Single versus dual innervation in facial palsy reanimation with free functional muscle transfers: a systematic review and meta-analysis
Background: Free functional muscle transfers (FFMTs) have emerged as the gold standard for reanimation of chronic facial palsy. However, the various options for neuronal input to power the transferred muscle remain an issue of debate, especially the question whether a single or two different nerves...
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Elsevier
2025-09-01
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| Series: | JPRAS Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S235258782500107X |
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| author | Andrin S Brader Jonathan Leckenby Adriaan O Grobbelaar Cédric Zubler |
| author_facet | Andrin S Brader Jonathan Leckenby Adriaan O Grobbelaar Cédric Zubler |
| author_sort | Andrin S Brader |
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| description | Background: Free functional muscle transfers (FFMTs) have emerged as the gold standard for reanimation of chronic facial palsy. However, the various options for neuronal input to power the transferred muscle remain an issue of debate, especially the question whether a single or two different nerves are used. The purpose of this study was to review the available clinical data on single versus dual innervation in FFMTs and compare their outcomes to better understand if dual innervation offers a significant benefit. Methods: A systematic review and meta-analysis were performed. Cochrane, EMBASE and PubMed MEDLINE database were searched following PRISMA guidelines 2020. All publications providing original clinical outcome data on dual nerve innervation of FFMTs in human patients were included. Results: The initial search yielded 451 studies of which 16 met the inclusion criteria for qualitative analysis and 4 for quantitative meta-analysis. A total of 98 patients were analysed, with 53 (51.94 %) women, mean age of 44.5 years in the single-innervation group and 41.2 years in the dual-innervation group, and an average follow-up period of 15 months. Both groups individually showed significant improvements (single innervation 41.1 %, p = 0.003, dual-innervation 50.7 %, p = 0.017). However, there is insufficient evidence to conclude a statistically significant difference in outcomes between the two methods. Conclusion: Both methods show meaningful improvements post-treatment. The dual innervation patients tended to have longer palsy durations and slightly better but more varied post-treatment improvements with overall no statistically significant difference to the single innervation group. |
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| institution | Matheson Library |
| issn | 2352-5878 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
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| series | JPRAS Open |
| spelling | doaj-art-59b8a646f9b64de6870a85d0f2ed3ca42025-07-11T04:31:29ZengElsevierJPRAS Open2352-58782025-09-0145239250Single versus dual innervation in facial palsy reanimation with free functional muscle transfers: a systematic review and meta-analysisAndrin S Brader0Jonathan Leckenby1Adriaan O Grobbelaar2Cédric Zubler3Department of Plastic and Hand Surgery, Inselspital University Hospital Bern, University of Bern, Freiburgstrasse 18, Bern, SwitzerlandDepartment of Surgery, Division of Plastic Surgery, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, USA; Department of Plastic and Reconstructive Surgery, Great Ormond Street Hospital for Children, Guilford St, London WC1N 3BH, United KingdomDepartment of Plastic and Hand Surgery, Inselspital University Hospital Bern, University of Bern, Freiburgstrasse 18, Bern, Switzerland; Department of Plastic and Reconstructive Surgery, Great Ormond Street Hospital for Children, Guilford St, London WC1N 3BH, United Kingdom; Division of Surgery and Interventional Science, University College of London, Royal Free Hospital, 9th Floor (East), 2QG, 10 Pond St, London NW3 2PS, United KingdomDepartment of Plastic and Hand Surgery, Inselspital University Hospital Bern, University of Bern, Freiburgstrasse 18, Bern, Switzerland; Department of Plastic and Reconstructive Surgery, Great Ormond Street Hospital for Children, Guilford St, London WC1N 3BH, United Kingdom; Corresponding author.Background: Free functional muscle transfers (FFMTs) have emerged as the gold standard for reanimation of chronic facial palsy. However, the various options for neuronal input to power the transferred muscle remain an issue of debate, especially the question whether a single or two different nerves are used. The purpose of this study was to review the available clinical data on single versus dual innervation in FFMTs and compare their outcomes to better understand if dual innervation offers a significant benefit. Methods: A systematic review and meta-analysis were performed. Cochrane, EMBASE and PubMed MEDLINE database were searched following PRISMA guidelines 2020. All publications providing original clinical outcome data on dual nerve innervation of FFMTs in human patients were included. Results: The initial search yielded 451 studies of which 16 met the inclusion criteria for qualitative analysis and 4 for quantitative meta-analysis. A total of 98 patients were analysed, with 53 (51.94 %) women, mean age of 44.5 years in the single-innervation group and 41.2 years in the dual-innervation group, and an average follow-up period of 15 months. Both groups individually showed significant improvements (single innervation 41.1 %, p = 0.003, dual-innervation 50.7 %, p = 0.017). However, there is insufficient evidence to conclude a statistically significant difference in outcomes between the two methods. Conclusion: Both methods show meaningful improvements post-treatment. The dual innervation patients tended to have longer palsy durations and slightly better but more varied post-treatment improvements with overall no statistically significant difference to the single innervation group.http://www.sciencedirect.com/science/article/pii/S235258782500107XFacial palsyFacial reanimationSingle innervationDual innervationBell’s palsyReconstructive surgery |
| spellingShingle | Andrin S Brader Jonathan Leckenby Adriaan O Grobbelaar Cédric Zubler Single versus dual innervation in facial palsy reanimation with free functional muscle transfers: a systematic review and meta-analysis JPRAS Open Facial palsy Facial reanimation Single innervation Dual innervation Bell’s palsy Reconstructive surgery |
| title | Single versus dual innervation in facial palsy reanimation with free functional muscle transfers: a systematic review and meta-analysis |
| title_full | Single versus dual innervation in facial palsy reanimation with free functional muscle transfers: a systematic review and meta-analysis |
| title_fullStr | Single versus dual innervation in facial palsy reanimation with free functional muscle transfers: a systematic review and meta-analysis |
| title_full_unstemmed | Single versus dual innervation in facial palsy reanimation with free functional muscle transfers: a systematic review and meta-analysis |
| title_short | Single versus dual innervation in facial palsy reanimation with free functional muscle transfers: a systematic review and meta-analysis |
| title_sort | single versus dual innervation in facial palsy reanimation with free functional muscle transfers a systematic review and meta analysis |
| topic | Facial palsy Facial reanimation Single innervation Dual innervation Bell’s palsy Reconstructive surgery |
| url | http://www.sciencedirect.com/science/article/pii/S235258782500107X |
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