Clinical observation of masseter-to-facial nerve anastomosis for treatment of facial paralysis

Abstract

Objective To evaluate the efficiency and functional improvement of masseter-to-facial nerve transfer for patients who acquired a proximal iniury to the facial nerve and preliminary determine the influence factors for recovery. Methods From January, 2015 to May, 2016, the clinical data of 6 patients with facial paralysis underwent nerve anastomosis were analyzed retrospectively. These patients were required to come back to the hospital for a check every 3 months, in order to evaluate their facial nerve function. House-Brackmann (H-B) grading was used to evaluate the pre-oerative, post-operative and follow-up status. The masseter-to-facial nerve anastomosis was performed in all the 6 patients. Results All patients were followed-up. The mean time of follow-up was 16 months (ranged from 6 to 23 months) . Among 6 cases, the facial nerve function was improved in 5 cases, unchanged in 1 case. The postoperative H-B grades were II in 3 cases, III in 2 cases. The improvement of facial paralysis was most significant for orbicularis muscles, followed by the orbicularis oculi muscles, and the worst was the improvement of frontal muscles. Conclusion Masseter-to-facial nerve transfer anatomosis is a useful treatment for facial paralysis and can improve the facial function. Key words: Facial palsy; Masseter nerve; Nerve end-end anastomosis; Nerve end-side anastomosis