{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:55:06Z","timestamp":1790009706218,"version":"4.0.1"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T00:00:00Z","timestamp":1689206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003The aim of this study was to assess the ability to smile following a hypoglossal\u2013facial nerve transfer (N12\u2013N7).<\/jats:p><jats:p>\n          Design\u2003This is a retrospective chart review.<\/jats:p><jats:p>\n          Setting\u2003National tertiary referral center for skull base pathology.<\/jats:p><jats:p>\n          Participants\u2003Seventeen patients.<\/jats:p><jats:p>\n          Main Outcome Measures\u2003The ability to smile following an N12\u2013N7 transfer was assessed by five medical doctors on photographs of the whole face and frontal, orbital, and oral segments. The (segmented) photographs were scored for the symmetry, asymmetry, and correct or incorrect assessment of the affected side.<\/jats:p><jats:p>\n          Results\u2003Seventeen patients were analyzed by 5 assessors providing 85 assessments. The whole face at rest was judged symmetrical in 26% of the cases and mildly asymmetrical in 56%. Frontal, orbital, and oral segments were symmetrical in 63, 20, and 35%, respectively. The affected side was correctly identified in 76%. When smiling, the whole face was symmetrical in 6% and mildly asymmetric in 59%. The affected side was correctly identified in 94%. The frontal, orbital, and oral segments during smiling were symmetrical in 67, 15, and 6%, respectively. The affected side of the frontal, orbital, and buccal facial segments during smiling was correctly identified in 89, 89, and 96%, respectively. Interobserver variability with Fleiss' kappa analysis showed that the strength of the agreement during smile of the total face was good (0.771)<\/jats:p><jats:p>\n          Conclusion\u2003Following an N12\u2013N7 transfer, a good facial symmetry at rest can be achieved. During smiling, almost all patients showed asymmetry of the face, which was predominantly determined by the orbital and oral segments. To improve the ability to smile after an N12\u2013N7 transfer, additional procedures are needed.<\/jats:p>","DOI":"10.1055\/a-2128-5191","type":"journal-article","created":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T22:51:38Z","timestamp":1689288698000},"page":"546-552","source":"Crossref","is-referenced-by-count":4,"title":["Reestablishment of the Smile after Hypoglossal\u2013Facial Nerve Transfer: What Can We Learn?"],"prefix":"10.1055","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4477-1080","authenticated-orcid":false,"given":"M.C.","family":"Kleijwegt","sequence":"additional","affiliation":[{"name":"ENT Department, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Wever","sequence":"additional","affiliation":[{"name":"ENT Department, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.F.","family":"Hensen","sequence":"additional","affiliation":[{"name":"ENT Department, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.C.","family":"Jansen","sequence":"additional","affiliation":[{"name":"ENT Department, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.W.","family":"Koot","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.J.A.","family":"Malessy","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Leiden University Medical Center, Leiden, The 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