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 journalArticle

Abstract

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
Volume40
Issue number2
DOIs
Publication statusPublished - Feb 2012

Fingerprint

Facial Nerve
Facial Muscles
Morbidity
Facial Paralysis
Tissue Donors
Hypoglossal Nerve
Time and Motion Studies
Mastication
Electromyography
Paralysis
Transplants

Keywords

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

ASJC Scopus subject areas

  • Oral Surgery
  • Otorhinolaryngology
  • Surgery

Cite this

Biglioli, F., Frigerio, A., Colombo, V., Colletti, G., Rabbiosi, D., Mortini, P., ... Brusati, R. (2012). Masseteric-facial nerve anastomosis for early facial reanimation. Journal of Cranio-Maxillofacial Surgery, 40(2), 149-155. https://doi.org/10.1016/j.jcms.2011.03.005

Masseteric-facial nerve anastomosis for early facial reanimation. / Biglioli, Federico; Frigerio, Alice; Colombo, Valeria; Colletti, Giacomo; Rabbiosi, Dimitri; Mortini, Pietro; Dalla Toffola, Elena; Lozza, Alessandro; Brusati, Roberto.

In: Journal of Cranio-Maxillofacial Surgery, Vol. 40, No. 2, 02.2012, p. 149-155.

Research output: Contribution to journalArticle

Biglioli, F, Frigerio, A, Colombo, V, Colletti, G, Rabbiosi, D, Mortini, P, Dalla Toffola, E, Lozza, A & Brusati, R 2012, 'Masseteric-facial nerve anastomosis for early facial reanimation', Journal of Cranio-Maxillofacial Surgery, vol. 40, no. 2, pp. 149-155. https://doi.org/10.1016/j.jcms.2011.03.005
Biglioli, Federico ; Frigerio, Alice ; Colombo, Valeria ; Colletti, Giacomo ; Rabbiosi, Dimitri ; Mortini, Pietro ; Dalla Toffola, Elena ; Lozza, Alessandro ; Brusati, Roberto. / Masseteric-facial nerve anastomosis for early facial reanimation. In: Journal of Cranio-Maxillofacial Surgery. 2012 ; Vol. 40, No. 2. pp. 149-155.
@article{fdd3a7ec85614e3f958b982e1dc315fc,
title = "Masseteric-facial nerve anastomosis for early facial reanimation",
abstract = "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.",
keywords = "Early facial reanimation, Facial paralysis, Masseter nerve, Masseter-facial anastomosis",
author = "Federico Biglioli and Alice Frigerio and Valeria Colombo and Giacomo Colletti and Dimitri Rabbiosi and Pietro Mortini and {Dalla Toffola}, Elena and Alessandro Lozza and Roberto Brusati",
year = "2012",
month = "2",
doi = "10.1016/j.jcms.2011.03.005",
language = "English",
volume = "40",
pages = "149--155",
journal = "Journal of Maxillofacial Surgery",
issn = "1010-5182",
publisher = "Churchill Livingstone",
number = "2",

}

TY - JOUR

T1 - Masseteric-facial nerve anastomosis for early facial reanimation

AU - Biglioli, Federico

AU - Frigerio, Alice

AU - Colombo, Valeria

AU - Colletti, Giacomo

AU - Rabbiosi, Dimitri

AU - Mortini, Pietro

AU - Dalla Toffola, Elena

AU - Lozza, Alessandro

AU - Brusati, Roberto

PY - 2012/2

Y1 - 2012/2

N2 - 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.

AB - 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.

KW - Early facial reanimation

KW - Facial paralysis

KW - Masseter nerve

KW - Masseter-facial anastomosis

UR - http://www.scopus.com/inward/record.url?scp=84856083589&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84856083589&partnerID=8YFLogxK

U2 - 10.1016/j.jcms.2011.03.005

DO - 10.1016/j.jcms.2011.03.005

M3 - Article

C2 - 21463951

AN - SCOPUS:84856083589

VL - 40

SP - 149

EP - 155

JO - Journal of Maxillofacial Surgery

JF - Journal of Maxillofacial Surgery

SN - 1010-5182

IS - 2

ER -