Masseteric nerve supercharge bypass in primary reconstruction of facial nerve
- 102 Downloads
Facial paralysis is a severe disease and presents a formidable treatment challenge. A wide variety of surgical procedures are available with limited evidence. Major risk factors of suboptimal recovery include the duration of paralysis as well as higher age. In this paper, we demonstrate reconstruction of the facial nerve via an intratemporal end-to-end anastomosis and concomitant transfer of an intact masseteric nerve to the side of facial nerve trunk. The supercharge (reverse end-to-side) transfer resulted in preservation of target muscles and faster recovery. Masseteric supercharge bypass may be an acceptable surgical technique to restore muscle function in potentially higher risk cases.
KeywordsFacial nerve palsy Masseteric nerve Nerve transfer Supercharge bypass
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The patient has consented to the submission of the case report for submission to the journal. Additional informed consent was obtained from patient for whom identifying photography is included in this article.
All procedures performed in study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- 4.Biglioli F, Colombo V, Tarabbia F, Pedrazzoli M, Battista V, Giovanditto F, Dalla Toffola E, Lozza A, Frigerio A (2012) Double innervation in free-flap surgery for long-standing facial paralysis. J Plast Reconstr Aesthet Surg 65:1343–1349. https://doi.org/10.1016/j.bjps.2012.04.030 CrossRefGoogle Scholar
- 6.Borschel GH, Kawamura DH, Kasukurthi R, Hunter DA, Zuker RM, Woo AS (2012) The motor nerve to the masseter muscle: an anatomic and histomorphometric study to facilitate its use in facial reanimation. J Plast Reconstr Aesthet Surg 65:363–366. https://doi.org/10.1016/j.bjps.2011.09.026 CrossRefGoogle Scholar
- 13.Fujiwara T, Matsuda K, Kubo T, Tomita K, Hattori R, Masuoka T, Yano K, Hosokawa K (2007) Axonal supercharging technique using reverse end-to-side neurorrhaphy in peripheral nerve repair: an experimental study in the rat model. J Neurosurg 107:821–829. https://doi.org/10.3171/JNS-07/10/0821 CrossRefGoogle Scholar
- 18.Isaacs J, Allen D, Chen LE, Nunley J 2nd (2005) Reverse end-to-side neurotization. J Reconstr Microsurg 21:43–48; discussion 49-50. https://doi.org/10.1055/s-2005-862780
- 22.Letievant E (1873) Traite Des Sections Nerveuses, ParisGoogle Scholar
- 24.Manktelow RT, Tomat LR, Zuker RM, Chang M (2006) Smile reconstruction in adults with free muscle transfer innervated by the masseter motor nerve: effectiveness and cerebral adaptation. Plast Reconstr Surg 118:885–899. https://doi.org/10.1097/01.prs.0000232195.20293.bd CrossRefGoogle Scholar
- 26.Nadi M, Ramachandran S, Islam A, Forden J, Guo GF, Midha R (2018) Testing the effectiveness and the contribution of experimental supercharge (reversed) end-to-side nerve transfer. J Neurosurg:1–10. https://doi.org/10.3171/2017.12.JNS171570
- 28.Socolovsky M, Martins RS, di Masi G, Bonilla G, Siqueira M (2016) Treatment of complete facial palsy in adults: comparative study between direct hemihypoglossal-facial neurorrhaphy, hemihipoglossal-facial neurorrhaphy with grafts, and masseter to facial nerve transfer. Acta Neurochir 158:945–957; discussion 957. https://doi.org/10.1007/s00701-016-2767-7