{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T04:47:11Z","timestamp":1771562831503,"version":"3.50.1"},"reference-count":12,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,9]],"date-time":"2020-10-09T00:00:00Z","timestamp":1602201600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Paralysis of the frontalis muscle is extremely difficult to reverse. The best treatment for facial paralysis reanimation which preserves spontaneity and muscle specificity is end\u2010to\u2010end neurorrhaphy through cross\u2010face nerve grafting. However, it is rarely possible. Muscle\u2010nerve\u2010muscle (MNM) neurotization consists of an interposition of a nerve graft connecting the normal muscle to the denervated muscle. The axons of the muscle with intact innervation grow inside a neural graft towards the paralyzed muscle resulting in neurotization. The purpose of this report is to present a case of frontalis muscle paralysis reanimated by MNM neurotization. A 65\u2010year\u2010old female patient presented complete facial paralysis after temporomandibular joint surgery. Five months afterwards, the patient spontaneously recovered facial muscle movements except the frontalis muscle. Definitive paralysis of the frontalis muscle was diagnosed after 11\u2009months, and MNM neurotization was chosen and performed. Three strings of sural nerve were placed in separated tunnels in the subcutaneous plane, through small skin incisions to connect the two bellies of frontalis muscle bilaterally, and then sutured into the muscle pocket of each side. The patient presented voluntary and synchronic contraction of the bilateral frontalis muscle, 4 months after neurotization. Electroneuromyography confirmed muscle contraction by contralateral stimulation. Despite its efficacy still being researched, it is a very promising technique for the reanimation of small muscles in facial paralysis.<\/jats:p>","DOI":"10.1002\/micr.30665","type":"journal-article","created":{"date-parts":[[2020,10,9]],"date-time":"2020-10-09T15:50:05Z","timestamp":1602258605000},"page":"181-185","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Unilateral frontalis muscle paralysis reanimated by contralateral frontalis muscle through sural nerve graft connecting the two muscles (muscle\u2010nerve\u2010muscle neurotization technique)\u2014A case report"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1237-7767","authenticated-orcid":false,"given":"Yung Chia","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Microsurgery of Hospital dos Servidores do Estado (HFSE)  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo Luiz","family":"Vanz","sequence":"additional","affiliation":[{"name":"Department of Microsurgery of Hospital dos Servidores do Estado (HFSE)  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliana Calvet","family":"Auren\u00e7\u00e3o","sequence":"additional","affiliation":[{"name":"Department of Microsurgery of Hospital dos Servidores do Estado (HFSE)  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4381-5560","authenticated-orcid":false,"given":"Tamsin","family":"Burgues","sequence":"additional","affiliation":[{"name":"Norwich Medical School  Norfolk UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Schanaider","sequence":"additional","affiliation":[{"name":"Department of Surgery School of Medicine, Universidade Federal do Rio de Janeiro (UFRJ)  Rio de Janeiro RJ Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,10,9]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489416686587"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.127.10.1211"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489418795980"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.1985.tb02981.x"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940111000901"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1054\/jcms.2001.0233"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2000-8397"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1554937"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.3171\/2013.1.JNS121525"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.5812\/traumamon.22066"},{"key":"e_1_2_5_12_1","first-page":"S91","article-title":"Why does the frontalis muscle \"never come back\"? 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