{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T04:20:14Z","timestamp":1768450814037,"version":"3.49.0"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"04","funder":[{"name":"Swedish Research Council for Clinical Research in Medicine"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Facial Plast Surg"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Early facial nerve reconstruction should be offered in every patient with oncological resections of the facial nerve due to the debilitating functional and psychosocial consequences of facial nerve palsy. Oncologic pathology or oncologic resection accounts for the second most common cause of facial nerve palsy. In the case of these acute injuries, selecting an adequate method for reconstruction to optimize functional and psychosocial well-being is paramount. Authors advocate consideration of the level of injury as a framework for approaching the viable options of reconstruction systematically. Authors breakdown oncologic injuries to the facial nerve in three levels in relation to their nerve reconstruction methods and strategies: Level I (intracranial to intratemporal), Level II (intratemporal to extratemporal and intraparotid), and Level III (extratemporal and extraparotid). Clinical features, common clinical scenarios, donor nerves available, recipient nerve, and reconstruction priorities will be present at each level. Additionally, examples of clinical cases will be shared to illustrate the utility of framing acute facial nerve injuries within injury levels. Selecting donor nerves is critical in successful facial nerve reconstruction in oncological patients. Usually, a combination of facial and nonfacial donor nerves (hybrid) is necessary to achieve maximal reinnervation of the mimetic muscles. Our proposed classification of three levels of facial nerve injuries provides a selection guide, which prioritizes methods for function nerve reconstruction in relation of the injury level in oncologic patients while prioritizing functional outcomes.<\/jats:p>","DOI":"10.1055\/a-2318-6989","type":"journal-article","created":{"date-parts":[[2024,5,3]],"date-time":"2024-05-03T23:06:45Z","timestamp":1714777605000},"page":"450-458","source":"Crossref","is-referenced-by-count":2,"title":["Rethinking Oncologic Facial Nerve Reconstruction in the Acute Phase Through Classification of the Level of Injury"],"prefix":"10.1055","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7149-1156","authenticated-orcid":false,"given":"Jessica M.","family":"Winter","sequence":"additional","affiliation":[{"name":"Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden"},{"name":"Department of Surgical Sciences, Uppsala University, Uppsala, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleonora O.F.","family":"Dimovska","sequence":"additional","affiliation":[{"name":"Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden"},{"name":"Department of Surgical Sciences, Uppsala University, Uppsala, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chieh-Han John","family":"Tzou","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery, Hospital of Divine Savior and Sigmund Freud University, Vienna, Austria"},{"name":"Faculty of Medicine, Sigmund Freud University of Vienna, Vienna, Austria"},{"name":"Facial Palsy Center, TZOU MEDICAL, Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andres","family":"Rodriguez-Lorenzo","sequence":"additional","affiliation":[{"name":"Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden"},{"name":"Department of Surgical Sciences, Uppsala University, Uppsala, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,6,3]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1053\/j.sult.2022.11.005","article-title":"The facial nerve: anatomy and pathology","volume":"44","author":"A C Ottaiano","year":"2023","journal-title":"Semin Ultrasound CT MR"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1055\/s-2004-823118","article-title":"A review of facial nerve anatomy","volume":"18","author":"T M Myckatyn","year":"2004","journal-title":"Semin Plast Surg"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"520e","DOI":"10.1097\/PRS.0000000000010539","article-title":"Evidence-based practices in facial reanimation surgery","volume":"152","author":"S Aronson","year":"2023","journal-title":"Plast Reconstr Surg"},{"issue":"549","key":"ref4","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1080\/000164802760370736","article-title":"Bell's palsy: the spontaneous course of 2,500 peripheral facial nerve palsies of different etiologies","author":"E Peitersen","year":"2002","journal-title":"Acta Otolaryngol Suppl"},{"issue":"07","key":"ref5","doi-asserted-by":"crossref","first-page":"E283","DOI":"10.1002\/lary.24542","article-title":"Etiology, diagnosis, and management of facial palsy: 2000 patients at a facial nerve center","volume":"124","author":"M H Hohman","year":"2014","journal-title":"Laryngoscope"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1136\/bjophthalmol-2014-305719","article-title":"Structural and functional outcomes of anaesthetic cornea in children","volume":"99","author":"R G Lambley","year":"2015","journal-title":"Br J Ophthalmol"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/j.otc.2018.07.007","article-title":"Management of long-standing flaccid facial palsy: periocular considerations","volume":"51","author":"N Homer","year":"2018","journal-title":"Otolaryngol Clin North Am"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1055\/s-0042-1759616","article-title":"Lower eyelid management in facial paralysis","volume":"39","author":"N Jowett","year":"2023","journal-title":"Facial Plast Surg"},{"issue":"05","key":"ref9","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1097\/PRS.0b013e31820e9138","article-title":"Facial reanimation using the masseter-to-facial nerve transfer","volume":"127","author":"M JA Klebuc","year":"2011","journal-title":"Plast Reconstr Surg"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"1891","DOI":"10.1097\/PRS.0b013e3181bf81f6","article-title":"Outcomes of mini-hypoglossal nerve transfer and direct muscle neurotization for restoration of lower lip function in facial palsy","volume":"124","author":"J K Terzis","year":"2009","journal-title":"Plast Reconstr Surg"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1002\/micr.30992","article-title":"Selective ansa cervicalis nerve transfer to the marginal mandibular nerve for lower lip reanimation: an anatomical study in cadavers and a case report","volume":"43","author":"V Vejbrink Kildal","year":"2023","journal-title":"Microsurgery"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1089\/fpsam.2023.0144","article-title":"Hypoglossal nerve transfer for facial nerve paralysis: a systematic review and meta-analysis","volume":"26","author":"O A Hamdi","year":"2024","journal-title":"Facial Plast Surg Aesthet Med"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"698256","DOI":"10.1155\/2014\/698256","article-title":"Peripheral nerve reconstruction after injury: a review of clinical and experimental therapies","volume":"2014","author":"D Grinsell","year":"2014","journal-title":"BioMed Res Int"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1055\/s-2004-823124","article-title":"Donor nerve selection in facial reanimation surgery","volume":"18","author":"M Klebuc","year":"2004","journal-title":"Semin Plast Surg"},{"issue":"03","key":"ref15","first-page":"135","article-title":"Clinical approach and treatment of benign and malignant parotid masses, personal experience","volume":"31","author":"F Bussu","year":"2011","journal-title":"Acta Otorhinolaryngol Ital"},{"issue":"04","key":"ref16","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1055\/s-0042-1751105","article-title":"Facial nerve repair following acute nerve injury","volume":"49","author":"E Fliss","year":"2022","journal-title":"Arch Plast Surg"},{"issue":"05","key":"ref17","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1055\/s-2006-946711","article-title":"Free vascularized lateral femoral cutaneous nerve graft with anterolateral thigh flap for reconstruction of facial nerve defects","volume":"22","author":"T Iida","year":"2006","journal-title":"J Reconstr Microsurg"},{"issue":"08","key":"ref18","doi-asserted-by":"crossref","first-page":"2578","DOI":"10.1097\/SCS.0000000000005619","article-title":"Contemporary concepts of primary dynamic facial nerve reconstruction in the oncologic patient","volume":"30","author":"H J Klein","year":"2019","journal-title":"J Craniofac Surg"},{"issue":"12","key":"ref19","doi-asserted-by":"crossref","first-page":"e1164","DOI":"10.1097\/GOX.0000000000001164","article-title":"Platysma motor nerve transfer for restoring marginal mandibular nerve function","volume":"4","author":"A Rodriguez-Lorenzo","year":"2016","journal-title":"Plast Reconstr Surg Glob Open"}],"container-title":["Facial Plastic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2318-6989.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T17:21:52Z","timestamp":1730827312000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2318-6989"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,3]]},"references-count":19,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2024,7,19]]},"published-print":{"date-parts":[[2024,8]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2318-6989","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0736-6825","1098-8793"],"issn-type":[{"value":"0736-6825","type":"print"},{"value":"1098-8793","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,5,3]]},"published":{"date-parts":[[2024,5,3]]}}}