Evidence map›Paper›PMID 41694805›Full record

ReviewFrontiers in surgery2026

Rewiring faces: advances and outcomes in facial nerve reconstruction after facial vascularized composite allotransplantation.

Leonard Knoedler, Tobias Niederegger, Robert Munzinger, Surbhi Joshi, Thomas Schaschinger, Curtis L Cetrulo, Christian Festbaum, Andreas Kehrer, Gabriel Hundeshagen, Max Heiland and 4 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Frontiers in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Leonard Knoedler *Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Tobias Niederegger *Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany.
Robert MunzingerMedical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany.
Surbhi JoshiMedical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany.
Thomas SchaschingerMedical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany.
Curtis L CetruloDivision of Plastic and Reconstructive Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, United States.
Christian FestbaumDepartment of Plastic, Hand, and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany.
Andreas KehrerDepartment of Plastic, Hand, and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany.
Gabriel HundeshagenDepartment of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Hospital Ludwigshafen, Department of Plastic and Hand Surgery, University of Heidelberg, Ludwigshafen, Germany.
Max HeilandDepartment of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Steffen KoerdtDepartment of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Norbert NeckelDepartment of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Jan O VossDepartment of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Alexandre G LellouchDivision of Plastic and Reconstructive Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Facial vascularized composite allotransplantation (FVCA) provides transformative restoration for patients with severe craniofacial defects, but successful outcomes depend heavily on facial nerve (FN) reconstruction and reinnervation. Unlike standard nerve repair, FN coaptation in FVCA must address donor-recipient mismatch and immunologic variability. This systematic review synthesizes clinical and preclinical evidence on FN reconstruction strategies in FVCA and their functional outcomes. Methods: This review adhered to PRISMA 2020 guidelines and was registered with PROSPERO (ID: CRD420251029430). A comprehensive search of PubMed, EMBASE, Cochrane Library, Web of Science, and Google Scholar. Methodological quality was assessed using the Newcastle-Ottawa Scale (NOS) and SYRCLE tool for preclinical studies. Results: Overall, Conclusion: FN reconstruction in FVCA is feasible and often results in partial functional recovery. However, outcomes remain heterogeneous and are influenced by surgical approach, immunologic status, and rehabilitative support. Standardized assessment tools should be more widely adopted to improve comparability and guide individualized treatment planning. Translational research and multicenter data collection are needed. FN reconstruction represents both a clinical challenge and an opportunity to improve long-term quality of life in FVCA recipients.

Indexed as

face transplantationfacial nerve reconstructionfunctional facial reanimationnerve coaptationvascularized composite allotransplantation

Identifiers

PMID41694805
PMCPMC12901399

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.