Restoration of Trigeminal Cutaneous Sensation with Cross-Face Sural Nerve Grafts: A Novel Approach to Facial Sensory Rehabilitation. 2015

Joseph Catapano, and David Scholl, and Emily Ho, and Ronald M Zuker, and Gregory H Borschel
Toronto, Ontario, Canada From the Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children; and the Department of Surgery, University of Toronto.

Although treating facial palsy is considered debilitating for patients, trigeminal nerve palsy and sensory deficits of the face are overlooked components of disability. Complete anesthesia leaves patients susceptible to occult injury, and facial sensation is an important component of interaction and activities of daily living. Sensory reconstruction is well established in the restoration of hand sensation; however, only one previous report proposed a surgical strategy for sensory nerve reconstruction of the face with use of nerve transfers. Nerve transfers, when used alone, have limited application because of their restricted arc of rotation in the face; extending their arc by adding nerve grafts greatly expands their utility. The following cases demonstrate the early results after V2 and V3 reconstruction with cross-face nerve grafts in three patients with acquired trigeminal nerve palsy. Cross-face nerve grafts using the sural nerve permit more proximal reconstruction of the infraorbital and mental nerves, which allows reinnervation of their entire cutaneous distribution. All patients demonstrated improved sensation in the reconstructed dermatomes, and no patients reported donor-site abnormalities. Cross-face nerve grafts result in minimal donor-site morbidity and are promising as a surgical strategy to address sensory deficits of the face. METHODS Therapeutic, V.

UI MeSH Term Description Entries
D008297 Male Males
D005145 Face The anterior portion of the head that includes the skin, muscles, and structures of the forehead, eyes, nose, mouth, cheeks, and jaw. Faces
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012867 Skin The outer covering of the body that protects it from the environment. It is composed of the DERMIS and the EPIDERMIS.
D013497 Sural Nerve A branch of the tibial nerve which supplies sensory innervation to parts of the lower leg and foot. Nerve, Sural,Nerves, Sural,Sural Nerves
D016067 Nerve Transfer Surgical reinnervation of a denervated peripheral target using a healthy donor nerve and/or its proximal stump. The direct connection is usually made to a healthy postlesional distal portion of a non-functioning nerve or implanted directly into denervated muscle or insensitive skin. Nerve sprouts will grow from the transferred nerve into the denervated elements and establish contact between them and the neurons that formerly controlled another area. Nerve Crossover,Neurotization,Crossover, Nerve,Crossovers, Nerve,Nerve Crossovers,Nerve Transfers,Neurotizations,Transfer, Nerve,Transfers, Nerve
D061221 Trigeminal Nerve Injuries Traumatic injuries to the TRIGEMINAL NERVE. It may result in extreme pain, abnormal sensation in the areas the nerve innervates on face, jaw, gums and tongue and can cause difficulties with speech and chewing. It is sometimes associated with various dental treatments. Cranial Nerve V Injury,Fifth Cranial Nerve Injuries,Fifth Cranial Nerve Injury,Fifth-Nerve Palsy, Traumatic,Fifth-Nerve Trauma,Injury, Cranial Nerve V,Injury, Fifth Cranial Nerve,Traumatic Fifth-Nerve Palsy,Trigeminal Nerve Avulsion,Trigeminal Nerve Contusion,Trigeminal Nerve Injury,Trigeminal Nerve Transection,Trigeminal Nerve Trauma,Trigeminal Neuropathy, Traumatic,Avulsion, Trigeminal Nerve,Avulsions, Trigeminal Nerve,Contusion, Trigeminal Nerve,Contusions, Trigeminal Nerve,Fifth Nerve Palsy, Traumatic,Fifth Nerve Trauma,Fifth-Nerve Palsies, Traumatic,Fifth-Nerve Traumas,Injuries, Trigeminal Nerve,Injury, Trigeminal Nerve,Nerve Avulsion, Trigeminal,Nerve Avulsions, Trigeminal,Nerve Contusion, Trigeminal,Nerve Contusions, Trigeminal,Nerve Injuries, Trigeminal,Nerve Injury, Trigeminal,Nerve Transection, Trigeminal,Nerve Transections, Trigeminal,Nerve Trauma, Trigeminal,Nerve Traumas, Trigeminal,Neuropathies, Traumatic Trigeminal,Neuropathy, Traumatic Trigeminal,Palsies, Traumatic Fifth-Nerve,Palsy, Traumatic Fifth-Nerve,Transection, Trigeminal Nerve,Transections, Trigeminal Nerve,Trauma, Fifth-Nerve,Trauma, Trigeminal Nerve,Traumas, Fifth-Nerve,Traumas, Trigeminal Nerve,Traumatic Fifth Nerve Palsy,Traumatic Fifth-Nerve Palsies,Traumatic Trigeminal Neuropathies,Traumatic Trigeminal Neuropathy,Trigeminal Nerve Avulsions,Trigeminal Nerve Contusions,Trigeminal Nerve Transections,Trigeminal Nerve Traumas,Trigeminal Neuropathies, Traumatic

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