Masseteric-facial nerve coaptation--an alternative technique for facial nerve reinnervation.

Abstract

BACKGROUND: Reinnervation of the facial musculature when there is loss of the proximal facial nerve poses a difficult clinical problem. Restoration of spontaneous mimetic motion is the aim and, to this end, the use of cross-facial nerve grafts has long been considered the reconstruction of choice. The nerve to masseter has been used very successfully for reinnervation of microvascular functioning muscle transfers for facial reanimation in established facial palsy but its use as a direct nerve transfer to the facial nerve to reinnervate 'viable' facial musculature has been scarce. METHODS: Electron micrographic studies of axonal counts in the nerve to masseter and nerve to gracilis in a clini..