The masseteric nerve: a versatile power source in facial animation techniques.

Area of Science:

• Neurosurgery
• Plastic Surgery
• Facial Nerve Surgery

Background:

• The masseteric nerve is a viable donor for facial reanimation due to its advantages like low morbidity and strong motor impulse.
• It has been utilized for neuromuscular transplant reinnervation and treating recent facial palsies with positive outcomes.

Purpose of the Study:

• To retrospectively evaluate the efficacy and outcomes of facial animation procedures using the masseteric nerve over a 10-year period.
• To assess the success rates, reinnervation times, and functional/cosmetic results in patients with diverse facial palsies.

Main Methods:

• Retrospective analysis of 60 patients undergoing facial animation procedures with the masseteric nerve.
• Procedures included masseteric nerve coaptation with the facial nerve, combined with cross-facial nerve grafting, or reinnervation of gracilis neuromuscular transplants.
• Evaluation of reinnervation success, time to reinnervation, and both functional (mastication, smile) and cosmetic outcomes.

Main Results:

• Successful reinnervation was achieved in all 60 patients.
• Mean reinnervation time was 4 months for facial nerve coaptation and 4 months for neuromuscular transplants.
• Excellent or good cosmetic outcomes were reported in 50 patients (83%), with all patients achieving a smile independent of biting and no impairment of masticatory function.

Conclusions:

• The masseteric nerve is a versatile and effective option for facial reanimation in recent, established, and congenital facial palsies.
• Combined techniques utilizing the masseteric nerve yield excellent results, particularly in unilateral palsies, establishing it as a primary treatment consideration.