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Original Investigation
Sept/Oct 2016

Facial Nerve Reconstruction With Concurrent Masseteric Nerve Transfer and Cable Grafting

Author Affiliations
  • 1Department of Otorhinolaryngology–Head and Neck Surgery, University of Michigan, Ann Arbor
  • 2Department of Otorhinolaryngology–Head and Neck Surgery, University of Texas Health Sciences Center at Houston
JAMA Facial Plast Surg. 2016;18(5):335-339. doi:10.1001/jamafacial.2016.0345
Abstract

Importance  Reconstruction of the facial nerve after radical parotidectomy is commonly performed with cable grafting, which is associated with slow recovery of nerve function and synkinesis.

Objective  To describe facial nerve reconstruction after radical parotidectomy using concurrent masseteric nerve transfer and cable grafting.

Design, Setting, and Participants  This retrospective medical record review at a tertiary referral hospital included 9 patients who underwent concurrent masseteric nerve transfer and cable grafting for facial nerve reconstruction performed by a single surgeon from January 1, 2014, to October 31, 2015. Final follow-up was completed on March 14, 2016.

Main Outcomes and Measures  Improvement in resting facial symmetry and oral commissure excursion and synkinesis.

Results  Nine patients (6 women; mean age, 62.6 years; age range, 51-73 years) underwent immediate facial nerve reconstruction after radical parotidectomy using concurrent cable grafting and masseteric nerve transposition. All patients had return of oral commissure motion within 2 to 7 months after surgery with good excursion and minimal synkinesis.

Conclusions and Relevance  Masseteric nerve transposition can be combined with cable grafting to improve outcomes in facial rehabilitation after radical parotidectomy.

Level of Evidence  4.

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