Restoration of smile: The role of the masseteric to facial nerve transfer in facial reanimation

Published Date: 17th May 2022

Publication Authors: Snashall E, Harper-Machin A, Martin H

Objectives
The masseteric nerve has become a popular donor nerve for transfer in facial reanimation surgery. Results are comparable to, if not better than other nerve transfer techniques. This article describes the use of a masseteric to facial nerve transfer for facial reanimation in a group of patients with facial palsy with a variety of aetiologies.

Materials and Methods
A retrospective review was performed of 5 consecutive facial palsy patients over a 2-year period who had undergone a masseteric to facial nerve transfer for reanimation of the midface and perioral region. Patients were assessed by physical examination and video analysis.

Results
Of the 5 patients, aetiology of facial paralysis was schwannoma (n = 2), cholesteatoma (n = 1), base of skull fracture (n = 1) and unknown facial nerve pathology (n = 1). Mean age was 48 years. Mean time to surgery from paralysis was 8.8 months. A concomitant static procedure was performed in 3 patients. There were no postoperative complications. Successful reinnervation occurred in 4 patients. Mean time to first movement was 3.3 months.

Conclusion
The masseteric to facial nerve transfer is an effective tool in facial reanimation for a wide group of facial palsy aetiologies, with low morbidity and complication rate. In our unit, this procedure is now planned to be offered concomitantly at the time of tumour resection. This procedure may not be effective in patients with an unknown facial nerve palsy aetiology due to uncertainty over distal nerve viability. With careful patient selection, consistent results in smile restoration can be achieved through this technique, providing a safe and well-tolerated tool in the armoury of the facial palsy surgeon.

 

Snashell, E; Harper-Machin, A; Martin, H. (2022). Restoration of smile: The role of the masseteric to facial nerve transfer in facial reanimation. Craniomaxillofacial Trauma & Reconstruction. 15(1), p.32. [Online]. Available at: https://doi.org/10.1177/19433875221091460 [Accessed 21 February 2023]

 

« Back