Gracilis Muscle Transfer Brings Smiles to Children with Permanent Facial Paralysis

The improvement in smiling has the potential to improve quality of life.

Success rates are inconsistent for surgical reanimation in children with permanent facial nerve paralysis. A surgical reanimation team in Massachusetts reports outcomes in 17 children and adolescents (age range, 4–18 years) who underwent 19 consecutive free gracilis transfers for permanent facial paralysis from a variety of causes.

Gracilis muscle was harvested from the medial thigh and transferred to the right or left side of the face. The gracilis muscle received a donor nerve from either the contralateral facial nerve or a branch of the ipsilateral trigeminal nerve. On the basis of smile excursion measurements taken before and after the procedure, mean commissure excursion improvement was 8 mm. One patient had complete muscle failure as a…

Reviewing Author

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)