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Italian Journal of Maxillofacial Surgery 2011 June;22(2):125-30


language: English

Bilateral facial paralysis reanimation with gracilis free flap in a case of Moebius syndrome

Valentini V., Gennaro P., Aboh I. V., Longo G., Cassoni A., Iannetti G.

Department of Maxillo Facial Surgery, Policlinico Umberto I, “La Sapienza” University, Rome, Italy


The Moebius’s Syndrome is a rare congenital pathology characterized by oculo-facial paralysis whose clinical picture is dominated from the facial amimia, inability to smile, to blink and to move the eyes sideways. Such syndrome is due to an anomaly of development of the VII c.n, that it is also associated to anomaly of the VI c.n. in 75% of the cases. The authors introduce the clinical case of a young patient suffering from Moebius syndrome, who underwent a bilateral reanimation of the VII c.n. with microvascular gracilis free flap in the Department of maxillo-facial surgery of La Sapienza University of Rome. They performed two operations with an interval of time of nine months in order to restore bilaterally the facial expressions and especially the ability to smile. Microneurovascular free muscle transfer is a standardized procedure in the treatment of established or long-standing facial paralysis. However, there is no general agreement about which is the best muscular free flap to use. In this clinical case we have chosen microvascular gracilis free flap. The reasons of this choice were: thinness of the flap, reduction of operative time and possibility of working in double equipe, good esthetical and functional outcomes of donor site. After a period of 6 months we recorded a satisfactory functional results and the patient became able to smile.

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