Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London
(plain text version here)
Motor Neurotization: A Scoping Review of Periocular Direct Reinnervation Techniques and Outcomes in Facial Nerve Palsy
Author: Ahsen Hussain
ePoster Number: 164,00
Purpose
Periocular motor neurotization is a surgical approach that can be indicated for restoring dynamic eyelid function in patients with facial nerve palsy. The orbicularis oculi muscle (OOM), responsible for eyelid closure, can be the target of a variety of re-innervation techniques, such as direct nerve transfers and muscle transposition. Despite increased interest in this type of intervention, the literature on these techniques is not well systematized. This scoping review aims to identify the efficacy of various approaches, such as direct neurotization and muscle transposition of the orbicularis oculi. We aim to highlight gaps in the literature to inform future research and clinical practices.
Methods
A systematic search of major databases was conducted. Articles were screened based on predefined inclusion criteria focusing on neurotization techniques of the OOM in patients with facial nerve palsy.
Results
A total of 106 patients were included, and three techniques were identified: Direct Neurotization (DN), Nerve Transfer (NT) with DN, and OOM transposition. Ninety-six patients underwent DN alone, demonstrating clinically significant improvements in blink function and eyelid closure. The contralateral facial nerve yielded the highest blink improvement (15.25%–43.8%), whereas ipsilateral CNVII, CNVIII, CNXII, and combined CNIV/CNXI yielded decreased yet still clinically significant improvements (12.25% – 29.4%). Six patients received mini hypoglossal-facial NT (CNXII-VII) followed by DN. Blink improvement was 15.52% for contralateral CNXII + CNVII (p = 0.049) and 44.67% for ipsilateral CNXII + contralateral CNVII (p > 0.05). Four patients received OOM transposition, reporting improvements in muscle function, lagophthalmos, visual acuity, and House-Brackmann scores, with no major donor site morbidity.
Conclusion
Motor neurotization of the OOM shows promising results in restoring eyelid closure and spontaneous blink function. However, more research is required due to inconsistencies in patient demographics, surgical techniques and outcome measurements.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Abdelrahman | Abu Osba | Dalhousie University |
| Mohammad | Abdullah | Dalhousie University |
| Oyeleye | Oyesode | Dalhousie University |
Abstract ID: 25-142
