Abstract
Moebius syndrome is a developmental neurological disorder characterized by unilateral or bilateral facial and abducens nerve paralysis. Free functional gracilis muscle transfer is the gold standard treatment for long-standing facial paralysis; innervation of the muscle with extrafacial donor motor nerves is performed when the contralateral facial nerve is not available, such as in patients with classic Moebius syndrome; however, in the case of incomplete Moebius syndrome, the contralateral facial nerve is functional, but its power is severely diminished. In order to achieve symmetry and adequate oral commissure excursion, a dually innervated gracilis muscle flap is performed, combining stimulus from the contralateral facial and ipsilateral masseter nerves: Use of the contralateral facial nerve connected to a cross-facial nerve graft (CFNG) allows synchronic and spontaneous movement, while the masseter nerve’s high axonal count allows for quick reinnervation and strong muscle contraction.
The objective of this chapter is to present an approach developed for the evaluation and management of patients afflicted with Moebius syndrome.
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Telich Tarriba, J.E., Cárdenas-Mejía, A. (2020). Facial Reanimation in Congenital Facial Palsy (Moebius Syndrome). In: Clinical Scenarios in Reconstructive Microsurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-94191-2_33-1
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DOI: https://doi.org/10.1007/978-3-319-94191-2_33-1
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