Multivector functioning muscle transfer using superficial subslips of the serratus anterior muscle for longstanding facial paralysis
Multivector functioning muscle transfer using superficial subslips of the serratus anterior muscle for longstanding facial paralysis
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DOI：
10.1016/j.bjps.2018.12.029
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发表时间：
2019-06-01
影响因子：
2.7
通讯作者：
Shimizu, Yusuke
中科院分区：
文献类型：
--
作者：
Sakuma, Hisashi;Tanaka, Ichiro;Shimizu, Yusuke
各种供体肌肉已被确定为恢复面部功能，由于长期面瘫。供体肌肉如股薄肌和背阔肌经常被使用，并且通常产生一个或两个可靠的力向量。然而，使用这些肌肉存在缺点，包括分离多向量功能肌肉单元的不稳定性和有限的肌肉收缩量。前锯肌移位的优点是可以用单个神经血管蒂产生多个独立功能的运动单位。本文介绍了多向量肌肉转移使用两个或三个浅表subslips的前锯肌在一个单一的神经血管蒂，以产生一个审美的微笑，是定制模仿对侧模仿肌肉的功能。12例长期单侧面瘫的患者接受了由同侧咬肌神经支配的前锯肌的多向量浅亚滑组成的肌肉转移。手术后过程顺利，患者获得了极好的结果，上唇偏移、口角和下唇同时充分工作。采用前锯肌多向量浅层肌瓣移位术治疗陈旧性面瘫是一种有效的方法。这种技术避免了术后面颊肌肉的臃肿，实现了更自然和对称的微笑。(C)2018年英国整形，重建和美容外科医生协会。由爱思唯尔有限公司出版。保留所有权利。
Various donor muscles have been identified for restoring facial function due to longstanding facial paralysis. Donor muscles such as the gracilis and latissimus dorsi are frequently used and often produce one or two reliable vectors of force. However, there are drawbacks of using these muscles, including the instability of separating multivector functioning muscle units and limited amount of muscle contraction. Serratus anterior muscle transfer has the advantages of multiple independently functioning motor units that can be created with a single neurovascular pedicle. This article describes multivector muscle transfer using two or three superficial subslips of the serratus anterior muscle on a single neurovascular pedicle to produce an esthetic smile that is customized to imitate the function of the contralateral mimetic muscles. Twelve patients who had longstanding unilateral facial paralysis underwent muscle transfer consisting of multivector superficial subslips of the serratus anterior muscle innervated by the ipsilateral masseteric nerve. The procedure had an uneventful postoperative course, and patients obtained excellent results, with sufficient upper lip excursion, mouth angle, and lower lip working simultaneously. Functioning muscle transfer using multivector superficial subslips of the serratus anterior muscle is effective for treating longstanding facial paralysis. This technique avoids postoperative bulkiness of the cheek muscle and achieves a more natural and symmetrical smile. (C) 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.