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J Reconstr Microsurg 2002; 18(8): 677-680
DOI: 10.1055/s-2002-36499
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Neurotization of the Frontal Muscle After Scalp Replantation: Case Report

A. Aydan Köse1 , Mehmet Sezgin2 , Yakup Karabag-li1 , Mahmut Õzyilmaz1 , Emre Koçman1 , Cengiz Çetin1
  • 1Osmangazi University Medical Faculty, Turkey
  • 2Military Hospital, Eskíşehir, Turkey
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Publication History

Publication Date:
13 January 2003 (online)

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ABSTRACT

A case of immediate replantation of an avulsed scalp by microvascular anastomosis is presented. Microvascular replantation of the scalp seems to offer significant social and psychological advantages over secondary reconstructive procedures. The significance of the case presented is the regaining of the motor neural function of the facial nerve after 38 months.

KEYWORD

Scalp amputation - scalp replantation - neural function

REFERENCES

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  • 2 Buncke H J, Rose E H, Brownstein M J. Successful replantation of two avulsed scalps by microvascular anastomoses.  Plast Reconstr Surg. 1978;  61 666-672
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  • 3 Van Beek L A, Zook E G. Scalp replantation by microsurgical revascularization.  Plast Reconstr Surg . 1978;  611 774-777
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1 *Editorial Note: Clearly, transverse forehead creases are noted all across the forehead, including the area lateral to the replantation scar. I suspect that an appropriate explanation is that the plane of avulsion was superficial to the temporal fascia in the right temporal area, leaving the trunk of the frontal branch of the facial nerve intact as it courses obliquely over the zygomatic arch on its way to innervate the frontalis muscle. Over time, direct neurotization of the replanted muscle was achieved by sprouting from the depth into the muscle fibers. Additionally, I would speculate that there was some degree of cross-neurotization from the contralateral frontal branch of the facial nerve from the contralateral frontalis muscle on the uninjured side. This case is a good example of the fact that sometimes our laborious efforts are rewarded with results that are beyond our level of expectation! Elliot H. Rose, M.D.