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To the Editor.—I read with interest the article by Dr Crumley, "Interfascicular Nerve Repair: Is it Applicable in Facial Nerve Injuries?" in the June Archives (106:313-316, 1980). Although I am in agreement with the theory and recommendations made, I am disturbed by one part of his representation. His follow-up examination at 18 months is represented by an off-center, close-up photograph of a hirsute gentleman in repose. No other photographs were included for deliberation.
The operation described was performed solely to improve the patient's control of mimic expression and Dr Crumley's results cannot be assessed from one snapshot. At the 1979 Facial Nerve Symposium in Nashville, Tenn, it was repeatedly emphasized that the interfascicular nerve must be evaluated in its dynamic state.
A minimum of two photographs should be the standard—one with the patient in repose and one showing maximal mimic muscle contraction. Ideally, these poses should be presented in
MITCHELL SA. Preoperative and Postoperative Photographic Standards. Arch Otolaryngol. 1981;107(2):130. doi:10.1001/archotol.1981.00790380060015