title: Comparison of hemihypoglossal nerve versus masseteric nerve transpositions in the rehabilitation of short-term facial paralysis using the Facial Clima evaluating system.
abstract: BACKGROUND
  Masseteric and hypoglossal nerve transfers are reliable alternatives for reanimating short-term facial paralysis. To date, few studies exist in the literature comparing these techniques. This work presents a quantitative comparison of masseter-facial transposition versus hemihypoglossal facial transposition with a nerve graft using the Facial Clima system.
  
  
  METHODS
  Forty-six patients with complete unilateral facial paralysis underwent reanimation with either hemihypoglossal transposition with a nerve graft (group I, n = 25) or direct masseteric-facial coaptation (group II, n = 21). Commissural displacement and commissural contraction velocity were measured using the Facial Clima system. Postoperative intragroup commissural displacement and commissural contraction velocity means of the reanimated versus the normal side were first compared using a paired sample t test. Then, mean percentages of recovery of both parameters were compared between the groups using an independent sample t test. Onset of movement was also compared between the groups.
  
  
  RESULTS
  Significant differences of mean commissural displacement and commissural contraction velocity between the reanimated side and the normal side were observed in group I but not in group II. Mean percentage of recovery of both parameters did not differ between the groups. Patients in group II showed a significantly faster onset of movement compared with those in group I (62 ± 4.6 days versus 136 ± 7.4 days, p = 0.013).
  
  
  CONCLUSIONS
  Reanimation of short-term facial paralysis can be satisfactorily addressed by means of either hemihypoglossal transposition with a nerve graft or direct masseteric-facial coaptation. However, with the latter, better symmetry and a faster onset of movement are observed. In addition, masseteric nerve transfer avoids morbidity from nerve graft harvesting.
  
  
  METHODS
  Therapeutic, III.
authors.affiliation: Pamplona, Spain From the Department of Plastic and Reconstructive Surgery, Clinica Universidad de Navarra.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Hontanilla
authors.forename: Diego
authors.initials: D
authors.lastname: Marré
mesh_terms: D000328:Adult; D000368:Aged; D005154:Facial Nerve / Q000637:transplantation*; D005158:Facial Paralysis / Q000534:rehabilitation / Q000601:surgery*; D005260:Female; D006801:Humans; D007002:Hypoglossal Nerve / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D016067:Nerve Transfer / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods / Q000534:rehabilitation; D016896:Treatment Outcome; D055815:Young Adult