The nerve to the mylohyoid as a donor for facial nerve reanimation procedures: a cadaveric feasibility study.
OBJECTIVE
Facial nerve injury with resultant facial muscle paralysis is disfiguring and disabling. Reanimation of the facial nerve has been performed using different regional nerves. The nerve to the mylohyoid has not been previously explored as a donor nerve for facial nerve reanimation procedures.


METHODS
Five fresh adult human cadavers (10 sides) were dissected to identify an additional nerve donor candidate for facial nerve neurotization. Using a curvilinear cervicofacial skin incision, the nerve to the mylohyoid and facial nerve were identified. The nerve to the mylohyoid was transected at its point of entrance into the anterior belly of the digastric muscle. Measurements were made of the length and diameter of the nerve to the mylohyoid, and this nerve was repositioned superiorly to the various temporofacial and cervicofacial parts of the extracranial branches of the facial nerve. All specimens had a nerve to the mylohyoid. The mean length of this nerve available inferior to the mandible was 5.5 cm and the mean diameter was 1 mm. In all specimens, the nerve to the mylohyoid reached the facial nerve stem and the temporofacial and cervicofacial trunks without tension. No gross evidence of injury to surrounding neurovascular structures was identified.


CONCLUSIONS
To the authors' knowledge, the use of the nerve to the mylohyoid for facial nerve reanimation has not been explored previously. Based on the results of this cadaveric study, the use of the nerve to the mylohyoid may be considered for facial nerve reanimation procedures.
Tubbs
R Shane
RS
Section of Pediatric Neurosurgery, Children's Hospital, Birmingham, Alabama 35233, USA. rstubbs@uab.edu
Loukas
Marios
M
Shoja
Mohammadali M
MM
Acakpo-Satchivi
Leslie
L
Wellons
John C
JC
Blount
Jeffrey P
JP
Oakes
W Jerry
WJ
D000368:Aged; D002102:Cadaver; D004210:Dissection; D005145:Face / Q000033:anatomy & histology; D005158:Facial Paralysis / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008340:Mandibular Nerve / Q000033:anatomy & histology* / Q000601:surgery; D009333:Neck / Q000033:anatomy & histology; D016067:Nerve Transfer