This educational activity is intended for plastic surgery practitioners, residents, and other healthcare professionals interested in translating expanded knowledge into practice for the improvement of patient outcomes in plastic and reconstructive surgery.
In this video, Greg Borschel, MD, and Ronald Zuker, MD, perform Corneal and Facial Neurotization on a patient who has previously survived a brain tumor. The tumor rendered her cornea insensate, which is leading to vision loss as the cornea opacifies. The goal of the surgery is to restore protective sensation to the cornea as well as reinnervate her cheek, upper and lower lips. Dr. Zuker harvests a sural nerve which is segmented and passed subcutaneously across three areas of the face (chin, lip and eye) to reinnervate the insensate side of the face by tapping into the active nerves on the unaffected side. Drs. Borschel and Zuker demonstrate the process for harvest, identifying viable facial nerve candidates to connect to and then creating the subcutaneous tunnels to pass the sural nerve grafts from one side of the face to the other, starting with the coroneal reinnervation. At one year post-op, the patient achieved protective and tactile sensation to the cheek and lower lip and has developed 60 mm of corneal sensation.
Medical Disclosures:
The Surgery Spotlight program was created to bridge a difficult gap between classroom theory and clinical application. Every month, PSEN seeks out experts in the clinical field to demonstrate their approach to a given surgical problem. By presenting the Surgical Spotlight program, the PSEN does not suggest that any one surgeon's operative method is the sole or only appropriate approach that should be considered. Every surgeon should use their own judgment in planning their operative approach to suit their own skill set and the needs of their patients. The views expressed in the Surgery Spotlight programs are the views of the operating surgeons and do not necessarily reflect the views of PSEN.
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