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Updated: Mar 1, 2026

Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
Masseteric to buccal branch nerve transfer
Sinehan B Bayrak1, J David Kriet, Clinton D Humphrey
1Department of Otolaryngology - Head and Neck Surgery, Kansas University Medical Center, Kansas City, Kansas, USA.
Purpose Of Review:
To review recent literature pertaining to the use of masseteric-facial nerve neurorrhaphy (MFNN) for facial reanimation in patients with facial paralysis.
Recent Findings:
First, MFNN effectively restores some midface tone and function, including the ability to smile. Second, use of the masseteric nerve minimizes synkinesis, dysarthria, and dysphagia that frequently occur after hypoglossal-facial nerve neurorrhaphy. Third, concurrent cable grafting to the zygomatic branch from an intact proximal facial nerve remnant - when available - can restore dynamic eye closure.
Summary:
Masseteric nerve transfer is an alternative to hypoglossal nerve transfer that improves midface appearance and function for properly selected patients with facial paralysis.
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