J 2024

Restoring the spontaneous smile through free functional muscle transfer. A systematic review and meta-analysis of the last twenty years' experience

BAYEZID, Kadir Can, Suat MORKUZU, Erdem KARABULUT, Adam BAJUS, Libor STREIT et. al.

Basic information

Original name

Restoring the spontaneous smile through free functional muscle transfer. A systematic review and meta-analysis of the last twenty years' experience

Authors

BAYEZID, Kadir Can (792 Turkey, belonging to the institution), Suat MORKUZU, Erdem KARABULUT, Adam BAJUS and Libor STREIT (203 Czech Republic, guarantor, belonging to the institution)

Edition

JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY, OXFORD, ELSEVIER SCI LTD, 2024, 1748-6815

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30212 Surgery

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 2.700 in 2022

Organization unit

Faculty of Medicine

UT WoS

001124492300001

Keywords in English

Facial palsy; Facial reanimation; Free functional; muscle transfer; Spontaneous smile; Dual innervation

Tags

International impact, Reviewed
Změněno: 14/2/2024 08:54, Mgr. Tereza Miškechová

Abstract

V originále

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 metaanalysis of prevalence was performed using Freeman-Tukey double arcsine transformation, I2 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. (c) 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Links

MUNI/A/1360/2022, interní kód MU
Name: Evaluace inovativních postupů plastické a rekonstrukční chirurgie III
Investor: Masaryk University, Evaluation of Innovative Procedures in Plastic and Reconstructive Surgery III
MUNI/A/1457/2021, interní kód MU
Name: Evaluace inovativních postupů plastické a rekonstrukční chirurgie II
Investor: Masaryk University
MUNI/11/SUP/01/2020, interní kód MU
Name: Reanimace obličeje při obrně lícního nervu: Zdvojená inervace motorické jednotky v experimentu in vivo
Investor: Masaryk University