Masseteric-facial nerve anastomosis for early facial reanimation

Federico Biglioli, Alice Frigerio, Valeria Colombo, Giacomo Colletti, Dimitri Rabbiosi, Pietro Mortini, Elena Dalla Toffola, Alessandro Lozza, Roberto Brusati

Research output: Contribution to journalArticlepeer-review


Objective: Early repair of facial nerve paralysis when cortical neural input cannot be provided by the facial nerve nucleus, is generally accomplished anastomozing the extracranial stump of the facial nerve to a motor donor nerve. That is generally the hypoglossus, which carries a variable degree of morbidity. The present work aims to demonstrate the effectiveness of the masseteric nerve as donor for early facial reanimation, with the advantage that harvesting is associated with negligible morbidity. Methods: Between October 2007 and August 2009, 7 patients (2 males, 5 women) with unilateral facial paralysis underwent a masseter-facial nerves anastomosis with an interpositional nerve graft of the great auricular nerve. The interval between the onset of paralysis and surgery ranged from 8 to 48 months (mean 19.2 months). All patients included in the study had signs of facial mimetic muscle fibrillations on electromyography. The degree of preoperative facial nerve dysfunction was grade VI following the House-Brackmann scale for all patients. Results: At the time of the study, all the patients with a minimum follow-up time of 12 months after the onset of mimetic function had recovered facial animation. Facial muscles showed signs of recovery within 2-9 months, mean 4.8 months, with the restoration of facial symmetry at rest. Facial movements appeared while the patients activated their chewing musculature. Morbidity related to this intervention is only the loss of sensitivity of earlobe and preauricular region. Conclusion: The present technique seems to be a valid alternative to classical hypoglossal-facial nerve anastomosis because of similar facial nerve recovery and lower morbidity.

Original languageEnglish
Pages (from-to)149-155
Number of pages7
JournalJournal of Cranio-Maxillofacial Surgery
Issue number2
Publication statusPublished - Feb 2012


  • Early facial reanimation
  • Facial paralysis
  • Masseter nerve
  • Masseter-facial anastomosis

ASJC Scopus subject areas

  • Oral Surgery
  • Otorhinolaryngology
  • Surgery


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