The masseteric nerve: a versatile power source in facial animation techniques.
The masseteric nerve has many advantages including low morbidity, its proximity to the facial nerve, the strong motor impulse, its reliability, and the fast reinnervation that is achievable in most patients. Reinnervation of a neuromuscular transplant is the main indication for its use, but it has been used for the treatment of recent facial palsies with satisfactory results. We have retrospectively evaluated 60 patients who had facial animation procedures using the masseteric nerve during the last 10 years. The patients included those with recent, and established or congenital, unilateral and bilateral palsies. The masseteric nerve was used for coaptation of the facial nerve either alone or in association with crossfacial nerve grafting, or for the reinnervation of gracilis neuromuscular transplants. Reinnervation was successful in all cases, the mean (range) time being 4 (2-5) months for facial nerve coaptation and 4 (3-7) months for neuromuscular transplants. Cosmesis was evaluated (moderate, n=10, good, n=30, and excellent, n=20) as was functional outcome (no case of impairment of masticatory function, all patients able to smile, and achievement of a smile independent from biting). The masseteric nerve has many uses, including in both recent, and established or congenital, cases. In some conditions it is the first line of treatment. The combination of combined techniques gives excellent results in unilateral palsies and should therefore be considered a valid option.
Maxillo-Facial Surgery Division (Head: Professor Enrico Sesenna), Head and Neck Department, University Hospital of Parma, Italy.
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Bianchi
Maxillo-Facial Surgery Division (Head: Professor Enrico Sesenna), Head and Neck Department, University Hospital of Parma, Italy. Electronic address: a.ferri@libero.it.
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Ferri
Maxillo-Facial Surgery Division (Head: Professor Enrico Sesenna), Head and Neck Department, University Hospital of Parma, Italy.
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Ferrari
Maxillo-Facial Surgery Division (Head: Professor Enrico Sesenna), Head and Neck Department, University Hospital of Parma, Italy.
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Copelli
Maxillo-Facial Surgery Division (Head: Professor Enrico Sesenna), Head and Neck Department, University Hospital of Parma, Italy.
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Salvagni
Maxillo-Facial Surgery Division (Head: Professor Enrico Sesenna), Head and Neck Department, University Hospital of Parma, Italy.
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Sesenna
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D004954:Esthetics; D005152:Facial Muscles / Q000294:innervation / Q000503:physiopathology; D005154:Facial Nerve / Q000601:surgery*; D005158:Facial Paralysis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008340:Mandibular Nerve / Q000637:transplantation; D008406:Masseter Muscle / Q000294:innervation*; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D018482:Muscle, Skeletal / Q000294:innervation / Q000637:transplantation; D016067:Nerve Transfer / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D012904:Smiling / Q000502:physiology; D055815:Young Adult
Bilateral facial palsy; Facial palsy; Facial reanimation; Masseteric nerve; Smile surgery; Unilateral facial palsy