Related Experiment Video
Updated: Jan 25, 2026
19:53
Single-stage Dynamic Reanimation of the Smile in Irreversible Facial Paralysis by Free Functional Muscle Transfer
Published on: March 1, 2015
106.4K
Five-Year Experience with Fifth-to-Seventh Nerve Transfer for Smile
Caroline A Banks1, Nate Jowett1, Carlo Iacolucci1
1From the Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear Infirmary.
Plastic and Reconstructive Surgery
|April 30, 2019
Summary
Masseteric- or deep temporal-to-facial nerve transfer (five-to-seven nerve transfer) is a viable facial reanimation technique. Shorter denervation times and preoperative flaccidity predict successful outcomes, particularly in flaccid facial paralysis.
Area of Science:
- Neurosurgery
- Plastic Surgery
- Reconstructive Surgery
Background:
- Facial reanimation surgery utilizes five-to-seven nerve transfer for smile restoration.
- Indications and predictive factors for five-to-seven nerve transfer outcomes require definition.
Purpose of the Study:
- To report early experiences with five-to-seven nerve transfer.
- To identify clinical variables predicting outcomes in facial reanimation.
Main Methods:
- Retrospective chart review of 60 patients undergoing five-to-seven nerve transfer (2012-2017).
- Analysis of patient demographics, paralysis characteristics, surgical details, and functional outcomes.
- Preoperative and postoperative assessment of facial nerve function and quality of life.
Main Results:
- Masseteric nerve transfer achieved 88% success in flaccid paralysis; deep temporal nerve transfer had 60% success.
- Five-to-seven nerve transfer success rate was 20% in postparalysis facial palsy.
- Quality of life scores significantly improved in patients with successful nerve transfer for flaccid paralysis.
Conclusions:
- Five-to-seven nerve transfer is a viable facial reanimation option.
- Shorter denervation times and preoperative flaccidity are favorable prognostic indicators.
- Results are unreliable in postparalysis facial palsy; adjunct use enhances smile function.
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