Comparison of results utilizing one-step and two-step triple innervation techniques

Biglioli, Federico; Guerra, Maria Beatrice; Rabbiosi, Dimitri; Ciardiello, Cristina; Allevi, Fabiana

doi:10.1016/j.jcms.2021.03.006

Cited by 6 publications

(2 citation statements)

References 24 publications

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“…10 However, previously, techniques involving simultaneous masseter nerve transfer and cross facial nerve grafting have been performed in a delayed setting. 10,12…”

Section: Introductionmentioning

confidence: 99%

“…10 However, previously, techniques involving simultaneous masseter nerve transfer and cross facial nerve grafting have been performed in a delayed setting. 10,12 Prolonged denervation time has been associated with inferior outcomes following facial reanimation. 6,13 When performing dual source reanimation in a delayed fashion, the targets of the cross facial grafts may not receive a motor signal for 6 months or more added to denervation time from tumor resection because the coaptations on the paralyzed side are done downstream to the masseter transfer.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Early Simultaneous Cross Facial Nerve Graft and Masseteric Nerve Transfer for Facial Paralysis after Tumor Resection

Sergesketter

Shammas

Massa³

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: We describe a new approach for facial reanimation after skull base tumor resection with known facial nerve sacrifice, involving simultaneous masseter nerve transfer with selective cross facial nerve grafting (CFNG) within days after tumor surgery. This preliminary study compared outcomes of this approach versus a staged procedure involving a masseter nerve “babysitter” performed in a delayed timeline. Methods: Patients undergoing masseter nerve transfer and CFNG for facial paralysis after skull base tumor resection were consented to participate in video interviews. Facial Clinimetric Evaluation (FaCE) Scale (0–100) patient-reported outcome, eFACE, and Facial Grading Scale scores were compared. Results: Nine patients had unilateral facial paralysis from resection of a schwannoma (56%), acoustic neuroma (33%), or vascular malformation (11%). Five underwent early simultaneous CFNG and masseter nerve transfer (mean 3.6 days after resection), whereas four underwent two-stage reanimation including a babysitter procedure (mean 218 days after resection). Postoperative FaCE scale and Facial Grading Scale scores were similar in both groups (P > 0.05). Postoperative mean eFACE scores were similar for both groups for smile (early: 71.5 versus delayed: 75.5; P = 0.08), static (76.3 versus 82.1; P = 0.32), and dynamic scores (59.7 versus 64.9; P = 0.19); however, synkinesis scores were inferior in the early group (76.4 versus 91.1; P = 0.04). Conclusions: Early simultaneous masseter nerve transfer and CFNG provides reanimated movement sooner and in fewer stages than a staged approach in a delayed timeline. The early technique appears to result in similar clinician- and patient-reported outcomes compared with delayed procedures; however, in this preliminary study, the early approach was associated with greater synkinesis, meriting further investigation.

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“…10 However, previously, techniques involving simultaneous masseter nerve transfer and cross facial nerve grafting have been performed in a delayed setting. 10,12…”

Section: Introductionmentioning

confidence: 99%