Abstract
Facial paralysis is either congenital or acquired, and of varying severity, which
leads to an asymmetrical or absent facial expression. It is an important disability
both from the aesthetic and functional points of view. Between 2003 and 2008, at the
Department of Maxillofacial Surgery, University of Parma, Italy, 21 patients with
facial paralysis had their faces reanimated with a gracilis transplant reinnervated
by the masseter motor nerve. All free-muscle transplants survived the transfer, and
no flap was lost. Facial symmetry at rest and while smiling was excellent or good
in most cases, and we found an appreciable improvement in both speech and oral competence.
We consider that the masseter motor nerve is a powerful and reliable donor nerve,
which allows us to obtain movement of the commissure and upper lip similar to those
of the normal site for degree and direction. There may be a role for the masseter
motor nerve in innervation of patients with facial paralysis.
Keywords
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References
- Reanimation of the paralyzed face.Otolaryngol Clin North Am. 1992; 25: 649-667
- Results of management of facial palsy with microvascular free-muscle transfer.Plast Reconstr Surg. 1990; 86: 12-24
- A new classification system for facial paralysis in the clinical setting.J Craniofac Surg. 2003; 14: 672-679
- Dynamic restoration in Möbius and Möbius-like patients.Plast Reconstr Surg. 2003; 111: 40-55
- Quantitative facial motion analysis after functional free muscle reanimation procedures.Plast Reconstr Surg. 1997; 100: 1710-1722
- Analysis of 100 cases of free-muscle transplantation for facial paralysis.Plast Reconstr Surg. 1997; 99: 1905-1921
- Neurovascular free muscle transfer combined with cross-face nerve grafting for the treatment of facial paralysis in children.Plast Reconstr Surg. 1998; 101: 1765-1773
- A comparison of commissure excursion following gracilis muscle transplantation for facial paralysis using a cross-face nerve graft versus the motor nerve to the masseter nerve.Plast Reconstr Surg. 2006; 117: 2407-2413
- Cross-facial nerve graft: past and present.J Plast Reconstr Aesthet Surg. 2008; 61: 250-256
- Smile reconstruction in adults with free muscle transfer innervated by the masseter motor nerve: effectiveness and cerebral adaptation.Plast Reconstr Surg. 2006; 118: 885-899
- Facial paralysis in children.Clin Plast Surg. 1990; 17: 95-99
- Facial animation in children with Möbius syndrome after segmental gracilis muscle transplant.Plast Reconstr Surg. 2000; 106: 1-9
- Long term outcomes of free-muscle transfer for smile restoration in adults.Plast Reconstr Surg. 2009; 123: 877-888
- Long term outcomes of free-muscle transfer for smile restoration in children.Plast Reconstr Surg. 2009; 123: 543-555
- Facial paralysis measurement with a handheld ruler.Plast Reconstr Surg. 2008; 121: 435-442
- Facial animation in children with Moebius and Moebius-like syndromes.J Pediatr Surg. 2009; 44: 2236-2242
- Facial animation with free muscle transfer innervated by the masseter motor nerve in unilateral facial paralysis.J Oral Maxillofac Surg. 2010; 68: 1524-1529
- Cortical adaptation to restoration of smiling after free muscle transfer innervated by the nerve to the masseter.Plast Reconstr Surg. 2005; 115: 1472-1482
- Localization of the cortical response to smiling using new imaging paradigms with functional magnetic resonance imaging.Plast Reconstr Surg. 2001; 108: 1136-1144
Article info
Publication history
Published online: September 01, 2011
Accepted:
July 24,
2011
Identification
Copyright
© 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
