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.
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.
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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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