Cross-face nerve transfer for established trigeminal branch II palsy.
Reconstruction for trigeminal nerve II palsy is challenging. Cross-face nerve transfer from the contralateral trigeminal nerve facilitates this reconstruction. However, the microanatomy and techniques required for nerve sutures cause problems for many surgeons. Following the recent development of supramicrosurgical techniques appropriate for the microanatomy of peripheral nerves, a new method of intraoral "cross-face nerve transfer" was successfully used for repairing trigeminal nerve II palsy. Two cases of trigeminal nerve II palsy were repaired with contralateral trigeminal nerve transfer without any nerve graft. Affected upper labial sensory recovery was 1.65 to 2.44 (Semmes-Weinstein values) and 15 to 30 mm (moving 2-point discriminations) at 1 to 1 1/2 years after surgery. The advantages of this method are excellent nerve regeneration and the lack of donor site morbidity. It is a brief and simple operation in comparison to free nerve grafts. The disadvantage is a need for a supramicrosurgical technique, using a needle less than 80 microm wide.
Koshima
Isao
I
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. koushimai-pla@h.u-tokyo.ac.jp
Narushima
Mitsunaga
M
Mihara
Makoto
M
Uchida
Gentaro
G
Nakagawa
Masahiro
M
D003528:Carcinoma, Adenoid Cystic / Q000601:surgery; D005151:Facial Injuries / Q000601:surgery; D005158:Facial Paralysis / Q000209:etiology / Q000601:surgery*; D005260:Female; D050723:Fractures, Bone / Q000601:surgery; D006801:Humans; D008866:Microsurgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009416:Nerve Regeneration; D016067:Nerve Transfer / Q000379:methods*; D009918:Orbital Neoplasms / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery; D013536:Suture Techniques; D020433:Trigeminal Nerve Diseases / Q000601:surgery*