Trigeminal Neoneurotization of the Paralysed Facial Musculature
Many investigators have entertained the concept of facial muscle reinnervation from the trigeminal pathway following facial nerve paralysis. In this paper we present a documented clinical case as well as experimental evidence that trigeminal facial crossover does occur and can be used as a concept to maximize early rehabilitation of the paralyzed face. A case is presented demonstrating unequivocal clinical evidence of trigeminal facial cross-innervation. A 62-year-old white female underwent a left parotidectomy 30 years ago. In December 1990, left facial paralysis developed over 24 h. CT scan revealed a deep lobe parotid tumor. She then underwent a total parotidectomy with sacrifice of the facial nerve at the stylomastid foramen. Ten months later, she spontaneously demonstrated the ability to smile on the left side while chewing. This was documented both photographically and by video and confirmed by EMG testing. We hypothesize that this phenomenon is due to trigeminal facial crossover.