JPRAS Open最新文献

{"title":"The future of free flap monitoring by laser continuous doppler flowmetry: A prospective assessment in consecutive 71 patients","authors":"Hiroki Kodama ,&nbsp;Katsuhiro Ishida ,&nbsp;Haruyuki Hirayama ,&nbsp;Doruk Orgun ,&nbsp;Kazuho Kawashima ,&nbsp;Dariush Nikkhah ,&nbsp;James May ,&nbsp;Panicos A Kyriacou ,&nbsp;Takeshi Miyawaki","doi":"10.1016/j.jpra.2024.11.004","DOIUrl":"10.1016/j.jpra.2024.11.004","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluated the effectiveness of laser Doppler flowmetry (LDF) in detecting perfusion disturbances during microvascular free tissue transfer.</div></div><div><h3>Methods</h3><div>Conducted at a single centre from December 2020 to September 2022, this prospective study involved 71 patients mainly undergoing head and neck free flap reconstructions, using the Pocket LDF™ for continuous perfusion monitoring.</div></div><div><h3>Results</h3><div>Out of the 71 cases, data from 69 cases were analysed after excluding those with significant noise or sensor detachment. Blood flow disturbances were observed in 9 cases (13.0 %), with 5 of these cases with a history of surgery or radiation in the same area. There were 5 cases of ischaemia, 4 of which occurred during monitoring. There were 4 cases of venous congestion, with 1 occurring during monitoring. Re-operation was necessary in 8 cases (11.6 %), involving flap replacements, vascular re-anastomoses and hematoma evacuation. Complete flap necrosis occurred in 5 cases (7.2 %) and partial necrosis occurred in 3 cases (4.3 %). The LDF device demonstrated the ability to identify perfusion issues hours before the clinical symptoms manifested, suggesting its potential for early intervention. However, challenges included maintaining continuous monitoring immediately post-surgery and during patient transfers.</div></div><div><h3>Conclusion</h3><div>LDF is a valuable, non-invasive tool for early detection of perfusion disturbances in free flap procedures. It provides continuous, real-time feedback on microcirculation, facilitating timely interventions. Despite its benefits, enhancements in sensor adhesion and wireless technology are needed to improve monitoring reliability. Further studies are recommended to refine LDF usage and validate its efficacy in various clinical settings.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 140-152"},"PeriodicalIF":1.5,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensory preservation in reduction mammoplasty using the nipple-areola complex-carrying pedicle technique for gigantomastia: A systematic review and meta-analysis","authors":"F. Bonomi ,&nbsp;Y. Harder ,&nbsp;G. Treglia ,&nbsp;E. Limido ,&nbsp;M. De Monti ,&nbsp;C. Parodi","doi":"10.1016/j.jpra.2024.11.005","DOIUrl":"10.1016/j.jpra.2024.11.005","url":null,"abstract":"<div><h3>Background</h3><div>Gigantomastia is a disabling condition characterized by excess breast tissue. Historically, free nipple graft (FNG) has been preferred, prioritizing the nipple-areola complex (NAC) vascularity. The NAC-carrying pedicle technique, which is most commonly used in case of hypertrophy of the breast, has been suggested as a viable alternative for gigantomastia according to recent evidence, with reduced rates of NAC necrosis and improved outcomes. Nevertheless, a detailed outcome evaluation of the technique in terms of sensory preservation is currently lacking. Therefore, this systematic review and meta-analysis aimed to assess the risk of sensory loss associated with the NAC-carrying pedicle technique in cases of gigantomastia.</div></div><div><h3>Methods</h3><div>Following the PRISMA guidelines, a literature search identified studies reporting postoperative sensitivity with the NAC-carrying pedicle technique in resections exceeding 1000 g of adipo-glandular tissue. Then, a proportion meta-analysis was conducted to assess the pooled rate of sensation loss through the NAC-carrying pedicle technique.</div></div><div><h3>Results</h3><div>Seventeen studies (843 patients, 1685 breasts) met the inclusion criteria. The meta-analysis revealed an exceptionally low risk of sensory loss with the NAC-carrying pedicle technique (1.3%; 95% confidence interval: 0.7-2.0), without significant statistical heterogeneity.</div></div><div><h3>Conclusion</h3><div>This study provides the first comprehensive evaluation of sensory preservation with the NAC-carrying pedicle technique in gigantomastia. The NAC-carrying pedicle technique emerges as the first choice, offering safety and favorable functional outcomes. Surgical caution remains crucial with the option to switch to FNG as required, ensuring patient safety and procedure success. Further research on the impact of different NAC-carrying pedicle techniques on sensory preservation is warranted.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 153-163"},"PeriodicalIF":1.5,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel ‘mini-incision’ metacarpal fixation technique for long oblique and spiral shaft fractures","authors":"Safwat Ibrahim ,&nbsp;Conor Cuggy ,&nbsp;Jamal El-Deib","doi":"10.1016/j.jpra.2024.11.007","DOIUrl":"10.1016/j.jpra.2024.11.007","url":null,"abstract":"<div><h3>Background</h3><div>Metacarpal shaft fractures account for 30 % of all hand fractures, and long oblique and spiral shaft fractures represent a significant quantity. Closed or open reduction and internal fixation is generally indicated for unstable fractures, rotational malalignment or significant metacarpal shortening. Various techniques can achieve appropriate fixation, though no single technique has been proven to be superior across all cases. The choice of fixation often depends on the fracture pattern, surgeon expertise and patient factors.</div></div><div><h3>Objectives</h3><div>This large series aimed to show that our novel technique can achieve excellent clinical and aesthetic outcomes for metacarpal fractures despite being inferior in biomechanical studies.</div></div><div><h3>Methods</h3><div>Briefly, 120 fractures in 115 hands were included in centres across Ireland and Saudi Arabia between 2016 and 2022. Inclusion criteria were patients with long oblique and spiral metacarpal mid-shaft fractures with significant displacement, metacarpal shortening and/or rotational malalignment. Fixation was achieved via cerclage wires inserted through a minimal dorsal incision. We examined the clinical and radiological outcomes of these patients.</div></div><div><h3>Results</h3><div>We observed excellent results in our cohort, with 92.5 % of the patients obtaining full passive and active range of motion at the final follow-up. The mean qDASh score was 4.5. There was 1 case of malunion and 1 wire migration. No patients had cosmetic concerns regarding the dorsal hand scars.</div></div><div><h3>Conclusion</h3><div>Our novel metacarpal cerclage can help patients regain excellent range of motion and avoid extended immobilisation. We believe that this method is technically simple, forgiving to mistakes, affordable and can provide excellent cosmesis</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 357-365"},"PeriodicalIF":1.5,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Xeroform gauze versus silver sulfadiazine for mixed-depth pediatric scald injuries: A retrospective study","authors":"Dominic Alessio-Bilowus,&nbsp;Justin D Klein,&nbsp;Elika Ridelman,&nbsp;Christina M Shanti","doi":"10.1016/j.jpra.2024.11.006","DOIUrl":"10.1016/j.jpra.2024.11.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Silver sulfadiazine 1 % cream had historically been the mainstay initial treatment for scald wounds at our institution. However, we transitioned to using closed dressings of only petrolatum-impregnated 3 % bismuth tribromophenate gauze (Xeroform) for all partial-thickness burns. Xeroform adheres to the wound while allowing the exudates to drain and acts as a scaffold for re-epithelialization, after which it falls off without traumatizing the wound bed, theoretically allowing viable tissue to declare itself while requiring less frequent dressing changes.</div></div><div><h3>Materials and Methods</h3><div>A retrospective chart review was conducted of patients aged ≤5 years with mixed-depth scald injuries between the years 1) 2004 and 2008, during which silver sulfadiazine was the standard initial choice and 2) 2015 and 2018, when only Xeroform was used as the standard.</div></div><div><h3>Results</h3><div>The study included 347 patients, among whom 200 were treated with silver sulfadiazine and 147 were treated with Xeroform alone. The 2 groups had similar burn sizes and rates of skin grafting (silver group 30/200 [15.0 %] and Xeroform group 20/147 [17.7 %]) However, the Xeroform group showed longer time from injury to grafting (24 vs. 9.9 days, <em>p</em> = 0.002) but showed a significantly smaller mean graft size than the silver group (147 vs. 336 cm², <em>p</em> = 0.027).</div></div><div><h3>Conclusions</h3><div>These findings suggest that using Xeroform may promote better wound healing than using silver sulfadiazine. In addition, patients with Xeroform can be discharged with their dressings in place for grafting in the outpatient setting, during which time they are in closed dressings without frequent changes and associated discomfort.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 133-139"},"PeriodicalIF":1.5,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the venous supply of the face: An illustrated overview of contemporary literature","authors":"Jeremy Isaac ,&nbsp;Lee Walker ,&nbsp;Stephen R. Ali ,&nbsp;Iain S. Whitaker","doi":"10.1016/j.jpra.2024.10.019","DOIUrl":"10.1016/j.jpra.2024.10.019","url":null,"abstract":"<div><div>Understanding the vascular anatomy of the face is crucial for ensuring safe clinical practices, especially as aesthetic procedures involving hyaluronic acid fillers are gaining popularity. Although vascular complications from these procedures are rare, there has been a documented increase in adverse events linked to venous and arterial occlusions. This review addresses the knowledge gap regarding the facial venous system compared to the well-documented facial artery system, emphasising the importance of thorough anatomical knowledge to mitigate risks during injectable cosmetic procedures. The complex and variable anatomy of the facial veins, including connections to the intracerebral venous system, allows for the retrograde spread of infections and fillers, with key tributaries such as the angular and infraorbital veins facilitating communication with the cavernous sinus. Notably, the absence of valves in certain venous regions can lead to retrograde filler flow, exacerbating complications. This illustrated review provides an analysis of the facial venous anatomy, focusing on the distribution and depth of venous structures, and aims to equip practitioners with insights that can help reduce the incidence of vascular complications associated with cosmetic procedures.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 92-104"},"PeriodicalIF":1.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-Year Quality of Life Outcomes of Delayed Unilateral Autologous Breast Reconstruction and Associated Patient Factors","authors":"Michael S. Mayr-Riedler ,&nbsp;Sebastian Holm ,&nbsp;Iliana Aristokleous ,&nbsp;Bart de Vries ,&nbsp;Andres Rodriguez-Lorenzo ,&nbsp;Tua Riilas ,&nbsp;Maria Mani","doi":"10.1016/j.jpra.2024.10.014","DOIUrl":"10.1016/j.jpra.2024.10.014","url":null,"abstract":"<div><h3>Introduction</h3><div>As breast cancer survival rates improve, the long-term quality of life (QoL) has become increasingly important. With a significant number of patients still undergoing mastectomy and experiencing its well-known negative impacts on QoL, breast reconstruction aims to mitigate this by restoring body integrity. This study aimed to evaluate the changes in QoL and satisfaction in patients after breast reconstruction and influence of various patient-related factors.</div></div><div><h3>Methods</h3><div>Patients who underwent delayed unilateral deep inferior epigastric perforator (DIEP) breast reconstruction at a single institution between January 2016 and April 2019 were surveyed. QoL was assessed using the BREAST-Q questionnaire preoperatively and one year postoperatively. Scores were compared between the time points, and regression analysis was conducted to identify the influence of age, body mass index, economic status, education level, and relationship status on QoL.</div></div><div><h3>Results</h3><div>Among the 93 patients, 55 completed the preoperative and one-year postoperative BREAST-Q questionnaires (response rate: 59%). Postoperative QoL scores significantly increased for the domains “satisfaction with breasts,” physical well-being chest,” “sexual well-being,” and “psychosocial well-being” (p&lt;0.001). The scores for the domain “physical well-being abdomen” remained unchanged one year postoperatively. Higher education correlated with greater satisfaction with the breasts. Lack of an intimate partnership was identified as a significant negative factor for poorer psychosocial well-being.</div></div><div><h3>Conclusions</h3><div>Delayed unilateral DIEP breast reconstruction significantly enhances QoL and breast satisfaction one year postoperatively without causing long-term physical discomfort at the donor site. Education level and relationship status significantly affect the postoperative outcomes. Tailored preoperative counseling and psychosocial support are essential to maximize patient satisfaction and well-being following reconstruction.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 56-66"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silicone Breast Implants and Autoimmunity: A case report","authors":"Alan González ,&nbsp;Laura Ortega-Muñoz ,&nbsp;Daniela Quibano-Ordoñez ,&nbsp;Pedro A. Moreno ,&nbsp;Patricia E. Vélez-Varela","doi":"10.1016/j.jpra.2024.10.017","DOIUrl":"10.1016/j.jpra.2024.10.017","url":null,"abstract":"<div><div>The impact of breast implants on the immune system has been debated since their introduction in the 1960s, linking silicone to systemic autoimmune diseases. Recent studies have shown that silicone gel can migrate from the implant capsule, triggering immune responses by proliferating immune cells and releasing cytokines, affecting T-cell function. Silicone particles can induce the release of IL-1β and activate the NALP3 inflammasome and B cells, causing an imbalance in regulatory T cells, responder T cells, and Th17 cells. A 41-year-old female patient with a history of breast implants presented with hyperpigmented, irregular, expanding lesions and was diagnosed withmorphea in 2017. The patient also experienced symptoms such as headaches, vertigo, polyarticular pain, dry skin, and fatigue. The medical history included silicone breast implants in 2005 (PIP brand, 395 cc) and 2014 (Silimed brand, 325 cc). The patient was diagnosed with psoriasis and Sjögren's syndrome in 2018, and ASIA syndrome in 2021 and subsequently underwent implant removal, leading to clinical improvement. The patient exhibited poliautoimmunity, with multiple autoimmune conditions. Postsurgery, the patient experienced controlled polyarticular pain, with no new skin plaques and improved clinical status. The temporal correlation between implant placement and autoimmune symptoms, alongside clinical improvement post-breast implant removal, supports the hypothesis that implants function as immune adjuvants. Genetic susceptibility and environmental factors, such as silicone exposure, likely contribute to this pathology. This case highlights the potential for silicone implants to act as immune adjuvants and highlights the importance of multidisciplinary approaches in diagnosing and treating patients with autoimmune manifestations and exposure to adjuvants.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 67-73"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective management of continuous salivary flow through a pharyngocutaneous fistula using a negative pressure wound therapy device","authors":"Taku Maeda ,&nbsp;Nayuta Tsushima ,&nbsp;Kosuke Ishikawa ,&nbsp;Yuhei Yamamoto","doi":"10.1016/j.jpra.2024.10.016","DOIUrl":"10.1016/j.jpra.2024.10.016","url":null,"abstract":"<div><div>Esophagojejunal anastomotic fistula is difficult to treat because of continuous salivary flow. This report describes the innovative use of a negative pressure wound therapy device with a slit drain to treat an esophagojejunal anastomotic fistula after free jejunal transfer. Insertion of a slit drain was very effective for management of saliva. This device worked as a portable suction machine, allowing earlier healing without the need for surgery. A negative pressure wound therapy device using a slit drain can be useful for recalcitrant esophagojejunal anastomotic fistula with salivary flow after free jejunal transfer.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 74-78"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variation and distribution in temporalis muscle innervation: A systematic review and meta-analysis of anatomical studies","authors":"Zhen Yu Wong ,&nbsp;Kai Qi Ou ,&nbsp;Koen J.A.O. Ingels ,&nbsp;Niels van Heerbeek ,&nbsp;Sjaak Pouwels","doi":"10.1016/j.jpra.2024.10.018","DOIUrl":"10.1016/j.jpra.2024.10.018","url":null,"abstract":"<div><h3>Background</h3><div>Despite extensive discourse on the utilisation of the temporal muscle for facial reanimation, anatomical description regarding the innervation of its motor nerve branches is incomplete and varied. This systematic review aimed to consolidate the existing evidence concerning the distribution and variation in the pattern of temporalis innervation.<!--> </div></div><div><h3>Methods</h3><div>A PRISMA-compliant systematic literature search was conducted in November 2023 and included studies offering anatomical insights into the distribution and variation of temporalis innervation patterns. Multiple category prevalence and proportional meta-analysis were conducted.</div></div><div><h3>Results</h3><div>The initial search yielded 978 results, from which 13 studies were selected for inclusion. The inferior anterior temporalis muscle region was found to receive innervation from the buccal nerve's superior branch and inferior posterior region from the masseteric nerve. In the superior part, comprising anterior, middle and posterior regions, innervation is provided by the branches of the deep temporal nerve (DTN) arising from various branches of the mandibular or masseteric nerves. Analysis revealed that the most common variation of DTN was the presence of two branches (46%, 95% CI: 46%-63%, I²=94%), followed by three branches (26%, 95% CI: 24%-39%). Subgroup analyses of 86 patients indicated high prevalence rates of innervation by the temporal branches of the buccal nerve (85%, 95% CI: 76%-92%, I²=98%) and temporal branches of the masseteric nerve (72%, 95% CI: 63%-81%, I²=90%).</div></div><div><h3>Conclusion</h3><div>In conclusion, this systematic review and meta-analysis highlight the evolving understanding and complexities of temporalis innervation, revealing the variations in nerve branches and emphasising the need for further research.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 122-132"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of temporalis muscle-based facial reanimation surgery: A systematic review and meta-analysis","authors":"Zhen Yu Wong ,&nbsp;Frank W. de Jongh ,&nbsp;Koen J.A.O. Ingels ,&nbsp;Niels van Heerbeek ,&nbsp;Sjaak Pouwels","doi":"10.1016/j.jpra.2024.10.015","DOIUrl":"10.1016/j.jpra.2024.10.015","url":null,"abstract":"<div><h3>Background</h3><div>Despite the encouraging findings of temporalis muscle-based facial reanimation surgery without the need for nerve grafting, there is a need for comprehensive evaluation of the impact of temporalis-based facial reanimation surgery on key outcome measures.</div></div><div><h3>Methods</h3><div>Comprehensive search in Medline and Embase databases were carried out up to 25 February 2023. The articles that examined facial reanimation surgery using the temporalis muscle were included in this study. Postoperative changes in smile excursion and the angle of the mouth while smiling were pooled using the DerSimonian and Laird random-effects model. Narrative synthesis was conducted for other outcomes including assessments of spontaneous smile, subjective evaluation of facial symmetry using validated rating tools, functional outcomes, aesthetic outcomes and patient-reported outcomes owing to heterogeneity in reporting of the outcomes.</div></div><div><h3>Results</h3><div>Twenty-four studies were included in the analysis. Conflicting evidence was demonstrated regarding emotional smile outcomes and its definition. The pooled changes in smile excursion postsurgery were 7.06 mm (95% CI: 3.73-10.40, P &lt; 0.001; I² = 0%) and the angle of the mouth were 11.76° (95% CI: 8.80-14.71, P &lt; 0.001; I² = 0%). Significant improvement was reported across the validated rating scales of symmetry, functional outcomes, aesthetic outcomes and patient-reported outcomes whereas the superiority compared to other procedures remained inconclusive.</div></div><div><h3>Conclusion</h3><div>Overall, temporalis-based facial reanimation surgery is a promising option for addressing the negative effects of facial nerve paralysis on the patients’ quality of life. This study highlights the uncertainty surrounding the technique and need for further studies.</div></div>","PeriodicalId":37996,"journal":{"name":"JPRAS Open","volume":"43 ","pages":"Pages 105-121"},"PeriodicalIF":1.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}