Background: The recovery of the spontaneous smile has become a primary focus in facial reanimation surgery and its major determinant is the selected neurotizer. We aimed to compare the spontaneity outcomes of the most preferred neurotization methods in free functional muscle transfer for long-standing facial paralysis.
Methods: The Embase, Ovid Medline, and PubMed databases were queried with 21 keywords. All clinical studies from the last 20 years reporting the postoperative spontaneity rate for specified neurotization strategies [cross-face nerve graft (CFNG), contralateral facial nerve (CLFN), motor nerve to the masseter (MNM), and dual innervation (DI)] were included. A meta-analysis of prevalence was performed using Freeman-Tukey double arcsine transformation, I statistic, and generic inverse variance with a random-effects model. Risk Of Bias In Non-randomized Studies of Interventions and Newcastle-Ottawa scale were used to assess bias and study quality.
Results: The literature search produced 2613 results and 473 unique citations for facial reanimation. Twenty-nine studies including 2046 patients were included in the systematic review. A meta-analysis of eligible data (1952 observations from 23 studies) showed statistically significant differences between the groups (CFNG: 0.94; 95% confidence interval [CI], 0.76-1.00, CLFN: 0.91; 95% CI, 0.49-1.00, MNM: 0.26; 95% CI, 0.05-0.54, DI: 0.98; 95% CI, 0.90-1.00, P < 0.001). In pairwise comparisons, statistically significant differences were found between MNM and other neurotization strategies (P < 0.001 in CFNG compared with MNM, P = 0.013 for CLFN compared with MNM, P < 0.001 for DI compared with MNM).
Conclusions: DI- and CLFN-driven strategies achieved the most promising outcomes, whereas MNM showed the potential to elicit spontaneous smile at a lower extent. Our meta-analysis was limited primarily by incongruency between spontaneity assessment systems. Consensus on a standardized tool would enable more effective comparisons of the outcomes.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.bjps.2023.10.124 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Outcomes of temporalis muscle-based facial reanimation surgery: A systematic review and meta-analysis.
JPRAS Open
March 2025
Department of Surgery, Marien Hospital Herne, University Hospital of Ruhr University Bochum, Herne, NRW, Germany.
Background: Despite the encouraging findings of temporalis muscle-based facial reanimation surgery without the need for nerve grafting, there is a need for comprehensive evaluation of the impact of temporalis-based facial reanimation surgery on key outcome measures.
Methods: Comprehensive search in Medline and Embase databases were carried out up to 25 February 2023. The articles that examined facial reanimation surgery using the temporalis muscle were included in this study.
Facing emotional vocalizations and instrumental sounds: Sighted and blind individuals spontaneously and selectively activate facial muscles in response to emotional stimuli.
Emotion
December 2024
Department of Psychology, University of California, San Diego.
Facial mimicry of visually observed emotional facial actions is a robust phenomenon. Here, we examined whether such facial mimicry extends to auditory emotional stimuli. We also examined if participants' facial responses differ to sounds that are more strongly associated with congruent facial movements, such as vocal emotional expressions (e.
View Article and Find Full Text PDFA Prospective Randomised Clinical Trial Evaluating Pulpotomy in Primary Molars With Three Bioceramic Calcium Silicate Cements: 24 Month Follow-Up.
Int J Paediatr Dent
December 2024
Private Practitioner at Pediatric Dental Care Associates, Las Vegas, Nevada, USA.
Background: In recent times, bioceramic calcium silicates have gained attention due to high success rates with pulpotomy in primary teeth.
Aims: To evaluate and compare the clinical and radiographic outcomes of three different bioceramic calcium silicate cements in vital deciduous teeth treated with pulpotomies over a period of 24 months.
Design: Children aged 4-9 years, with deep dentinal caries (ICDAS 4-6) in primary molars, having no history of spontaneous pain or signs of non-vitality were included in the study.
Quantifying the Effect of the Cross-Facial Nerve Graft on the Nonparalyzed Side.
Otolaryngol Head Neck Surg
November 2024
University of North Carolina Department of Otolaryngology, Chapel Hill, North Carolina, USA.
Objective: The cross-facial nerve graft (CFNG) is employed in facial reanimation surgery to restore neural connectivity from the nonparalyzed side of the face to the paralyzed side, facilitating spontaneous smiling. Typically, the sural nerve, due to its length, serves as the donor graft. Implantation involves functional facial branch transection to provide graft input.
View Article and Find Full Text PDFOrthodontic Management of a Growing Patient With a Skeletal Class III Malocclusion and an Anterior Open Bite: A Case Report.
Cureus
October 2024
Orthodontics and Dentofacial Orthopaedics, Manav Rachna Dental College, Faridabad, IND.
Class III malocclusion presents many challenges due to its varying elements of imbalance in skeletal, dental, and soft tissues. This necessitates a comprehensive treatment plan, including growth modification during the pre-pubertal growth phase, and long-term retention to reduce the chances of orthognathic surgery later. The components of Class III malocclusion include maxillary retrognathism, mandibular prognathism, or, in some cases, a combination of both.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!