{"title":"Advances in multiparametric magnetic resonance imaging combined with biomarkers for the diagnosis of high-grade prostate cancer","authors":"Song-lin Li, Ming-yong Zha, Qi Wang, Yong Tang","doi":"10.3389/fsurg.2024.1429831","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1429831","url":null,"abstract":"Clinical decisions based on the test results for prostate-specific antigen often result in overdiagnosis and overtreatment. Multiparametric magnetic resonance imaging (mpMRI) can be used to identify high-grade prostate cancer (HGPCa; Gleason score ≥3 + 4); however, certain limitations remain such as inter-reader variability and false negatives. The combination of mpMRI and prostate cancer (PCa) biomarkers (prostate-specific antigen density, Proclarix, TMPRSS2:ERG gene fusion, Michigan prostate score, ExoDX prostate intelliscore, four kallikrein score, select molecular diagnosis, prostate health index, and prostate health index density) demonstrates high accuracy in the diagnosis of HGPCa, ensuring that patients avoid unnecessary prostate biopsies with a low leakage rate. This manuscript describes the characteristics and diagnostic performance of each biomarker alone and in combination with mpMRI, with the intension to provide a basis for decision-making in the diagnosis and treatment of HGPCa. Additionally, we explored the applicability of the combination protocol to the Asian population.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141643792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M.J. Encarnacion Ramirez, Ismael Antonio Peralta Baez, Gervith Reyes Soto, Jeff Ntalaja Mukengeshay, Cherubin mpoyi tshiunza, A. Rosario, Nikolenko Vladimir Nikolaevich, R. Nurmukhametov, Siddarth Kannan, Keith Simfukwe, Luis Miguel Duchén Rodríguez, Gennady Chmutin, Egor Chmutin, Albert Sufianov, J. A. Soriano Sánchez, A. K. Demetriades, Matias Baldoncini, Alvaro Campero, Gennadii Piavchenko, Juan Carlos Roa Montes de Oca, K. K. Kalangu, Alistair Jenkins, Jesus Lafuente
{"title":"Challenging assumptions: “unveiling meritocracy’s reality in neurosurgery”","authors":"M.J. Encarnacion Ramirez, Ismael Antonio Peralta Baez, Gervith Reyes Soto, Jeff Ntalaja Mukengeshay, Cherubin mpoyi tshiunza, A. Rosario, Nikolenko Vladimir Nikolaevich, R. Nurmukhametov, Siddarth Kannan, Keith Simfukwe, Luis Miguel Duchén Rodríguez, Gennady Chmutin, Egor Chmutin, Albert Sufianov, J. A. Soriano Sánchez, A. K. Demetriades, Matias Baldoncini, Alvaro Campero, Gennadii Piavchenko, Juan Carlos Roa Montes de Oca, K. K. Kalangu, Alistair Jenkins, Jesus Lafuente","doi":"10.3389/fsurg.2024.1423999","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1423999","url":null,"abstract":"Meritocracy, a concept revered as the cornerstone of fairness and equal opportunity, is critically examined in the context of neurosurgery. This article challenges the notion that success in this demanding field is solely determined by individual abilities and effort. It reveals that factors such as background, gender, and socioeconomic status significantly influence one's career trajectory. By investigating how these systemic barriers impact admissions to neurosurgical training programs and professional advancement, the paper underscores the complexity of meritocracy in neurosurgery, suggesting that the meritocratic ideal is more nuanced and influenced by external variables than commonly believed.Certain universities deemed elite offer a curriculum divergent from that of their counterparts in low and middle-income countries. Students at these “elite” institutions gain exposure to new technologies and research incentives, which brings us to the realm of research. Remarkably, 75% of articles originating from developed nations account for just 25% of traumatic brain injury cases. This disparity highlights a significant research imbalance, and the common refrain underscores the need to bolster research capabilities in low-income countries. For neurosurgeons in the developing world, engaging in research often becomes a luxury due to multifaceted challenges. Financial barriers, including publication costs and paywalls for accessing articles, pose significant hurdles. Comparing salaries between countries underscores the glaring divide according to “Neurosurgeon Salary” in 2024. Neurosurgeons in the United States receive a median salary of $412,000 dollars per year, compared to $13,200 dollars in Latin America, as of June 2023. Given such incongruities, the prospect of even attending conferences or workshops abroad remains difficult for neurosurgeons from developing nations. Research isn't cast aside due to a lack of interest but due to resource limitations. The present landscape demands reconsideration.We underscore the journey towards a more inclusive and equitable future in neurosurgery as not just a goal, but a dynamic process fuelled by resilience, collaboration, and a commitment to diversity. The narrative promotes a collective endeavour to dismantle barriers and embrace innovation, emphasizing the importance of mentorship, cross-institutional collaboration, and the amplification of underrepresented voices.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141643877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Z. Jian, Xinhua Jiang, Dejian Li, Jianhua Zhou, Baoqing Yu, Chengqing Yi
{"title":"Finite element analysis of a novel anatomical plate in posterolateral plateau fractures","authors":"Z. Jian, Xinhua Jiang, Dejian Li, Jianhua Zhou, Baoqing Yu, Chengqing Yi","doi":"10.3389/fsurg.2024.1346462","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1346462","url":null,"abstract":"This study aims to analyze the biomechanical characteristics of posterolateral plateau fractures fixed by a novel anatomical plate using finite element analysis.A three-dimensional digital model of the full length of right tibiofibula was obtained by CT scanning. A posterolateral tibial plateau fracture model was then created. The acquired fracture model was assembled with 4 groups of internal fixations: Group A, novel anatomical plate; Group B, straight buttress plate; Group C, oblique T-shaped locking plate; Group D, two lag screws. Axial loads of 500, 1,000 and 1,500 N perpendicular to the horizontal plane were used to simulate the stress on the lateral plateau of a 65 kg person standing, walking and fast running.Vertical displacements of the posterolateral fragments in each of the four groups gradually increased under loads from 500 N to 1,500 N. The maximum displacement of the fracture fragment in four groups were all located on the lateral side of the proximal part, and the displacement gradually decreased from the proximal part to the distal end. The maximum displacement values under the axial load of 1,500 N was in the following order: novel anatomical plate (1.2365 mm) < oblique T-shaped locking plate (1.314 mm) < two lag screws (1.3747 mm) < straight buttress plate (1.3932 mm). As the axial load increased, the stress value of the different internal fixation models gradually increased. The stress behavior of the same internal fixation model under different loads was similar. The maximum stress value under the axial load of 1,500 N was in the following order: novel anatomical plate (114.63 MPa) < oblique T-shaped locking plate (277.17 MPa) < two lag screws (236.75 MPa) < straight buttress plate (136.2 MPa).The patients with posterolateral plateau fractures fixed with a novel anatomical plate in standing, walking and fast running can achieve satisfactory biomechanical results, which lays the foundation for future applications. At the same time, clinical fracture types are often diverse and accompanied by damage to the soft tissue. Therefore, the ideal surgical approach and appropriate internal fixation must be selected based on the patient's injury condition.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141648848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Iossa, Giovanni Traumueller Tamagnini, Francesco De Angelis, Alessandra Micalizzi, Giulio Lelli, Giuseppe Cavallaro
{"title":"TEP or TAPP: who, when, and how?","authors":"A. Iossa, Giovanni Traumueller Tamagnini, Francesco De Angelis, Alessandra Micalizzi, Giulio Lelli, Giuseppe Cavallaro","doi":"10.3389/fsurg.2024.1352196","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1352196","url":null,"abstract":"Groin hernia repair is the most common procedure performed by general surgeons. The open mesh technique generally represents the main technique for an inguinal repair, but a different approach is often required. Laparoscopy was found to be the answer to minimizing the impact of the preperitoneal open techniques described by Nyhus and Stoppa. The introduction of the totally extraperitoneal hernia repair (TEP) and transabdominal preperitoneal repair (TAPP) in the early 1990s started a new chapter in groin hernia surgery. The minimally invasive techniques vs. open mesh, and then one against the other, soon became a hot topic among abdominal wall surgeons. With time, the number of procedures and indications increased and are still increasing. This review aims to provide an overview of the two main laparoscopic techniques for groin hernia repair, answering the following questions: Who should perform them? What is the learning curve required to minimize complications and optimize operative time? When is a minimally invasive approach indicated, and which one (both in elective and in emergency setting)? How are they performed? The standard techniques have been described in detail, and personal observations from an abdominal wall surgery referral center were added. The main reviews from the early 2000s up to date, which compared the techniques, were analyzed, and the results reported, confirming the comparable safety and efficacy of both these techniques.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141647764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea Lisa, Giulia Bozzo, Valeriano Vinci, Francesco Maria Klinger, Valentina Errico, Corrado Tinterri, Marco Ettore Attilio Klinger, Alberto Testori
{"title":"Efficacy of axillary dead space closure after mastectomy, axillary clearance and prosthetic reconstruction: a single-center preliminary experience","authors":"Andrea Lisa, Giulia Bozzo, Valeriano Vinci, Francesco Maria Klinger, Valentina Errico, Corrado Tinterri, Marco Ettore Attilio Klinger, Alberto Testori","doi":"10.3389/fsurg.2024.1401699","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1401699","url":null,"abstract":"BackgroundPostoperative seroma is most frequent after mastectomy (ME) in combination with axillary lymph node dissection (ALND), and its reported incidence varies from 15.5% up to 90%. Seromas can be responsible for discomfort, infections and can lead to reconstruction failure. Therefore, many ways of seroma prevention have been studied, although from a recent overview it has become clear that no single method is reliably successful. Mechanical closure of the dead space, however, was consistently found to be significantly effective. The aim of our study is to evaluate if quilting of the axilla, in patients undergoing ME, immediate prosthetic breast reconstruction and ALND reduces the duration of drain maintenance, the incidence of seromas that require aspiration (clinically significant seromas, CSS) and reconstruction failure rate.Materials and methodsIn our study population we analyzed a total of 81 patients divided into two groups: 27 consecutive patients undergoing mastectomy, axillary lymph node dissection (ALND), breast reconstruction and quilting of the axilla. We subsequently randomly picked up a double number of patients (54) undergoing the same oncological and reconstructive procedures without undergoing axillary quilting, matched for clinical characteristics in order to analyze efficacy of the procedure while reducing any bias. Our observational retrospective data was collected from October 2016 to July 2020 in one single high-volume center. Our median follow-up time was of 40.6 months.ResultsIn the case group we observed a reduced time of drain maintenance: 16 vs. 20 days observed in the non-quilted group (<jats:italic>p</jats:italic> &lt; 0.05). Incidence of seromas that required aspiration was 11% in the control group, while 3,7% in the case group. In addition to that, we observed 6 cases of implant removal in the control group, while in the quilted group we only observed a single case.ConclusionPrevious literature and our results confirm that quilting of the axilla with flap fixation significantly decreases time of drain maintenance, allowing the earlier removal of the drains as well as decreasing the incidence of seroma, its eventual associated complications and related social costs. Moreover, our work suggests how quilting sutures decrease the incidence of seroma in patients undergoing immediate reconstruction, probably reducing the risk for implant removal.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141608416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Case Report: Dislocation of lateral menisci secondary to congenital lateral tibiofemoral cartilage thickening in both knees","authors":"Xingliang Zhang, Wentao Li, Zijin Li, Yibing Xie, Chenyu Zhu, Shaoyang Lei, Shuqian Zhang","doi":"10.3389/fsurg.2024.1395276","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1395276","url":null,"abstract":"A 24-year-old male patient complained of mild knee pain after jogging. The subsequent knee MRI demonstrated bilateral lateral thickened tibiofemoral cartilages, evidenced by deformities of the bilateral subchondral bone beneath the lateral femoral condyle cartilage. The corresponding dislocations of almost all the left lateral meniscus and part of the right lateral meniscus to the center of the joint were detected. After excluding diagnoses of congenital ring-shaped meniscus, bucket handle tear of the C-shaped lateral meniscus, and central tear of the discoid meniscus, the displacement of all or part of the lateral meniscus into the intercondylar notch was considered a consequence of congenital thickening of the lateral superior and inferior cartilage. This case may report a new variant of knee joint pathology.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141608420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intramedullary fixation versus plate fixation in the treatment of midshaft clavicle fractures: a meta-analysis of randomized controlled trials","authors":"Minpeng Lu, Hao Qiu, Yuting Liu, Jing Dong, Lingfang Jiang","doi":"10.3389/fsurg.2023.1194050","DOIUrl":"https://doi.org/10.3389/fsurg.2023.1194050","url":null,"abstract":"ObjectiveThe aim of this systematic review and meta-analysis is to assess the clinical efficacy of intramedullary fixation (IF) vs. plate fixation (PF) in the treatment of midshaft clavicle fractures.MethodsWe conducted a computerized search of the electronic databases (PubMed, EMBASE, Cochrane Library, Medlineand Chinese Journal Full-text Database) from the establishment of the database to the end of November 2022. The quality of the included studies was assessed according to the Cochrane Collaboration's “Risk of bias”. Comparisons between the two groups were based on 8 variables, including Constant score, disabilities of the arm, shoulder and hand (DASH) score, surgery time, length of incision, hospital stay; time to union, blood loss and infection.ResultsThirteen randomized controlled trials (RCTs) comprising a total of 928 patients were included in our meta-analysis. The pooled results showed that IF can benefit midshaft clavicle fractures with a reduced surgery time and hospital stay, a smaller incision, a better shoulder function (DASH score), shorter time to union and lower rate of infection compared with PF. However, there was no significant difference between the two groups in terms of Constant score at 12-month follow-up.ConclusionIF is superior to PF for the treatment of midshaft clavicle fractures.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141608419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effect of dexmedetomidine on somatosensory- and motor-evoked potentials in patients receiving craniotomy under propofol-sevoflurane combined anesthesia","authors":"Xue Yang, Xinyi Zhang, Puxuan Lin, Zeheng Liu, Shuhang Deng, Shanwen Liang, Xinyi Zhu, Qianqian Qiao, Qianxue Chen","doi":"10.3389/fsurg.2024.1386049","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1386049","url":null,"abstract":"IntroductionDexmedetomidine is often used as an adjunct to total intravenous anesthesia (TIVA) for procedures requiring intraoperative neurophysiologic monitoring (IONM). However, it has been reported that dexmedetomidine might mask the warning of a neurological deficit on intraoperative monitoring.MethodsWe reviewed the intraoperative neurophysiological monitoring data of 47 patients who underwent surgery and IONM from March 2019 to March 2021 at the Department of Neurosurgery, Renmin Hospital of Wuhan University. Pre- and postoperative motor function scores were recorded and analyzed. Dexmedetomidine was administered intravenously at 0.5 μg/kg/h 40 min after anesthesia and discontinued after 1 h in the dexmedetomidine group.ResultsWe found that the amplitude of transcranial motor-evoked potentials (Tce-MEPs) was significantly lower in the dexmedetomidine group than in the negative control group (<jats:italic>P</jats:italic> &lt; 0.0001). There was no statistically significant difference in the somatosensory-evoked potentials (SSEPs) amplitude or the Tce-MEPs or SSEPs latency. There was no significant decrease in postoperative motor function in the dexmedetomidine group compared with the preoperative group, suggesting that there is no evidence that dexmedetomidine affects patient prognosis. In addition, we noticed a synchronized bilateral decrease in the Tce-MEPs amplitude in the dexmedetomidine group and a mostly unilateral decrease on the side of the brain injury in the positive control group (<jats:italic>P</jats:italic> = 0.001).DiscussionAlthough dexmedetomidine does not affect the prognosis of patients undergoing craniotomy, the potential risks and benefits of applying it as an adjunctive medication during craniotomy should be carefully evaluated. When dexmedetomidine is administered, Tce-MEPs should be monitored. When a decrease in the Tce-MEPs amplitude is detected, the cause of the decrease in the MEPs amplitude can be indirectly determined by whether the decrease is bilateral.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141567563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hybrid endovascular and surgical staged approach for mycotic carotid pseudoaneurysms: a case report and literature review","authors":"Sallustro Marianna, Ficarelli Ilaria, Prisco Teresa, Pontarelli Armando, Foschini Giuseppe, Toni Marisole, Rinaldi Valerio, Nardi Priscilla, Piergaspare Palumbo, Illuminati Giulio, D’Andrea Vito, Ruotolo Carlo","doi":"10.3389/fsurg.2024.1394441","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1394441","url":null,"abstract":"BackgroundMycotic carotid pseudoaneurysms represent a challenge for surgeons. They are rare and associated with high mortality and morbidity.MethodsWe reported a case of a 61-year-old man with a mycotic pseudoaneurysm of carotid bifurcation. The case was managed by a staged procedure, starting with initial endovascular control using a stent graft, followed by open arterial reconstruction using a saphenous vein graft.ResultsThe patient was discharged home with a patent carotid artery and no sign of infection or bleeding. A computed tomography scan performed at 1 month, 6 months, and 1 year later confirmed good patency of the graft without imaging of cerebral ischemia.ConclusionsMycotic pseudoaneurysms of the extracranial carotid artery are rare and should always be treated surgically. This disease, despite its rarity, requires early detection and treatment to avoid fatal outcomes. A hybrid staged approach is suggested, compared to one-staged surgery, to avoid rupture and improve clinical outcomes. This approach involves using a stent graft combined with antibiotic therapy as bridge treatment until definitive surgery can be performed to enable arterial reconstruction with an autologous graft.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141567562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Friedemann Zumbusch, Peter Schlattmann, Orlando Guntinas-Lichius
{"title":"Frontiers | Facial nerve reconstruction for flaccid facial paralysis: a systematic review and meta-analysis","authors":"Friedemann Zumbusch, Peter Schlattmann, Orlando Guntinas-Lichius","doi":"10.3389/fsurg.2024.1440953","DOIUrl":"https://doi.org/10.3389/fsurg.2024.1440953","url":null,"abstract":"ObjectivesTo determine the functional outcome after facial nerve reconstruction surgery in patients with flaccid facial paralysis.MethodsA systematic review and meta-analysis was performed on studies reporting outcomes after direct facial nerve suture (DFS), facial nerve interpositional graft suture (FIGS), hypoglossal–facial nerve suture (HFS), masseteric–facial nerve suture (MFS), and cross-face nerve suture (CFS). These studies were identified from PubMed/MEDLINE, Embase, and Web of Science databases. Two independent reviewers performed two-stage screening and data extraction. A favorable result was defined as a final House–Brackmann grade I–III and is presented as a ratio of all patients in percentage. Pooled proportions were calculated using random-effects models.ResultsFrom 4,932 screened records, 54 studies with 1,358 patients were included. A favorable result was achieved after DFS in 42.67% of the patients [confidence interval (CI): 26.05%–61.12%], after FIGS in 66.43% (CI: 55.99%–75.47%), after HFS in 63.89% (95% CI: 54.83%–72.05%), after MFS in 63.11% (CI: 38.53%–82.37%), and after CFS in 46.67% (CI: 24.09%–70.70%). There was no statistically significant difference between the techniques (Q = 6.56, degrees of freedom = 4, p = 0.1611).ConclusionsThe established facial nerve reconstruction techniques including the single nerve cross-transfer techniques produce satisfactory results in most of the patients with permanent flaccid facial paralysis. An international consensus on standardized outcome measures would improve the comparability of facial reanimation techniques.","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141745449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}