title: Cross-facial nerve graft and masseteric nerve cooptation for one-stage facial reanimation: principles, indications, and surgical procedure.
abstract: BACKGROUND
  The use of facial cross-grafting in acquired recent unilateral facial palsy provides spontaneity and emotional activation. Masseteric nerve for facial animation has mainly been described for reinnervation of neuromuscular transplants, babysitter procedures, or direct facial nerve cooptation. The simultaneous use in a single procedure of cross-facial nerve grafting and masseteric cooptation has not been described.
  
  
  METHODS
  Eight patients underwent facial animation using single stage cross-facial nerve grafting and masseteric nerve cooptation. The mean duration of facial palsy was 10.2 months (range, 1-23 months).
  
  
  RESULTS
  Voluntary contraction in response to masseteric nerve activation was observed after 2 to 4 months. All patients underwent postoperative rehabilitation and spontaneous contraction was achieved in 7 to 13 months postoperatively. Cosmetic outcomes were evaluated as moderate in 1 patient, good in 5 patients, and excellent in the remaining 2 patients.
  
  
  CONCLUSIONS
  This new technique could provide good results with fast, reliable, and powerful reinnervation, spontaneity, and low morbidity.
authors.affiliation: Head and Neck Department, University Hospital of Parma, Parma, Italy.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Bianchi
authors.forename: Andrea
authors.initials: A
authors.lastname: Ferri
authors.forename: Silvano
authors.initials: S
authors.lastname: Ferrari
authors.forename: Chiara
authors.initials: C
authors.lastname: Copelli
authors.forename: Alice
authors.initials: A
authors.lastname: Magri
authors.forename: Teore
authors.initials: T
authors.lastname: Ferri
authors.forename: Enrico
authors.initials: E
authors.lastname: Sesenna
mesh_terms: D000328:Adult; D000368:Aged; D004644:Emotions; D005154:Facial Nerve / Q000637:transplantation*; D005158:Facial Paralysis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008406:Masseter Muscle / Q000637:transplantation*; D008875:Middle Aged; D009416:Nerve Regeneration; D016067:Nerve Transfer / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D016896:Treatment Outcome
keywords: cross facial nerve grafting; facial animation; facial nerve; facial palsy; masseteric nerve cooptation