Timing of pediatric reanimation?
When is the best age to consider facial reanimation in non-progressive congenital facial palsy? Many centers will perform facial reanimation by free muscle transfer in children at an early age (eg. 4 years). Is this the ideal age? The benefits include pre-school and limited memory of having the procedure. But on the other hand waiting until they are older (eg. 7 years) means that the child has motivation (they may have experienced bullying and want to do something about their difference) and is able to cooperate with rehabilitation more effectively. Is rehabilitation required in younger children if you use a cross face nerve graft. Is cortical adaptation better in younger children when using a cranial nerve transfer to power the muscle? Or is rehab more effective in older kids in this situation? There are no studies looking at the best age for reanimation in children. What is your view and do you have anecdotal experience you want to share?