{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T12:01:35Z","timestamp":1791979295707,"version":"4.4.0"},"reference-count":87,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T00:00:00Z","timestamp":1721606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine the functional outcome after facial nerve reconstruction surgery in patients with flaccid facial paralysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review and meta-analysis was performed on studies reporting outcomes after direct facial nerve suture (DFS), facial nerve interpositional graft suture (FIGS), hypoglossal\u2013facial nerve suture (HFS), masseteric\u2013facial nerve suture (MFS), and cross-face nerve suture (CFS). These studies were identified from PubMed\/MEDLINE, Embase, and Web of Science databases. Two independent reviewers performed two-stage screening and data extraction. A favorable result was defined as a final House\u2013Brackmann grade I\u2013III and is presented as a ratio of all patients in percentage. Pooled proportions were calculated using random-effects models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 4,932 screened records, 54 studies with 1,358 patients were included. A favorable result was achieved after DFS in 42.67% of the patients [confidence interval (CI): 26.05%\u201361.12%], after FIGS in 66.43% (CI: 55.99%\u201375.47%), after HFS in 63.89% (95% CI: 54.83%\u201372.05%), after MFS in 63.11% (CI: 38.53%\u201382.37%), and after CFS in 46.67% (CI: 24.09%\u201370.70%). There was no statistically significant difference between the techniques (Q\u2009=\u20096.56, degrees of freedom\u2009=\u20094, <jats:italic>p<\/jats:italic>\u2009=\u20090.1611).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The established facial nerve reconstruction techniques including the single nerve cross-transfer techniques produce satisfactory results in most of the patients with permanent flaccid facial paralysis. An international consensus on standardized outcome measures would improve the comparability of facial reanimation techniques.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2024.1440953","type":"journal-article","created":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T04:41:36Z","timestamp":1721623296000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Facial nerve reconstruction for flaccid facial paralysis: a systematic review and 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