Eyelid Reanimation with Free Platysma Graft: Final Stage of Reconstruction after Gunshot Wound to Face
Summary:. Patients with gunshot wounds to the face have massive soft tissue and bony damage from projectile and blast injuries. They often require multiple, staged reconstructive surgeries with cross-facial nerve grafting and free muscle flap for re-establishment of facial expression. Injury to or t...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2022-06-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004372 |
| _version_ | 1818219230803263488 |
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| author | Justin Hart, DO Rohun Gupta, BA Kongkrit Chaiyasate, MD |
| author_facet | Justin Hart, DO Rohun Gupta, BA Kongkrit Chaiyasate, MD |
| author_sort | Justin Hart, DO |
| collection | DOAJ |
| description | Summary:. Patients with gunshot wounds to the face have massive soft tissue and bony damage from projectile and blast injuries. They often require multiple, staged reconstructive surgeries with cross-facial nerve grafting and free muscle flap for re-establishment of facial expression. Injury to or total loss of the facial nerve and branches can result in loss of function of the orbicularis oculi muscle, which leads to the loss of protective mechanisms of eyelid function and blink reflex. The purpose of this article is to provide a literature review and discussion of eyelid reanimation after facial paralysis and to discuss our surgical technique with free platysma muscle grafts of the eyelid. The patient is a 45-year-old man with a history of a gunshot wound to the right face. He underwent multiple reconstructive surgeries in the past, and in preparation for eyelid reanimation, he underwent a cross-facial nerve graft from the left temporal branch to the right eyelid. At initial postoperative evaluation, the patient was able to close his right eye with minimal lagophthalmos, and at 3-month follow-up, he exhibited stronger blinking reflex. This case demonstrates that a free platysma graft with direct neurotization with cross-facial nerve graft fascicles can be utilized for restoration of spontaneous eyelid animation. However, there may be failure of neurotization and inability of the spontaneous blink reflex to be present. Despite these limitations, we still recommend the utilization of free platysma graft to provide upper eyelid reanimation through cross-facial nerve graft. |
| first_indexed | 2024-12-12T07:36:21Z |
| format | Article |
| id | doaj.art-67d482bc98684b30992ebb7e364cb51e |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-12T07:36:21Z |
| publishDate | 2022-06-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-67d482bc98684b30992ebb7e364cb51e2022-12-22T00:32:54ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742022-06-01106e437210.1097/GOX.0000000000004372202206000-00019Eyelid Reanimation with Free Platysma Graft: Final Stage of Reconstruction after Gunshot Wound to FaceJustin Hart, DO0Rohun Gupta, BA1Kongkrit Chaiyasate, MD2From the * Department of Plastic Surgery, Beaumont Health Systems, Royal Oak, Mich.† Oakland University William Beaumont School of Medicine, Rochester, Mich.From the * Department of Plastic Surgery, Beaumont Health Systems, Royal Oak, Mich.Summary:. Patients with gunshot wounds to the face have massive soft tissue and bony damage from projectile and blast injuries. They often require multiple, staged reconstructive surgeries with cross-facial nerve grafting and free muscle flap for re-establishment of facial expression. Injury to or total loss of the facial nerve and branches can result in loss of function of the orbicularis oculi muscle, which leads to the loss of protective mechanisms of eyelid function and blink reflex. The purpose of this article is to provide a literature review and discussion of eyelid reanimation after facial paralysis and to discuss our surgical technique with free platysma muscle grafts of the eyelid. The patient is a 45-year-old man with a history of a gunshot wound to the right face. He underwent multiple reconstructive surgeries in the past, and in preparation for eyelid reanimation, he underwent a cross-facial nerve graft from the left temporal branch to the right eyelid. At initial postoperative evaluation, the patient was able to close his right eye with minimal lagophthalmos, and at 3-month follow-up, he exhibited stronger blinking reflex. This case demonstrates that a free platysma graft with direct neurotization with cross-facial nerve graft fascicles can be utilized for restoration of spontaneous eyelid animation. However, there may be failure of neurotization and inability of the spontaneous blink reflex to be present. Despite these limitations, we still recommend the utilization of free platysma graft to provide upper eyelid reanimation through cross-facial nerve graft.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004372 |
| spellingShingle | Justin Hart, DO Rohun Gupta, BA Kongkrit Chaiyasate, MD Eyelid Reanimation with Free Platysma Graft: Final Stage of Reconstruction after Gunshot Wound to Face Plastic and Reconstructive Surgery, Global Open |
| title | Eyelid Reanimation with Free Platysma Graft: Final Stage of Reconstruction after Gunshot Wound to Face |
| title_full | Eyelid Reanimation with Free Platysma Graft: Final Stage of Reconstruction after Gunshot Wound to Face |
| title_fullStr | Eyelid Reanimation with Free Platysma Graft: Final Stage of Reconstruction after Gunshot Wound to Face |
| title_full_unstemmed | Eyelid Reanimation with Free Platysma Graft: Final Stage of Reconstruction after Gunshot Wound to Face |
| title_short | Eyelid Reanimation with Free Platysma Graft: Final Stage of Reconstruction after Gunshot Wound to Face |
| title_sort | eyelid reanimation with free platysma graft final stage of reconstruction after gunshot wound to face |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004372 |
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