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Research and Publications

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Advances in Treating Facial Paralysis

Listen to a podcast with Dr. P. Daniel Knott and his discussion on facial paralysis. Click here.

Motor Nerve to the Vastus Lateralis

P. Daniel Knott

Facial nerve paralysis is a potentially devastating cranial nerve injury with both functional and psychological impact. Neural compromise following tumor resection or in cases of traumatic and iatrogenic injury can be treated in several ways. Direct anastomosis is the preferred treatment in cases of neurotmesis if there is sufficient length to provide a tension-free coaptation. If direct anastomosis is not possible, a cable graft spanning the interrupted segment is accomplished with an autologous nerve. Resection of malignant tumors affecting the facial nerve commonly results in large segments of neural discontinuity that may involve several branches of the facial nerve. Full PDF available.

Happy Birthday Facial Nerve

P. Daniel Knott

One of the worst most moments in early lives of children occurs when they awake the morning after their birthday and realize that 364 days separate them from their next birthday. The seemingly endless, yearlong wait that faces the unhappy child the day after his or her birthday is exactly the same "treatment" that we recommend to many of our patients with facial paralysis. As treating physicians, we likely fail to fully appreciate the isolation, sadness, and subtle but innumerable reminders of facial disability that fill each of those 364 days of our patients' lives. Full PDF available.

Simultaneous Anterolateral Thigh Flap and Temporalis Tendon Transfer to Optimize Facial Form and Function After Radical Parotidectomy

P. Daniel Knott

Parotidectomy is the treatment of choice for many benign and malignant salivary gland tumors, whether metastatic or primary, and is often considered for aggressive cutaneous and temporal bone malignant tumors. High-grade parotid and aggressive cutaneous malignant tumors of the head and neck with neurotropic spread, direct parotid invasion, or metastatic spread commonly necessitate total parotidectomy with facial nerve sacrifice. Full PDF available.

Facial Nerve Neurorrhaphy and the Effects of Glucocorticoids in a Rat Model

Rahul Seth

Objective. After nerve injury, an exaggerated neuroinflamma- tory process may hinder neuron regeneration and recovery. Immunomodulation using glucocorticoids may therefore improve facial nerve injury outcomes. This study aims to examine the effect of both local and systemic dexametha- sone administration on facial nerve functional recovery after axotomy in a rat model. Full PDF available.

Split hypoglossal-facial nerve neurorrhaphy for treatment of the paralyzed face

Rahul Seth

Several methods of neural rehabilitation for facial paralysis using 12-7 transfers have been described. The purpose of this study is to report on a series for dynamic reinnervation of the paralyzed face by using a split 12-7 nerve transposition. The goals of this procedure are to minimize tongue morbidity and to provide good facial reinnervation. Full PDF available.

Sternocleidomastoid contour restoration: an added benefit of the anterolateral thigh free flap during facial reconstruction

Rahul Seth and P. Daniel Knott

To demonstrate the potential of the anterolateral thigh free flap for neck contour restoration. Full PDF available.

Total parotidectomy defect reconstruction using the buried free flap

Rahul Seth

1) Present an alternative method of total parotid- ectomy with or without neck dissection defect reconstruction that results in improved cosmesis. 2) Describe applications of free tissue transfer in parotidectomy defect reconstruction. Full PDF available.