continuity Problem
Nerve Continuity Problem
Nerve Continuity Problem
Cross Facial Nerve Grafting
Lee EI. Cross facial nerve graft: past and present. J plas recon aesth surg 2008
Synkinesis
Reinnervation--Drawbacks
Other options for nerve transposition
Masseter Nerve
Acknowldegements
Facial Nerve Team Here
Facial Reanimation - Conclusions
Conclusions
Facial Plastic and Reconstructive Surgery
Aesthetic and functional surgery of the faceFacial reanimation
Microvascular head and neck free flap surgery Facial skin cancer cancer reconstruction
Facial feminization surgery
P. Daniel Knott, MD [email protected]
Rahul Seth, MD [email protected]
https://ohns.ucsf.edu/facialnervehttps://ohns.ucsf.edu/facialplastics
Andrea Park, MD [email protected]
