{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T13:42:08Z","timestamp":1777642928545,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T00:00:00Z","timestamp":1659052800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Facial Plastic Surgery &amp; Aesthetic Medicine"],"published-print":{"date-parts":[[2022,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>During a two-stage free gracilis muscle transfer (FGMT) to restore smile to patients with facial paralysis, some surgeons assess nerve regeneration through the cross-face nerve graft (CFNG) with the Tinel sign and a nerve biopsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To test whether ultimate smile reanimation outcomes are correlated with (1) the Tinel sign or (2) myelinated axons of the biopsied CFNG at the time of FGMT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Retrospective case series was performed at a tertiary care facial nerve center. Dynamic smile outcomes were quantified with Emotrics analysis of pre- and postoperative photographs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of the 113 FGMT surgeries by CFNG performed since 2002, 92 patients had pre- and postoperative photo-documentation. Most patients (89%,\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u200982) had a positive Tinel sign at the time of FGMT; however, 14 patients with positive Tinel signs were deemed failures. Interestingly, 4 patients with a negative Tinel sign went on to have successful dynamic outcomes and 16 patients lacking myelinated axons in their CFNG biopsy ultimately achieved successful smile outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Although the majority of patients had a positive Tinel sign and myelinated axons in the CFNG at the time of FGMT, the presence or absence of either factor did not predict ultimate smile outcome in this series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/fpsam.2021.0207","type":"journal-article","created":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T10:45:01Z","timestamp":1654512301000},"page":"255-259","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["The Tinel Sign and Myelinated Axons in the Cross-Face Nerve Graft: Predictors of Smile Reanimation Outcome for Free Gracilis Muscle Transfer?"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4889-1052","authenticated-orcid":false,"given":"Jacqueline J.","family":"Greene","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery-Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoe","family":"Fullerton","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery-Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nate","family":"Jowett","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery-Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tessa","family":"Hadlock","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery-Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,7,29]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-197602000-00001"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2013.2463"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000232195.20293.bd"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000001327"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199411000-00009"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otot.2012.08.002"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000132675.12289.78"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0266-7681(93)90249-F"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/micr.1920140909"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1054\/bjps.2002.3965"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2014.617"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000893"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199909000-00010"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/jemt.20577"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.15-05-03886.1995"},{"key":"e_1_3_5_17_2","unstructured":"Cajal S. 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