Neurotization Preferences in Smile Reanimation: A Discrete Choice Experiment
Common donor nerve options in smile reanimation include ipsilateral trigeminal motor or contralateral facial nerve branches. Neurotization preference may be influenced by multiple factors, whose relative importance remains poorly understood. In this article, decision-making in smile reanimation is a...
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| Veröffentlicht in: | Plastic and reconstructive surgery (1963) 2021-09, Vol.148 (3), p.407e-415e |
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| container_title | Plastic and reconstructive surgery (1963) |
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| creator | Dusseldorp, Joseph R. Naunheim, Matthew R. Quatela, Olivia Fortier, Emily Hadlock, Tessa A. Jowett, Nate |
| description | Common donor nerve options in smile reanimation include ipsilateral trigeminal motor or contralateral facial nerve branches. Neurotization preference may be influenced by multiple factors, whose relative importance remains poorly understood. In this article, decision-making in smile reanimation is assessed using a stated preference model.
Qualitative interviews with facial palsy patients identified five relevant attributes for study: smile type ("smile when biting" versus "smile spontaneously" as proxies for trigeminal versus cross-facial neurotization), number of operations, success rates, complication rates, and side effects. Community volunteers (n = 250) completed a discrete-choice experiment relevant to free muscle transfer for smile reanimation. Preoperative and postoperative states were demonstrated through video vignettes, together with explanation of surgical risks, consequences, and benefits. Attribute importance was modeled using hierarchical Bayes estimation.
Two hundred forty-one responses met quality controls. Attribute importance ranked as follows: chance of success, 37.3 percent; smile type, 21.4 percent; side effects, 13.9 percent; complication rates, 13.8; and number of operations, 13.6 percent. All attributes significantly correlated with decision making (p < 0.0001). An aggregate response model revealed most participants (67.6 percent; standard error, 3.0 percent) preferred smile reanimation by cross-facial (assuming a success rate of 80 percent) as opposed to ipsilateral trigeminal motor branch neurotization. When the success rate for cross-facial neurotization was reduced below 67 percent, trigeminal neurotization was preferred.
Despite a higher risk of failure, most respondents preferred a cross-facial as opposed to trigeminal neurotization strategy for smile reanimation. These findings highlight the complexity of decision-making and need for individualized risk tolerance assessment in the field of facial reanimation. |
| doi_str_mv | 10.1097/PRS.0000000000008302 |
| format | Article |
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Qualitative interviews with facial palsy patients identified five relevant attributes for study: smile type ("smile when biting" versus "smile spontaneously" as proxies for trigeminal versus cross-facial neurotization), number of operations, success rates, complication rates, and side effects. Community volunteers (n = 250) completed a discrete-choice experiment relevant to free muscle transfer for smile reanimation. Preoperative and postoperative states were demonstrated through video vignettes, together with explanation of surgical risks, consequences, and benefits. Attribute importance was modeled using hierarchical Bayes estimation.
Two hundred forty-one responses met quality controls. Attribute importance ranked as follows: chance of success, 37.3 percent; smile type, 21.4 percent; side effects, 13.9 percent; complication rates, 13.8; and number of operations, 13.6 percent. All attributes significantly correlated with decision making (p < 0.0001). An aggregate response model revealed most participants (67.6 percent; standard error, 3.0 percent) preferred smile reanimation by cross-facial (assuming a success rate of 80 percent) as opposed to ipsilateral trigeminal motor branch neurotization. When the success rate for cross-facial neurotization was reduced below 67 percent, trigeminal neurotization was preferred.
Despite a higher risk of failure, most respondents preferred a cross-facial as opposed to trigeminal neurotization strategy for smile reanimation. These findings highlight the complexity of decision-making and need for individualized risk tolerance assessment in the field of facial reanimation.</description><identifier>ISSN: 0032-1052</identifier><identifier>EISSN: 1529-4242</identifier><identifier>DOI: 10.1097/PRS.0000000000008302</identifier><identifier>PMID: 34432695</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins</publisher><subject>Adult ; Facial Muscles - innervation ; Facial Paralysis - physiopathology ; Facial Paralysis - surgery ; Female ; Humans ; Male ; Middle Aged ; Nerve Regeneration - physiology ; Nerve Transfer - methods ; Nerve Transfer - psychology ; Patient Education as Topic ; Patient Preference - psychology ; Patient Preference - statistics & numerical data ; Qualitative Research ; Retrospective Studies ; Smiling - physiology ; Smiling - psychology ; Surveys and Questionnaires - statistics & numerical data ; Treatment Outcome ; Trigeminal Nerve - physiology ; Trigeminal Nerve - transplantation ; Young Adult</subject><ispartof>Plastic and reconstructive surgery (1963), 2021-09, Vol.148 (3), p.407e-415e</ispartof><rights>Lippincott Williams & Wilkins</rights><rights>Copyright © 2021 by the American Society of Plastic Surgeons.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3524-ffcff2a8394a3471fd703ce740169a0d523592eb935c77aeed3ffcd96cec2c4b3</citedby><cites>FETCH-LOGICAL-c3524-ffcff2a8394a3471fd703ce740169a0d523592eb935c77aeed3ffcd96cec2c4b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34432695$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dusseldorp, Joseph R.</creatorcontrib><creatorcontrib>Naunheim, Matthew R.</creatorcontrib><creatorcontrib>Quatela, Olivia</creatorcontrib><creatorcontrib>Fortier, Emily</creatorcontrib><creatorcontrib>Hadlock, Tessa A.</creatorcontrib><creatorcontrib>Jowett, Nate</creatorcontrib><title>Neurotization Preferences in Smile Reanimation: A Discrete Choice Experiment</title><title>Plastic and reconstructive surgery (1963)</title><addtitle>Plast Reconstr Surg</addtitle><description>Common donor nerve options in smile reanimation include ipsilateral trigeminal motor or contralateral facial nerve branches. Neurotization preference may be influenced by multiple factors, whose relative importance remains poorly understood. In this article, decision-making in smile reanimation is assessed using a stated preference model.
Qualitative interviews with facial palsy patients identified five relevant attributes for study: smile type ("smile when biting" versus "smile spontaneously" as proxies for trigeminal versus cross-facial neurotization), number of operations, success rates, complication rates, and side effects. Community volunteers (n = 250) completed a discrete-choice experiment relevant to free muscle transfer for smile reanimation. Preoperative and postoperative states were demonstrated through video vignettes, together with explanation of surgical risks, consequences, and benefits. Attribute importance was modeled using hierarchical Bayes estimation.
Two hundred forty-one responses met quality controls. Attribute importance ranked as follows: chance of success, 37.3 percent; smile type, 21.4 percent; side effects, 13.9 percent; complication rates, 13.8; and number of operations, 13.6 percent. All attributes significantly correlated with decision making (p < 0.0001). An aggregate response model revealed most participants (67.6 percent; standard error, 3.0 percent) preferred smile reanimation by cross-facial (assuming a success rate of 80 percent) as opposed to ipsilateral trigeminal motor branch neurotization. When the success rate for cross-facial neurotization was reduced below 67 percent, trigeminal neurotization was preferred.
Despite a higher risk of failure, most respondents preferred a cross-facial as opposed to trigeminal neurotization strategy for smile reanimation. These findings highlight the complexity of decision-making and need for individualized risk tolerance assessment in the field of facial reanimation.</description><subject>Adult</subject><subject>Facial Muscles - innervation</subject><subject>Facial Paralysis - physiopathology</subject><subject>Facial Paralysis - surgery</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nerve Regeneration - physiology</subject><subject>Nerve Transfer - methods</subject><subject>Nerve Transfer - psychology</subject><subject>Patient Education as Topic</subject><subject>Patient Preference - psychology</subject><subject>Patient Preference - statistics & numerical data</subject><subject>Qualitative Research</subject><subject>Retrospective Studies</subject><subject>Smiling - physiology</subject><subject>Smiling - psychology</subject><subject>Surveys and Questionnaires - statistics & numerical data</subject><subject>Treatment Outcome</subject><subject>Trigeminal Nerve - physiology</subject><subject>Trigeminal Nerve - transplantation</subject><subject>Young Adult</subject><issn>0032-1052</issn><issn>1529-4242</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkFtLAzEQhYMotlb_gcg--rI1193Gt1LrBYqWVp9Dmp2l0b3UZJeqv97Y1gsGhjBwzpmZD6FTgvsEy_RiOpv38Z83YJjuoS4RVMaccrqPuhgzGhMsaAcdef-MMUlZIg5Rh3HOaCJFF03uoXV1Yz90Y-sqmjrIwUFlwEe2iualLSCaga5suRFcRsPoynrjoIFotKytgWj8tgJnS6iaY3SQ68LDye7voafr8ePoNp483NyNhpPYMEF5nOcmz6keMMk14ynJsxQzAynHJJEaZ4IyISksJBMmTTVAxoIlk4kBQw1fsB463-auXP3agm9UGXaCotAV1K1XVCRcisAkCVK-lRpXex-uU6uwq3bvimD1xVEFjuo_x2A7201oFyVkP6ZvcL-567powPmXol2DU0vQRbPc5CWC8ZhiGoaELg5FOfsEAEV9lg</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Dusseldorp, Joseph R.</creator><creator>Naunheim, Matthew R.</creator><creator>Quatela, Olivia</creator><creator>Fortier, Emily</creator><creator>Hadlock, Tessa A.</creator><creator>Jowett, Nate</creator><general>Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20210901</creationdate><title>Neurotization Preferences in Smile Reanimation: A Discrete Choice Experiment</title><author>Dusseldorp, Joseph R. ; Naunheim, Matthew R. ; Quatela, Olivia ; Fortier, Emily ; Hadlock, Tessa A. ; Jowett, Nate</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3524-ffcff2a8394a3471fd703ce740169a0d523592eb935c77aeed3ffcd96cec2c4b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Facial Muscles - innervation</topic><topic>Facial Paralysis - physiopathology</topic><topic>Facial Paralysis - surgery</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nerve Regeneration - physiology</topic><topic>Nerve Transfer - methods</topic><topic>Nerve Transfer - psychology</topic><topic>Patient Education as Topic</topic><topic>Patient Preference - psychology</topic><topic>Patient Preference - statistics & numerical data</topic><topic>Qualitative Research</topic><topic>Retrospective Studies</topic><topic>Smiling - physiology</topic><topic>Smiling - psychology</topic><topic>Surveys and Questionnaires - statistics & numerical data</topic><topic>Treatment Outcome</topic><topic>Trigeminal Nerve - physiology</topic><topic>Trigeminal Nerve - transplantation</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dusseldorp, Joseph R.</creatorcontrib><creatorcontrib>Naunheim, Matthew R.</creatorcontrib><creatorcontrib>Quatela, Olivia</creatorcontrib><creatorcontrib>Fortier, Emily</creatorcontrib><creatorcontrib>Hadlock, Tessa A.</creatorcontrib><creatorcontrib>Jowett, Nate</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Plastic and reconstructive surgery (1963)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dusseldorp, Joseph R.</au><au>Naunheim, Matthew R.</au><au>Quatela, Olivia</au><au>Fortier, Emily</au><au>Hadlock, Tessa A.</au><au>Jowett, Nate</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neurotization Preferences in Smile Reanimation: A Discrete Choice Experiment</atitle><jtitle>Plastic and reconstructive surgery (1963)</jtitle><addtitle>Plast Reconstr Surg</addtitle><date>2021-09-01</date><risdate>2021</risdate><volume>148</volume><issue>3</issue><spage>407e</spage><epage>415e</epage><pages>407e-415e</pages><issn>0032-1052</issn><eissn>1529-4242</eissn><abstract>Common donor nerve options in smile reanimation include ipsilateral trigeminal motor or contralateral facial nerve branches. Neurotization preference may be influenced by multiple factors, whose relative importance remains poorly understood. In this article, decision-making in smile reanimation is assessed using a stated preference model.
Qualitative interviews with facial palsy patients identified five relevant attributes for study: smile type ("smile when biting" versus "smile spontaneously" as proxies for trigeminal versus cross-facial neurotization), number of operations, success rates, complication rates, and side effects. Community volunteers (n = 250) completed a discrete-choice experiment relevant to free muscle transfer for smile reanimation. Preoperative and postoperative states were demonstrated through video vignettes, together with explanation of surgical risks, consequences, and benefits. Attribute importance was modeled using hierarchical Bayes estimation.
Two hundred forty-one responses met quality controls. Attribute importance ranked as follows: chance of success, 37.3 percent; smile type, 21.4 percent; side effects, 13.9 percent; complication rates, 13.8; and number of operations, 13.6 percent. All attributes significantly correlated with decision making (p < 0.0001). An aggregate response model revealed most participants (67.6 percent; standard error, 3.0 percent) preferred smile reanimation by cross-facial (assuming a success rate of 80 percent) as opposed to ipsilateral trigeminal motor branch neurotization. When the success rate for cross-facial neurotization was reduced below 67 percent, trigeminal neurotization was preferred.
Despite a higher risk of failure, most respondents preferred a cross-facial as opposed to trigeminal neurotization strategy for smile reanimation. These findings highlight the complexity of decision-making and need for individualized risk tolerance assessment in the field of facial reanimation.</abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins</pub><pmid>34432695</pmid><doi>10.1097/PRS.0000000000008302</doi></addata></record> |
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| subjects | Adult Facial Muscles - innervation Facial Paralysis - physiopathology Facial Paralysis - surgery Female Humans Male Middle Aged Nerve Regeneration - physiology Nerve Transfer - methods Nerve Transfer - psychology Patient Education as Topic Patient Preference - psychology Patient Preference - statistics & numerical data Qualitative Research Retrospective Studies Smiling - physiology Smiling - psychology Surveys and Questionnaires - statistics & numerical data Treatment Outcome Trigeminal Nerve - physiology Trigeminal Nerve - transplantation Young Adult |
| title | Neurotization Preferences in Smile Reanimation: A Discrete Choice Experiment |
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