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January 1990

Facial Reanimation by Cranial Nerve Substitution Without Tongue or Shoulder Paralysis

Author Affiliations

Kansas City, Mo

Arch Otolaryngol Head Neck Surg. 1990;116(1):15. doi:10.1001/archotol.1990.01870010017006

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Facial reanimation using the sternocleidomastoid branch of the spinal accessory nerve (XI) was the subject of a paper presented by William R. Panje, MD, and Thomas J. Dobleman, MD, University of Chicago (Ill) Pritzker School of Medicine, at the Fifth International Symposium on Plastic and Reconstructive Surgery of the Head and Neck in Toronto, Canada, on June 21, 1989. This selective nerve XI-VII anastomosis avoids the problem of speech and swallowing dysfunction, or shoulder weakness that can occur with a hypoglossal or spinal accessory nerve transposition. In a previous cadaver study the authors had identified three types of innervation patterns to the sternocleidomastoid muscle. Each of these branching patterns afforded enough length after mobilization to be approximated to the pes anserinus.

In this paper, the authors reported their experience in five patients, some of whom had long-standing paralysis greater than 2 years. A microneural suture technique was used, as well

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