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Head Neck. 2018 Mar;40(3):561-568. doi: 10.1002/hed.25022. Epub 2017 Nov 20.

Free gracilis muscle transfer for smile reanimation after treatment for advanced parotid malignancy.

Author information

1
Department of Facial Plastic Reconstructive Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.

Abstract

BACKGROUND:

The purpose of this study was to characterize the outcomes of free gracilis muscle transfer for delayed smile reanimation after radical parotidectomy.

METHODS:

A retrospective chart review of patients who underwent free gracilis muscle transfer for smile reanimation after radical parotidectomy between 2003 and 2016 was performed. Patient-reported quality of life (Facial Clinimetric Evaluation Scale [FaCE]), physician-reported facial function ("eFACE" facial grading scale), and oral commissure excursion were compared preoperatively and postoperatively.

RESULTS:

Twelve patients were identified with prior surgery and adjuvant therapy (radiotherapy in 6 cases and chemoradiotherapy in 6 cases). Significant postoperative improvements were demonstrated for ipsilateral commissure excursion with smile (preoperatively: -2.2 mm [SD 2.3 mm] vs postoperatively: 7.9 mm [SD 2.5 mm]; P = .002), with meaningful smile achieved in 11 of 12 cases (91.7%). The average duration of facial paralysis before intervention was 72 months (range 12-204 months).

CONCLUSION:

Free gracilis muscle transfer is an option for dynamic smile reanimation in select patients who have undergone treatment for advanced parotid malignancy.

KEYWORDS:

facial paralysis; facial reanimation; gracilis; quality of life outcomes; radical parotidectomy

PMID:
29155463
DOI:
10.1002/hed.25022
[Indexed for MEDLINE]

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