The Masseteric-facial Nerve Anastomosis for Facial Paralysis: Report of 106 Cases

Introduction: Several methods of neural rehabilitation for facial paralysis have been described. The purpose of this study is to report on a series for dynamic reinnervation of the paralyzed face by using masseteric-facial nerve anastomosis. The goals of this procedure are to provide good facial reinnervation.

Methods: 108 patients who had facial paralysis admitted to our department from 2015-2024. All of them had underwent acoustic neuroma surgery before. 106 cases underwent masseteric-facial nerve anastomosis. The House-Brackmann scales of all the patients were recorded when they admitted and 12 months later after the masseteric-facial nerve anastomosis surgery respectively. The side effect of masseteric-facial nerve anastomosis were analyzed.

Results: The degree of HB scales was IV in 56 patients, V in 34 patients and VI in 18 patients before the anastomosis. After the masseteric-facial nerve anastomosis, all the patients were follow-up to 12 months. 92 patients achieved excellent HB scales in I or II. 9 patients had HB scales in III and 7 patients did not change compare the scale before the surgery. The synkinesis is the main side effect.

Conclusion : The masseteric-facial nerve anastomosis provides good rehabilitation of facial nerve paralysis. This technique may provide a favorable alternative to the traditional method of hypoglossal-facial nerve anastomosis.