The Best Reanimation Option for Early Stage Facial Paralysis: Triple Nerve Transfers Short-Term Outcomes

Area of Science:

• Reconstructive surgery
• Neurosurgery
• Facial nerve surgery

Background:

• Facial paralysis significantly impacts function and quality of life.
• Various surgical techniques exist for facial reanimation, including nerve reconstruction.
• Optimal surgical approach selection is multifactorial, considering patient-specific and disease-related factors.

Purpose of the Study:

• To evaluate facial movement and symmetry in patients with flaccid facial paralysis post-triple nerve transfer.
• To assess improvements in quality of life using validated outcome measures.
• To hypothesize that triple nerve transfer yields superior functional and quality-of-life results.

Main Methods:

• Twelve patients with flaccid facial paralysis underwent selective triple nerve transfer.
• Facial movement and symmetry were objectively quantified using AI-based facial analysis tools.
• Patient-reported outcomes were measured using the Facial Clinimetric Evaluation (FaCE) Scale.

Main Results:

• Significant improvement in oral commissure excursion (20.31 mm to 29.79 mm, p < 0.05).
• Enhanced dental exposure post-surgery (0.13 mm to 3.64 mm, p < 0.05).
• Mean FaCE Scale score increased from 34 to 50.3 (p < 0.05), indicating improved quality of life.

Conclusions:

• Triple nerve transfer is an effective surgical option for facial reanimation.
• The procedure demonstrates significant improvements in voluntary smile symmetry.
• Enhanced facial function positively impacts patients' quality of life.