Pectoralis Minor Transplantation in the Netherlands

Abstract

In 1986 the plastic surgeons participating in the Facial Nerve Study Group in the Netherlands were not satisfied with the results of their muscle transplantations. At the beginning of the 1980s, the extensor digitorum brevis muscle [5, 6, 8–11] was used in the Netherlands for reanimation of the paralyzed face. The overall impression was that this muscle did not have enough force after it was transplanted. Some Dutch plastic surgeons had experience with the gracilis muscle [2, 4, 6], but found it rather bulky. Therefore, the members of the Facial Nerve Study Group agreed to use the pectoralis minor muscle as a study object in patients with an irreversible facial palsy. A multicenter project was started, including hospitals in Amsterdam, Arnhem, Ede, and Utrecht. The pectoralis minor transplantation was introduced to us by Douglas Harrison [3]. One of the goals was to create a large group of patients. Whether or not this type of muscle would give satisfactory reanimation of the face, as well as possible improvements, would be discussed at a later stage. One of the authors (FPS) participated in all of the pectoralis minor transfers and videotaped the patients at regular intervals before and after the operation.