title: Facial reanimation by muscle-nerve neurotization after facial nerve sacrifice. Case report.
abstract: BACKGROUND
  Recovering a certain degree of mimicry after sacrifice of the facial nerve is a clinically recognized finding. The authors report a case of hemifacial reanimation suggesting a phenomenon of neurotization from muscle-to-nerve.
  
  
  METHODS
  A woman benefited from a parotidectomy with sacrifice of the left facial nerve indicated for recurrent tumor in the gland. The distal branches of the facial nerve, isolated at the time of resection, were buried in the masseter muscle underneath. The patient recovered a voluntary hémifacial motricity. The electromyographic analysis of the motor activity of the zygomaticus major before and after block of the masseter nerve showed a dependence between mimic muscles and the masseter muscle.
  
  
  CONCLUSIONS
  Several hypotheses have been advanced to explain the spontaneous reanimation of facial paralysis. The clinical case makes it possible to argue in favor of muscle-to-nerve neurotization from masseter muscle to distal branches of the facial nerve. It illustrates the quality of motricity that can be obtained thanks to this procedure.
  
  
  CONCLUSIONS
  The authors describe a simple implantation technique of distal branches of the facial nerve in the masseter muscle during a radical parotidectomy with facial nerve sacrifice and recovery of resting tone but also a quality voluntary mimicry.
authors.affiliation: Service de chirurgie maxillo-faciale, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen, France.
authors.forename: A
authors.initials: A
authors.lastname: Taupin
authors.affiliation: Service de chirurgie maxillo-faciale, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen, France. Electronic address: dr.labbe@wanadoo.fr.
authors.forename: D
authors.initials: D
authors.lastname: Labbé
authors.affiliation: Service d'oto-rhino-laryngologie, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen, France.
authors.forename: E
authors.initials: E
authors.lastname: Babin
authors.affiliation: 23-bis, avenue Jean-Monnet, 14000 Caen, France.
authors.forename: G
authors.initials: G
authors.lastname: Fromager
mesh_terms: D005152:Facial Muscles / Q000294:innervation; D005154:Facial Nerve / Q000601:surgery*; D005158:Facial Paralysis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008406:Masseter Muscle / Q000294:innervation; D008875:Middle Aged; D016067:Nerve Transfer; D010306:Parotid Gland / Q000601:surgery; D010307:Parotid Neoplasms / Q000601:surgery; D020127:Recovery of Function
keywords: Chirurgie plastique; Facial paralysis; Masseter muscle; Muscle masséter; Neurotisation; Neurotization; Paralysie faciale; Plastic surgery