COLLEGIO DI DIREZIONE - Azienda Ospedaliera di Parma

4) Bianchi, B; Copelli, C; Ferrari, S; Ferri, A; Sesenna, E (2012) Successful salvage surgery after
treatment failures with cross graft and free muscle transplant in facial reanimation JOURNAL OF
CRANIO-MAXILLOFACIAL SURGERY 40(2):185-189 IF=1.54 [Article]
Background: The microneurovascular transfer of a free-muscle transplant is the procedure of choice for facial
animation, It is characterized by low morbidity in both adult and paediatric patients. In spite of the improvements in
microsurgical techniques, failures due to absent revascularization or reinnervation of the transplanted muscle or
infections causing flap necrosis are observed. We propose a second surgical procedure based on the gracilis muscle
transplant reinnervated by the masseteric nerve as a solution for these cases. Methods: We analyzed and report on two
patients treated in our department after the failure of a previous cross-facial nerve graft and free muscle transplant. They
were treated with a new facial reanimation using the contralateral gracilis muscle and the masseteric nerve as the donor
nerve. Results and discussion: We did not observe any postoperative complications, and all of the flaps survived.
Reinnervation and contraction of the muscle appeared 3-4 months postoperatively, with good functional and aesthetic
results. Conclusions: This technique is a one-step procedure characterized by reliable flap harvesting, low donor site
morbidity and good activity of the masseteric nerve. We consider it as a good option for treatment of facial animation
failures. (C) 2011 European Association for Cranio-Maxillo-Facial Surgery.
5) Bianchi, B; Ferri, A; Ferrari, S; Copelli, C; Boni, P; Ferri, T; Sesenna, E (2012) The free anterolateral
thigh musculocutaneous flap for head and neck reconstruction: One surgeon's experience in 92 cases
MICROSURGERY 32(2):87-95 IF=1.555 [Article]
Background: Applications of the free anterolateral thigh (ALT) musculocutaneous flap have been largely
underestimated compared with indications for fasciocutaneous or perforator flaps. In this article, the authors critically
review the experience of a single surgeon with the free ALT musculocutaneous flap for head and neck reconstruction,
focusing on its applications in different cephalic areas and on advantages and disadvantages of this technique. Patients
and methods: Ninety-two patients were treated using a free ALT musculocutaneous flap. Reconstructed areas included
tongue, oropharynx, mandible, maxilla, hypopharynx, cheek, and skull base. Results: Flap survival rate was 97.8%.
Donor site morbidity consisted in two cases of partial necrosis of the skin graft used its closure with a final donor site
complication rate of 2.2%. Overall results showed an 89% of patients returned to a normal or a soft diet. Speech was
good or intelligible in 88% and cosmesis resulted good or acceptable in 89% of cases. Conclusion: The free ALT
musculocutaneous flap offers unique advantages in head and neck reconstructions including adequate bulk when
needed, obliteration of dead space, support for the soft tissues of the face, low donor-site morbidity, and harvesting
without needing for perforators dissection, allowing for optimal patient outcome. Excessive bulky and thickness of
subcutaneous tissue, especially in occidental population, have to be considered as the main disadvantages of this
technique, finally the high incidence of hairy skin in thigh area in male patients and donor site scars associated with the
use of skin grafts have to be considered as supplementary minor drawbacks.
6) Bianchi, B; Ferri, A; Ferrari, S; Copelli, C; Ferri, T; Sesenna, E (2012) Functional and Aesthetic
Approach to Adult Unoperated Mobius Syndrome: Orthognathic Surgery followed by Bilateral Free Gracilis
Muscle Transfers PLASTIC AND RECONSTRUCTIVE SURGERY 129(1):161E-162E IF=2.635
[Letter]