SynthesisThe Laryngoscope2026
Outcomes and Innervation of Gracilis for Pediatric Facial Paralysis: A Systematic Review.
Synthesis in The Laryngoscope, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis systematic review aims to describe and compare outcomes of innervation techniques for gracilis free muscle transfers for facial reanimation in the pediatric population. DATA SOURCES: CINAHL, PubMed, and SCOPUS were systematically queried from inception to November 18, 2025. REVIEW
methodsEligible studies included pediatric patients (≤ 18 years old) who underwent free gracilis muscle transfer for facial reanimation. Outcomes extracted included commissure excursion, facial asymmetry, validated instruments, patient satisfaction, and complications. Study quality was assessed using the Joanna Briggs Institute appraisal tool.
resultsA total of 15 retrospective studies were included for review, covering cross-facial nerve graft, masseteric innervation, and dual-innervation. The mean age at time of surgery was 9.0 ± 0.8 years with a mean follow-up time of 3.0 ± 0.5 years. Muscle innervation was achieved primarily with CFNG (52.1%), followed by masseteric (33.2%). Masseteric innervation generally produced the largest amount of commissure excursion (range: 6.1-8.6 mm), while CFNG also yielded moderate improvements (range: 4.6-6.9 mm). Overall satisfaction was high for all innervation techniques, ranging from 83% to 100%. Complications were infrequent and minor.
conclusionGracilis free muscle transfer is safe and effective for pediatric facial reanimation. Masseteric innervation provides strong, volitional smiles, while CFNG provides spontaneous smiles, with dual-innervation offering a balance of the two.
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