Regional muscle transposition for rehabilitation of the paralyzed face

Masseter and temporalis muscle transpositions may be considered in cases of longstanding facial paralysis and in the congenital absence of the facial nerve or muscles. The basic advantage of this technique is the introduction of a large volume of living and dynamic muscle into the face. Additional advantages include simplicity, the support provided, enhancement of the possibility of myoneurotization, and no loss of other significant function. In many instances, facial movement improves for a period of approximately two years, and the long-range effect would suggest some degree of rehabilitation of the facial muscles. Our combined experience with over 100 muscle transpositions indicates the efficacy and success of this technique in selected patients.