Masseteric cooptation and crossfacial nerve grafting: Is it still applicable 22 months after the onset of facial palsy?

Bianchi, Bernardo; Varazzani, Andrea; Pedrazzi, Giuseppe; Poddi, Valentina; Ferrari, Silvano; Brevi, Bruno; Ferri, Andrea

doi:10.1002/micr.30296

Cited by 8 publications

(6 citation statements)

References 21 publications

(19 reference statements)

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“…They also included in their results an improvement in the ability to close the eyes, in the movement of the mouth, and in the ability to smile. We can also mention the studies by Bianchi et al 11 (2018) and Altamami et al 12 (2019), in which recovery was successful, with the patients evolving from grade VI preoperatively to grades lower tahn IV on the HB scale after masseteric-facial nerve anastomosis. However, Vincent et al 13 (2019) found no statistically significant difference in their study, but suggest that masseteric-to-facial nerve transfer with selective neurectomy provides a significant improvement in the ability to smile, with a long-term decrease in synkinesis among patients unresponsive to botulinum toxin therapy or who, for other reasons, do not wish to continue with regular injections.…”

Section: Discussionmentioning

confidence: 89%

Masseteric-Facial Anastomosis: A Report of Three Cases

Bispo

Raffa²,

Aguiar

et al. 2021

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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Intoduction The pathways of the facial nerve are variable, and knowledge of that is essential. The worst impact caused by facial paralysis is related to quality of life, especially regarding the self-esteem and social acceptance on the part of the patients, leading to social isolation and disruption on their mental health. Case Report A 33-year-old female patient, with a stage-T3 acoustic neurinoma, presented with a moderate dysfunction (grades II to III) according to the House-Brackmann (HB) Facial Nerve Grading System. A 43-year-old male patient, with a stage-T4B trigeminal schwannoma, underwent a resective surgery and presented grade-VI dysfunction according to the HB scale. And a female patient with a stage-T4A acoustic neurinoma presented grade-IV dysfunction according to the HB scale. Discussion We performed a literature review of papers related to surgeries for masseteric-facial nerve anastomosis and compiled the results in table; then, we compared these data with those obtained from our cases. Conclusion The masseteric nerve is the one that shows the best prognosis among all the cranial nerves that could be used, but it is also necessary to perform well the surgical technique to access the facial branch and consequently achieve a better masseteric-facial nerve anastomosis.

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Section: Discussionmentioning

confidence: 89%

Masseteric-Facial Anastomosis: A Report of Three Cases

Bispo

Raffa²,

Aguiar

et al. 2021

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

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“…Poor prognosis could be predicted after a duration of 12 to 18 months, which could be attributable to mimetic muscle atrophy and dormant atrophied synaptic connections. Although one study had reported that masseteric/cross-facial nerve grafting is feasible for patients with palsies 20 to 24 months in duration, 16 additional researches are needed. The gold standard treatment for long-standing facial paralysis is neurovascular free muscle transfer—donor site various from gracilis muscle, 5 latissimus dorsi and serratus anterior muscle, innervated by masseteric nerve or contralateral facial nerve, or both 17 —providing a stable but monotonous smile, while a traditional facial sling is still an option in some cases 18 .…”

Section: Discussionmentioning

confidence: 99%

Facial Reanimation After Peripheral Facial Nerve Paralysis: A Single-institution Surgical Experience

Xie

et al. 2023

Journal of Craniofacial Surgery

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Facial nerve trauma occasionally develops during oral and maxillofacial surgery. This study was aimed at enhancing the available knowledge on facial nerve reanimation correlated to surgery and proposing our surgical algorithm. We retrospectively analyzed medical records of patients who underwent facial reanimation surgery at our hospital. The inclusion criterion was surgery for facial reanimation from January 2004 to June 2021. We included 383 eligible patients who underwent facial reanimation surgery. Trauma or maxillofacial neoplasms were noted in 208 of 383 and 164 of 383 cases, respectively. In 238 of 383 cases, nerve branches were likely more vulnerable. Facial nerve anastomosis was performed in 256 patients. Sixty-eight patients received nerve grafts. In 22 patients, distal facial nerve transfer to the masseteric nerve, sublingual nerve, or contralateral facial nerve was performed. Twenty-five patients received static surgery; in most cases, the temporalis fascia flap (20/25) was used. The nerve function outcomes were HB grade I (n=17), Grade Ⅱ (n=108), Grade Ⅲ (n=118), Grade Ⅳ (n=94), and Grade V (n=46). The mean follow-up time was 4.88 ± 3.93 years. Facial paralysis caused by trauma (P=0.000), branch injury (P=0.000), and the primary reconstruction of facial nerve (P=0.000) were predictive of favorable treatment outcomes. Although facial nerve injury caused by trauma was more likely, cases of interference in facial expression could be limited, and so did the injury to branches. Nerve anastomosis was prioritized if a tension-free suture was possible. Maintaining the integrity of the nerve and shortening the duration of mimetic muscular denervation were crucial.

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“…Clinical evidence also suggests that nerve grafting can achieve some degree of functional recovery even if facial palsy persists for more than 24 months. [15][16][17] This indicates the presence of neurotrophic factors in the injured facial nerve, and nerve grafting can reestablish nerve impulses and effectively prevent further muscle atrophy. 17,18 In order to avoid the complicated operation of vascularized nerve pedicle free muscle transfer, which may not meet the patient's expectations, the combined nerve transfer and simultaneous tensor fasciae lata angulus oris suspension method was still used in two patients with facial paralysis.…”

Section: Discussionmentioning

confidence: 99%

“…[15][16][17] This indicates the presence of neurotrophic factors in the injured facial nerve, and nerve grafting can reestablish nerve impulses and effectively prevent further muscle atrophy. 17,18 In order to avoid the complicated operation of vascularized nerve pedicle free muscle transfer, which may not meet the patient's expectations, the combined nerve transfer and simultaneous tensor fasciae lata angulus oris suspension method was still used in two patients with facial paralysis. Despite the course of the disease exceeding 24 months, the treatment choice was based on the economic and medical investment and the expected results on the patients.…”

Section: Discussionmentioning

confidence: 99%

The Selective Trigeminal Nerve Motor Branching Transfer: an Preliminary Clinical Application for Facial Reanimation

Liu

Yao

et al. 2023

Journal of Craniofacial Surgery

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Objective: To investigate the effectiveness and feasibility of selective trigeminal nerve motor branching in the repair of facial palsy. Materials and Methods: The clinical data of patients with advanced facial palsy from 2016 to 2021 were retrospectively analyzed, including pictures and videos before and 18 months after surgery. The House-Brackmann grading system was used to evaluate facial nerve function before and after repair, and the symmetry scale of oral commissure at rest and Terzis' smile functional evaluation scale were used to qualitatively assess the symmetry of the mouth angle and smile function. The distance of oral commissure movement was assessed to evaluate the dynamic repair effect, and the FaCE facial muscle function scale was used to assess patients' subjective perception before and after surgery. Results: A total of four patients were included in the study, all of whom showed signs of recovery of facial nerve function within six months. In all four cases, significant improvements were observed in House-Brackmann ratings, the smile function score and the symmetry scale of oral commissure at rest. Compared to the preoperative period, the four patients demonstrated various degrees of eye-closing function recovery, and a significant improvement in oral commissure movement was observed (P < 0.001). FaCE scores also improved significantly after surgery (P = 0.019). Conclusion: Concurrent selective facial nerve repair with trigeminal branch-facial nerve anastomosis resulted in eye-closing function recovery while improving static and dynamic symmetry, yielding acceptable postoperative results.

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Masseteric cooptation and crossfacial nerve grafting: Is it still applicable 22 months after the onset of facial palsy?

Abstract: Masseteric/crossfacial nerve grafting is feasible for patients with palsies 20-24 months in duration, affording satisfactory functional and esthetic results and a dramatic improvement in quality of life.

Cited by 8 publications

References 21 publications

Masseteric-Facial Anastomosis: A Report of Three Cases

Masseteric-Facial Anastomosis: A Report of Three Cases

Facial Reanimation After Peripheral Facial Nerve Paralysis: A Single-institution Surgical Experience

The Selective Trigeminal Nerve Motor Branching Transfer: an Preliminary Clinical Application for Facial Reanimation

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