Long-term results of facial animation surgery in patients with Moebius syndrome.

Abstract	Gracilis neuromuscular transplant is considered the gold standard for facial animation in Moebius syndrome patients. However, long-term evaluation of the results has not been critically examined in the international literature. Thus, it remains unknown how the transplanted flap changes with facial growth, and whether contraction (smiling) is maintained. Pediatric patients with Moebius syndrome who underwent facial animation surgery with at least 5 years of follow-up were retrospectively examined. Photographs taken at the 1-year and most recent follow-up visits were analyzed and compared using Emotrics software. Analyses focused on the rest position, and on gentle and maximum smiles. Eighteen patients were enrolled. Seven patients had bilateral and 11 unilateral Moebius syndrome; therefore, 25 gracilis transplants were analyzed. The latest follow-ups ranged from 5 to 13.2 years (mean 7.6 years). The three principal facial expressions that were examined did not differ significantly between 1 year and a mean of 7.6 years after surgery, but tended to improve in most patients. Commissure excursion and smile angle for the maximum smile did improve significantly (p = 0.002 and 0.029, respectively). The series examined in this study supports the limited literature regarding the long-term stability of gracilis transplantation to animate the faces of Moebius syndrome children.
Authors	Bernardo Bianchi, Francesca Zito, Giuseppe Perlangeli, Giuseppe Pedrazzi, Pier Francesco Ferrari, Elisa De Stefani, Enrico Sesenna, Andrea Di Tano, Andrea Ferri
Journal	Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery (J Craniomaxillofac Surg) Vol. 48 Issue 12 Pg. 1132-1137 (Dec 2020) ISSN: 1878-4119 [Electronic] Scotland
PMID	33191114 (Publication Type: Journal Article)
Copyright	Copyright © 2020 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
Topics	Child Facial Expression Facial Paralysis (surgery) Humans Mobius Syndrome (surgery) Plastic Surgery Procedures Retrospective Studies Smiling Treatment Outcome

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