Difficulty in Selecting the Motor Source in Dynamic Reconstruction with Latissimus Dorsi Myocutaneous Free Flap for Facial Nerve Palsy due to Möbius Syndrome

  • KAN Takeshi
    Department of Plastic and Reconstructive Surgery, Dokkyo Medical University Kosigaya Hospital
  • ASATO Hirotaka
    Department of Plastic and Reconstructive Surgery, Dokkyo Medical University School of Medicine
  • SUZUKI Yasutoshi
    Department of Plastic and Reconstructive Surgery, Dokkyo Medical University Kosigaya Hospital
  • UMEKAWA Kohei
    Department of Plastic and Reconstructive Surgery, Dokkyo Medical University School of Medicine
  • KURABAYASHI Takashi
    Department of Plastic and Reconstructive Surgery, Ashikaga Red Cross Hospital

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Other Title
  • メビウス症候群の顔面神経麻痺に対する,遊離広背筋移植による動的再建術において,動力源となる神経の選択に難渋した1例

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Möbius syndrome, a congenital neurological disorder, is defined as the combination of bilateral facial nerve palsy and abducens nerve palsy that is congenital and nonprogressive. The etiology is unknown and it is thought that disturbances in the 7th and 8th cranial nerves are caused by abnormalities in brainstem genesis, brainstem ischemia in fetal life, or gene depletion. The degree of facial nerve palsy varies from plegia to paresis and the selection of motor source is the most difficult factor in dynamic reconstruction with neurovascular transfer of a myocutaneous free flap. We experienced a case in which we chose the hypoglossal nerve as the motor source in dynamic reconstruction with a myocutaneous free flap for facial nerve palsy due to Möbius syndrome. At 7 years of follow-up, symmetrical appearance of the face at rest with natural smiling was observed.

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