Masseteric-Facial Nerve Anastomosis: Surgical Techniques and Outcomes —A Pilot Indian study

AbstractMasseteric-facial anastomosis has gained popularity in recent days compared to the facial –hypoglossal anastomosis. Masseteric nerve has numerous advantages like its proximity to the facial nerve, stronger motor impulse, its reliability, low morbidity in harvesting and sacrificing the nerve and faster re-innervation that is achievable in most patients. The present case series demonstra te the surgical technique and the effectiveness of the masseteric nerve as donor for early facial reanimation. Between January 2017 and February 2019, 6 patients (2 male, 4 female) with iatrogenic unilateral complete facial paralysis (grade VI, House Brackmann scale) who underwent masseteric-facial nerve anastomosis were included in the study. The time interval between the onset of paralysis and surgery ranged from 4 to 18 months (mean 8.5 months). In all patients pre-operative electromyography had facial mimetic muscle fibrillation potentials. All patients underwent end to end anastomosis e xcept for one patient where greater auricular interposition graft was used. In all cases, the facial muscles showed earliest sign of recovery at 2–5 months. These movements were first noticed on the cheek musculature when the patients activated their masseter muscle. Eye movements started appeari ng at 6–9 months (in 3 cases) and forehead movements at 18 months (in 1 case). According to the modified House-Brackmann grading scale, one patient had Grade I function, two patients had Grade II...
Source: Indian Journal of Otolaryngology and Head and Neck Surgery - Category: ENT & OMF Source Type: research