Spinal Accessory Nerve-Innervated Gracilis (XI-Gracilis) for Facial Reanimation: Chang Gung Experience

Background: Truly facial paralysis and postparalysis facial synkinesis both cause severe functional and aesthetic deficits. Gracilis functioning free muscle transplantation (FFMT) is our preferred muscle for facial reanimation. Three motor neurotizers: cross-face nerve graft (CFNG), spinal accessory (XI), and masseteric nerves (V3) are our preferred motor neurotizers for different indications. This chapter will focus on XI-gracilis.