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Update in facial nerve paralysis: tissue engineering and new technologies

Langhals, Nicholas B.a,b,*; Urbanchek, Melanie G.a,*; Ray, Amritac; Brenner, Michael J.c

Current Opinion in Otolaryngology & Head and Neck Surgery: August 2014 - Volume 22 - Issue 4 - p 291–299
doi: 10.1097/MOO.0000000000000062
FACIAL PLASTIC SURGERY: Edited by Travis T. Tollefson

Purpose of review To present the recent advances in the treatment of facial paralysis, emphasizing the emerging technologies. This review will summarize the current state of the art in the management of facial paralysis and discuss the advances in nerve regeneration, facial reanimation, and use of novel biomaterials. This review includes surgical innovations in reinnervation and reanimation as well as progress with bioelectrical interfaces.

Recent findings The last decade has witnessed major advances in the understanding of nerve injury and approaches for management. Key innovations include strategies to accelerate nerve regeneration, provide tissue-engineered constructs that may replace nonfunctional nerves, approaches to influence axonal guidance, limiting of donor-site morbidity, and optimization of functional outcomes. Approaches to muscle transfer continue to evolve, and new technologies allow for electrical nerve stimulation and use of artificial tissues.

Summary The fields of biomedical engineering and facial reanimation increasingly intersect, with innovative surgical approaches complementing a growing array of tissue engineering tools. The goal of treatment remains the predictable restoration of natural facial movement, with acceptable morbidity and long-term stability. Advances in bioelectrical interfaces and nanotechnology hold promise for widening the window for successful treatment intervention and for restoring both lost neural inputs and muscle function.

aSection of Plastic Surgery, Department of Surgery

bDepartment of Biomedical Engineering

cDivision of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology – Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA

*Nicholas B. Langhals and Melanie G. Urbanchek contributed equally to the writing of this article.

Correspondence to Michael J. Brenner, MD, Department of Otolaryngology – Head & Neck Surgery, University of Michigan School of Medicine, 1500 East Medical Center Drive, SPC 5312, 1904 Taubman Center, Ann Arbor, MI 48109-5312, USA. Tel: +1 734 232 9408; e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins