{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T11:07:53Z","timestamp":1779188873134,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"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"],"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To determine the cost-effectiveness of single-stage free tissue transfer techniques as compared to no intervention for the treatment of chronic facial paralysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The health utility values specific to unilateral facial paralysis and post-facial reanimation, as well as the cost and success rate of free tissue transfer, were derived from the published literature. Decision tree modeling with Monte Carlo simulation was used to calculate cost-effectiveness. A sensitivity analysis tested the validity of the conclusions by modeling variations in cost and utility values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The surgical pathway is $141,277 more costly and 2.49 quality-adjusted life years (QALY) more effective than no intervention. The incremental cost-effectiveness ratio between the two pathways is $56,737.80\/QALY. At a willingness to pay (WTP) threshold of $100,000 and $150,000, the surgery is cost-effective across all parameters tested (maximum cost end-point being $180,000).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Despite the imperfect success rate and risks involved, free tissue transfer surgery is a cost-effective treatment for facial paralysis as compared to no intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/26893614261429298","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T17:28:27Z","timestamp":1773250107000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost-Effectiveness of Free Tissue Transfer for Unilateral Facial Paralysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2740-7516","authenticated-orcid":false,"given":"Rema","family":"Shah","sequence":"first","affiliation":[{"name":"Division of Otolaryngology, Yale School of Medicine, New Haven, Connecticut, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sidharth","family":"Tyagi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yale School of Medicine, New Haven, Connecticut, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Munshi","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, Yale School of Medicine, New Haven, Connecticut, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shekhar K.","family":"Gadkaree","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic &amp; Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine,  Miami, Florida, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan H.","family":"Lee","sequence":"additional","affiliation":[{"name":"Facial Plastic &amp; Reconstructive Surgery, Division of Otolaryngology, Yale School of Medicine, New Haven, Connecticut, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suresh","family":"Mohan","sequence":"additional","affiliation":[{"name":"Facial Plastic &amp; Reconstructive Surgery, Division of Otolaryngology, Yale School of Medicine, New Haven, Connecticut, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,3,4]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/iop.0000000000002912"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.31997"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/26893614251363957"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2024.1440953"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2016.01.021"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/13548506.2021.1876891"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11102890"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2018.0866"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/fpsam.2022.0283"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2019.05.027"},{"key":"e_1_3_2_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.27112"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25424"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-154-3-201102010-00007"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181c91501"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czz127"},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.16932"},{"key":"e_1_3_2_18_1","doi-asserted-by":"publisher","DOI":"10.1089\/fpsam.2020.0292"},{"key":"e_1_3_2_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lio2.410"},{"key":"e_1_3_2_20_1","unstructured":"19.Hospital Adjusted Expenses per Inpatient Day. 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