title: Immediate facial reanimation in oncological parotid surgery with neurorrhaphy of the masseteric-thoracodorsal-facial nerve branch.
abstract: The extracranial facial nerve may be sacrificed together with the parotid gland during a radical parotidectomy, and immediate reconstruction of the facial nerve is essential to maintain at least part of its function. We report five patients who had had radical parotidectomy (two with postoperative radiotherapy) and immediate (n=3) or recent (n=2) reconstructions of the masseteric-thoracodorsal-facial nerve branch. The first mimetic musculature movements started 6.2 (range 4-8.5) months postoperatively. At 24 months postoperatively clinical evaluation (modified House-Brackmann classification) showed grade V (n=3), grade IV (n=1), and grade III (n=1) repairs. This first clinical series of masseteric-thoracodorsal-facial nerve neurorrhaphies has given encouraging results, and the technique should be considered as an option for immediate or recent reconstruction of branches of the facial nerve, particularly when its trunk is not available for proximal neurorrhaphy.
authors.affiliation: Maxillo-Facial Surgery Unit, San Paolo University Hospital, Milan, Italy. Electronic address: federico.biglioli@unimi.it.
authors.forename: Federico
authors.initials: F
authors.lastname: Biglioli
authors.affiliation: Maxillo-Facial Surgery Unit, San Paolo University Hospital, Milan, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Tarabbia
authors.affiliation: Maxillo-Facial Surgery Unit, San Paolo University Hospital, Milan, Italy.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Allevi
authors.affiliation: Maxillo-Facial Surgery Unit, San Paolo University Hospital, Milan, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Colombo
authors.affiliation: Maxillo-Facial Surgery Unit, San Paolo University Hospital, Milan, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Giovanditto
authors.affiliation: Maxillo-Facial Surgery Unit, San Paolo University Hospital, Milan, Italy.
authors.forename: Mahfuz
authors.initials: M
authors.lastname: Latiff
authors.affiliation: Neurophysiopathology Service, C. Mondino National Neurological Institute, Pavia, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lozza
authors.affiliation: Functional Rehabilitation Unit, San Paolo University Hospital, Milan, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Previtera
authors.affiliation: Functional Rehabilitation Unit, San Paolo University Hospital, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Cupello
authors.affiliation: Maxillo-Facial Surgery Unit, San Paolo University Hospital, Milan, Italy.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Rabbiosi
mesh_terms: D005154:Facial Nerve / Q000601:surgery*; D005158:Facial Paralysis; D006801:Humans; D008406:Masseter Muscle; D019635:Neurosurgical Procedures; D010306:Parotid Gland; D010307:Parotid Neoplasms / Q000601:surgery*; D019651:Plastic Surgery Procedures
keywords: Facial nerve branching; Facial nerve reconstruction; Facial reanimation; Masseteric nerve; Thoracodorsal nerve