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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.
Masseteric-facial nerve neurorrhaphy (MFNN) offers an alternative for facial paralysis, restoring midface function and smile. This technique minimizes complications compared to hypoglossal-facial nerve transfers.
Area of Science:
- Neurosurgery
- Facial Plastic Surgery
- Reconstructive Surgery
Background:
- Facial paralysis significantly impacts quality of life.
- Current reconstructive options have limitations.
Purpose of the Study:
- To review recent literature on masseteric-facial nerve neurorrhaphy (MFNN).
- To evaluate MFNN's efficacy for facial reanimation.
Main Methods:
- Literature review of studies on MFNN.
- Analysis of outcomes including midface function, smile restoration, and complications.
Main Results:
- MFNN effectively restores midface tone and smile.
- It minimizes synkinesis, dysarthria, and dysphagia compared to hypoglossal-facial nerve neurorrhaphy.
- Concurrent cable grafting can restore dynamic eye closure.
Conclusions:
- Masseteric nerve transfer is a viable alternative to hypoglossal nerve transfer.
- MFNN improves midface appearance and function in selected patients with facial paralysis.
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