
Facial Reanimation
Quiz by Ariel
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A 26-year-old man sustained complete right-sided unilateral facial nerve transection and paralysis from a circular saw 3 years ago. He is now seeking surgery to improve resting symmetry and to recreate a dynamic smile. Which of the following is the most appropriate surgical procedure to achieve these results?
A 15-year-old girl is brought to the office for follow-up evaluation 5 months after sustaining facial injuries from being bitten by a dog. She has an abnormal facial nerve examination and cannot generate a smile on the right side. Prior exploration during anesthesia showed missing segments of the facial nerve. Which of the following is the most appropriate management at this time?
An 8-year-old boy with congenital right facial hemiparesis is seen in consultation for possible facial reanimation. MRI shows absence of a right facial nerve trunk. A two-stage cross-facial nerve grafting procedure is planned. A sural nerve graft coapted to a buccal branch of the facial nerve with 10-0 nylon is planned. Which of the following factors will have the greatest influence on the outcome of this procedure?
A 60-year-old man is evaluated for a painful unilateral facial rash with blisters, intense ear pain, and complete ipsilateral facial nerve paralysis. Which of the following is the most likely diagnosis?
A 45-year-old man is brought to the emergency department 2 hours after sustaining a laceration to the face from a circular saw. Physical examination shows a deep, vertically oriented wound that extends from the lateral aspect of the right lower eyelid to the neck. The patient is unable to elevate the right upper lip. Which of the following is the longest interval after the injury during which the distal nerve can be successfully stimulated?