Masseteric-facial anastomosis for dynamic lower eyelid reanimation in facial paralysis

Abstract

Facial paralysis denervates the orbicularis oculi muscle with important functional and cosmetic deficits. When an intact neural circuit between the brainstem and orbicularis oculi cannot be reestablished, nerve transfer techniques are often utilized. The hypoglossal nerve has been the favored donor nerve for the past 40 years. The past 5 years has witnessed an increased interest in using the masseteric nerve due to its lower incidence of donor deficit and excellent static and dynamic results. We describe the surgical technique for end-to-end masseteric to facial nerve transfer and summarize the published results.