Facial reconstruction with vascularised serratus anterior muscle flap in patients with Parry–Romberg syndrome

Abstract 

Objective

Parry–Romberg syndrome, popularly known as progressive hemifacial atrophy, is a rare and complicated craniofacial deformity characterized by idiopathic and progressive atrophy of patient's face with compromised facial aesthetics and functions. In the present study, we performed a retrospective review on the vascularised serratus anterior muscle flap transfer for the treatment of the hemifacial atrophy in 4 consecutive Chinese patients with Parry–Romberg syndrome.

Methods

The serratus anterior muscle flaps were harvested and transferred to correct the facial defects together with simultaneous nerve anastomosis between the long thoracic nerve and the ipsilateral cervical branch of facial nerve in the patients with Parry–Romberg syndrome. The postoperative results from patients’ own perception of improvement of facial profile and symmetry were also evaluated.

Results

In this patient series, both of the vessels and nerves of all flaps were anastomosed successfully in the recipient facial regions without any microvascular failures. Satisfactory facial contour and favorable symmetry were achieved with minimal donor-site morbidity, complications, recurrence and little resorption in surgical reconstruction of hemifacial atrophy during our follow-up period.

Conclusions

Our results suggested that vascularised serratus anterior muscle flap transfer combined with simultaneous nerve anastomosis is a reliable and effective treatment of choice that offers satisfactory results in the surgical correction of facial atrophy associated with Parry–Romberg syndrome.

Keywords: Parry–Romberg syndrome, Anterior serratus muscle flap, Facial reconstruction, Neuroanastomosis