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Surgery Spotlight CME Course: Corneal and Facial Neurotization

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Sponsored by the American Society of Plastic Surgeons® (ASPS®)

Author: Greg Borschel, MD; Ronald Zuker, MD
Plastic Surgery Education Network (PSEN) Editors:
Editor-In-Chief: Raman Mahabir, MD
Reconstructive/Micro Section Editor: Bill Casey, MD
Accreditation Statement
The American Society of Plastic Surgeons (ASPS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Designation Statement
The ASPS designates this enduring material for a maximum of 0.75AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Patient Safety credit: 0.5
Media: video

Release Date: 3/11/2015
Reviewed Date: 9/1/2018
Re-relased Date: 1/1/2019
Expiration Date: 1/1/2022
Estimated time to complete this course: 45 minutes
Minimum Post-test Score to Claim Credit: 80%

Intended Audience
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.
Educational Overview
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.
Disclosures:
None of the ASPS/PSEN staff members managing this activity have relevant financial relationships or affiliations to disclose. All identified conflicts of interest have been resolved and the educational content thoroughly vetted by ASPS for fair balance, scientific objectivity, and appropriateness of patient care recommendations. The ASPS also requires faculty/authors to disclose when off-label/unapproved uses of a product are discussed in a CME activity or included in related materials.

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.

Systems Requirements:
Participants must have internet access, browser software (either Chrome, Firefox, or InternetExplorer), Adobe Flash, and Adobe Reader. Supported Operating & Browser Systems: Microsoft Windows - IE7 or later, Firefox 3.x or later, Chrome 8.x or later. Macintosh Mac OS - Firefox 3.x or later, Safari 4.x or later. Linux - Firefox 3.x or later. Minimum Hardware Configurations: Windows - Intel Pentium II 450MHz or faster processor and 128MB of RAM. Macintosh - Power PC G3 500 MHz or faster processor OR Intel Core Duo 1.33GHz or faster processor and 128MB of RAM. Linux - Modern processor 800MHz or faster and 512MB of RAM with 128MB of graphics memory.

Medical Disclaimer
The American Society of Plastic Surgeons* (ASPS*) maintains this website to provide information of a general nature about the specialty of plastic surgery. Additionally, any instrumentation shown on the site may or may not have received FDA approval. Any information in the publications, messages, postings, articles, online courses on the website should not be considered a substitute for consultation with a board-certified plastic surgeon to address individual medical needs. Your particular facts and circumstances will determine the plastic surgery treatment which is most appropriate for you.

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Questions: Contact the American Society of Plastic Surgeons (ASPS) Online Education Department via Phone: 1-800-766-4955 or Email: onlineeducation@plasticsurgery.org.

* “American Society of Plastic Surgeons” and “ASPS” are registered trademarks of American Society of Plastic Surgeons, a not-for-profit Corporation.





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Product Code: 19416