facial nerve reconstruction...facial plastic and reconstructive surgery aesthetic and functional...

Facial Nerve ReconstructionParadigm for Contour and Color Match

No Disclosures

Newest Developments and Pearls

Contour Restoration

SCM flap1

SMAS interposition flap2,3

Temporoparietal fascial flap4

Implants5

Autogenous fat grafts6,7

Free tissue transfer8-11

Contour Restoration

Submental Island Flap

Reconstructive Ladder- Assumptions

Muscle Volume Changes

Yamaguchi K, et al. Quantative analysis of free flap volume changes in head and neck reconstruction, Head Neck, 2012.

Parotid Contour

Cannady SB, Seth R, Fritz MA, Alam DS, Wax MK. Total parotidectomy defect reconstruction using the buried free flap,Otolaryngol Head Neck Surg. 2010 Nov;143(5):637-43

Durability of Vascularized Fat?

Radical Parotidectomy

A

CB

Vascularized Fat Following Radical Parotid

6 months1 month

Vascularized Fat following Radical Parotid

2 years1 month

Methods

Days Post-OpSurgery

7 Day Survey 30 Day Survey

1. Gabel, et al. Physical Therapy, (2012)2. Van der Wal, et al. Quality of Life Research (2012).

Results

Nerve Continuity Problem

Nerve Continuity Problem

Nerve Continuity Problem

Cross Facial Nerve Grafting

Lee EI. Cross facial nerve graft: past and present. J plas recon aesth surg 2008

Synkinesis

Reinnervation--Drawbacks

Other options for nerve transposition

Masseter Nerve

Acknowldegements

Facial Nerve Team Here

Facial Reanimation - Conclusions

Conclusions

Facial Plastic and Reconstructive Surgery

Aesthetic and functional surgery of the faceFacial reanimation

Microvascular head and neck free flap surgery Facial skin cancer cancer reconstruction

Facial feminization surgery

P. Daniel Knott, MD P.Daniel.Knott@ucsf.edu

Rahul Seth, MD Rahul.Seth@ucsf.edu

https://ohns.ucsf.edu/facialnervehttps://ohns.ucsf.edu/facialplastics

Andrea Park, MD Andrea.Park@ucsf.edu