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Facial Plast Surg 2024; 40(04): 450-458
DOI: 10.1055/a-2318-6989
Original Article

Rethinking Oncologic Facial Nerve Reconstruction in the Acute Phase Through Classification of the Level of Injury

Jessica M. Winter 
1   Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden
2   Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
,
Eleonora O.F. Dimovska
1   Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden
2   Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
,
Chieh-Han John Tzou
3   Plastic and Reconstructive Surgery, Hospital of Divine Savior and Sigmund Freud University, Vienna, Austria
4   Faculty of Medicine, Sigmund Freud University of Vienna, Vienna, Austria
5   Facial Palsy Center, TZOU MEDICAL, Vienna, Austria
,
Andres Rodriguez-Lorenzo
1   Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden
2   Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
› Institutsangaben Funding The study was generously funded by the Swedish Research Council for Clinical Research in Medicine (Avtal om Läkarutbildning och Forskning [ALF]).
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Abstract

Early facial nerve reconstruction should be offered in every patient with oncological resections of the facial nerve due to the debilitating functional and psychosocial consequences of facial nerve palsy. Oncologic pathology or oncologic resection accounts for the second most common cause of facial nerve palsy. In the case of these acute injuries, selecting an adequate method for reconstruction to optimize functional and psychosocial well-being is paramount. Authors advocate consideration of the level of injury as a framework for approaching the viable options of reconstruction systematically. Authors breakdown oncologic injuries to the facial nerve in three levels in relation to their nerve reconstruction methods and strategies: Level I (intracranial to intratemporal), Level II (intratemporal to extratemporal and intraparotid), and Level III (extratemporal and extraparotid). Clinical features, common clinical scenarios, donor nerves available, recipient nerve, and reconstruction priorities will be present at each level. Additionally, examples of clinical cases will be shared to illustrate the utility of framing acute facial nerve injuries within injury levels. Selecting donor nerves is critical in successful facial nerve reconstruction in oncological patients. Usually, a combination of facial and nonfacial donor nerves (hybrid) is necessary to achieve maximal reinnervation of the mimetic muscles. Our proposed classification of three levels of facial nerve injuries provides a selection guide, which prioritizes methods for function nerve reconstruction in relation of the injury level in oncologic patients while prioritizing functional outcomes.

Keywords

facial nerve classification - facial paralysis injury - nerve - reconstruction - surgical oncology


Publikationsverlauf

Accepted Manuscript online:
03. Mai 2024

Artikel online veröffentlicht:
03. Juni 2024

© 2024. Thieme. All rights reserved.

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  • References

  • 1 Ottaiano AC, Gomez GD, Freddi TAL. The facial nerve: anatomy and pathology. Semin Ultrasound CT MR 2023; 44 (02) 71-80
    CrossrefPubMedGoogle Scholar
  • 2 Myckatyn TM, Mackinnon SE. A review of facial nerve anatomy. Semin Plast Surg 2004; 18 (01) 5-12
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 3 Aronson S, Applebaum SA, Kelsey LJ, Gosain AK. Evidence-based practices in facial reanimation surgery. Plast Reconstr Surg 2023; 152 (03) 520e-533e
    CrossrefPubMedGoogle Scholar
  • 4 Peitersen E. Bell's palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies. Acta Otolaryngol Suppl 2002; (549) 4-30
    CrossrefPubMedGoogle Scholar
  • 5 Hohman MH, Hadlock TA. Etiology, diagnosis, and management of facial palsy: 2000 patients at a facial nerve center. Laryngoscope 2014; 124 (07) E283-E293 Accessed May 10, 2024 at: https://api.semanticscholar.org/CorpusID:8943164
    CrossrefPubMedGoogle Scholar
  • 6 Lambley RG, Pereyra-Muñoz N, Parulekar M, Mireskandari K, Ali A. Structural and functional outcomes of anaesthetic cornea in children. Br J Ophthalmol 2015; 99 (03) 418-424
    CrossrefPubMedGoogle Scholar
  • 7 Homer N, Fay A. Management of long-standing flaccid facial palsy: periocular considerations. Otolaryngol Clin North Am 2018; 51 (06) 1107-1118
    CrossrefPubMedGoogle Scholar
  • 8 Jowett N. Lower eyelid management in facial paralysis. Facial Plast Surg 2023; 39 (01) 47-52
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 9 Klebuc MJA. Facial reanimation using the masseter-to-facial nerve transfer. Plast Reconstr Surg 2011; 127 (05) 1909-1915
    CrossrefPubMedGoogle Scholar
  • 10 Terzis JK, Tzafetta K. Outcomes of mini-hypoglossal nerve transfer and direct muscle neurotization for restoration of lower lip function in facial palsy. Plast Reconstr Surg 2009; 124 (06) 1891-1904
    CrossrefPubMedGoogle Scholar
  • 11 Vejbrink Kildal V, Tee R, Reissig L, Weninger WJ, Tzou CJ, Rodriguez-Lorenzo A. Selective ansa cervicalis nerve transfer to the marginal mandibular nerve for lower lip reanimation: an anatomical study in cadavers and a case report. Microsurgery 2023; 43 (02) 142-150
    CrossrefPubMedGoogle Scholar
  • 12 Hamdi OA, Jones MK, Ziegler J, Basu A, Oyer SL. Hypoglossal nerve transfer for facial nerve paralysis: a systematic review and meta-analysis. Facial Plast Surg Aesthet Med 2024; 26 (02) 219-227
    CrossrefPubMedGoogle Scholar
  • 13 Grinsell D, Keating CP. Peripheral nerve reconstruction after injury: a review of clinical and experimental therapies. BioMed Res Int 2014; 2014: 698256
    CrossrefPubMedGoogle Scholar
  • 14 Klebuc M, Shenaq SM. Donor nerve selection in facial reanimation surgery. Semin Plast Surg 2004; 18 (01) 53-60
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 15 Bussu F, Parrilla C, Rizzo D, Almadori G, Paludetti G, Galli J. Clinical approach and treatment of benign and malignant parotid masses, personal experience. Acta Otorhinolaryngol Ital 2011; 31 (03) 135-143
    PubMedGoogle Scholar
  • 16 Fliss E, Yanko R, Zaretski A. et al. Facial nerve repair following acute nerve injury. Arch Plast Surg 2022; 49 (04) 501-509
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 17 Iida T, Nakagawa M, Asano T, Fukushima C, Tachi K. Free vascularized lateral femoral cutaneous nerve graft with anterolateral thigh flap for reconstruction of facial nerve defects. J Reconstr Microsurg 2006; 22 (05) 343-348
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 18 Klein HJ, Guedes T, Tzou CJ, Rodriguez-Lorenzo A. Contemporary concepts of primary dynamic facial nerve reconstruction in the oncologic patient. J Craniofac Surg 2019; 30 (08) 2578-2581
    CrossrefPubMedGoogle Scholar
  • 19 Rodriguez-Lorenzo A, Jensson D, Weninger WJ, Schmid M, Meng S, Tzou CHJ. Platysma motor nerve transfer for restoring marginal mandibular nerve function. Plast Reconstr Surg Glob Open 2016; 4 (12) e1164
    CrossrefPubMedGoogle Scholar