{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T18:50:59Z","timestamp":1778007059870,"version":"3.51.4"},"reference-count":46,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:00:00Z","timestamp":1756339200000},"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":[[2025,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Nerve transfers can restore lost motor function in cases of facial palsy, with recovery reliant on brain plasticity enabling volitional control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To quantify clinical and treatment factors influencing independent facial motor recovery after hypoglossal-to-facial nerve transfer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients with complete unilateral facial palsy who underwent hypoglossal (resultsXII) to facial (CNVII) nerve transfer were analyzed. Brain plasticity was graded using a 4-point Plasticity Grading Scale (PGS). Patient variables, including age, sex, surgical timing, follow-up duration, and rehabilitation quality, were recorded and analyzed for their relationship with PGS scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Sixty-six patients were included, with a median age of 45 years, of which 62% were male. Plasticity was classified as poor in 53% and absent in 41% of patients. No patient achieved complete independence of facial muscles from tongue movements. Higher PGS scores were associated with earlier surgical intervention (\u22646 months post-trauma;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.008), younger age (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.001), and adherence to rehabilitation at a specialized neurorehabilitation center (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Brain plasticity after hypoglossal-to-facial nerve transfer is often limited, failing to achieve independence of facial muscles from the donor nerve. Early intervention, younger age, and specialized rehabilitation enhanced functional recovery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/26893614251370307","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T17:58:29Z","timestamp":1759255109000},"page":"452-458","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Independence of Facial Movements from the Tongue Following Hypoglossal-to-Facial Nerve Transfer Using the Plasticity Grading Score"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1798-1690","authenticated-orcid":false,"given":"Simon","family":"Miedema","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mart\u00edn","family":"Bourguet","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, University of Buenos Aires School of Medicine, Buenos Aires, Argentina."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danilo","family":"Battaglia","sequence":"additional","affiliation":[{"name":"Peripheral Nerve &amp; 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