Latissimus dorsi muscle transplantation for the treatment of facial paralysis with phrenic nerve as a recipient motor nerve source / 中华显微外科杂志

ABSTRACT

Objective To evaluate the effect of microneurovascular muscle transplantation for long standing facial paralysis by employing phrenic nerve as recipient motor nerve source Method Three cases with long standing facial palsy were treated using this operative method The latissimus dorsi with thoracodorsal vessels and thoracordorsal nerve was used as donor The ipsilateral phrenic nerve was used as a recipient motor nerve source and the facial artery and vein as recipient vessels The transferred muscle was fixated on the zygomatic arch,the nasalabial fold and commissure of orbicular oris Results All of cases obtained function restoration of the transferred muscle during 12～16 weeks postoperatively Both static and dynamic facial appearance improved Among them,two cases showed a little over bulk in the operative side,among them,one case was improved by removing a part of subcutaneous fat and outer layer of transferred muscle in another operation Conclusion Comparing with the previous operative method,this new operation method could be completed in one stage,which had not to explore the buccal branch of facial nerve in the health side of face,therefore,there is no scar left in the health side In addition,phrenic nerve was easy to explore and longer enough for anastomosis to the nerve attached to the muscle,so the short length of nerve in the transferred muscle is more easy to regeneration after anastomosis to the recipient nerve All these suggests that the transplanted muscle with phrenic nerve as recipient motor source is a simple,short time consumption, less scar left and good effect operation method for facial paralysis