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Reinnervation with Selective Nerve Grafting from Multiple Donor Nerves.

Shiayin F Yang1, Jennifer C Kim2

  • 1Vanderbilt University Medical Center, 1215 21st Avenue South MCE, Suite 7209, Nashville, TN 37232, USA.

Facial Plastic Surgery Clinics of North America
|July 4, 2021
PubMed
Summary

Facial reanimation uses nerve transfers to restore movement and symmetry. Doctors choose donor nerves like the hypoglossal or masseteric nerve based on injury type and patient factors for optimal results.

Keywords:
Cross-facial nerve graftingFacial paralysis treatmentFacial reanimationHypoglossal nerve transferMasseteric nerve transferNerve substitution

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Area of Science:

  • Neurosurgery
  • Facial Plastic Surgery
  • Reconstructive Surgery

Background:

  • Facial nerve injury can lead to significant functional and aesthetic deficits.
  • Nerve substitution is a key strategy for restoring facial function.
  • Current techniques involve transferring alternative cranial nerves to reinnervate facial muscles.

Purpose of the Study:

  • To review nerve substitution techniques for facial reanimation.
  • To discuss various donor nerves used in facial nerve grafting.
  • To highlight the concept and benefits of multi-innervation in facial nerve repair.

Main Methods:

  • Review of common donor nerves for facial reanimation (hypoglossal, masseteric, cross-facial nerve graft).
  • Discussion of the advantages and disadvantages of each donor nerve.
  • Exploration of multi-innervation strategies combining multiple donor nerves.

Main Results:

  • Multiple donor nerves are available for facial reanimation, each with unique pros and cons.
  • The choice of donor nerve and technique depends on injury specifics and patient characteristics.
  • Multi-innervation aims to optimize outcomes by leveraging benefits and mitigating drawbacks of individual nerve transfers.

Conclusions:

  • Nerve transfer is a viable option for facial reanimation, aiming to restore movement, symmetry, and tone.
  • Careful selection of donor nerves and consideration of multi-innervation are crucial for successful outcomes.
  • Treatment must be individualized based on nerve injury type, duration, and patient factors.