Masseter-to-facial nerve transfer: Technique and outcomes utilizing a fibrin sealant for coaptation

Publication date: August 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery, Volume 71, Issue 8

Author(s): Enrique Salmerón-González, Eduardo Simón-Sanz, Elena García-Vilariño, Alberto Ruiz-Cases

Summary

Background

This article describes the use of fibrin sealant for nerve coaptation without sutures in masseter-to-facial nerve transfer; and the results obtained utilizing this technique in a series of eleven patients.

Methods

A retrospective review of eleven patients with facial paralysis grades V-VI was performed. All patients underwent masseter nerve transfer for facial reanimation utilizing a fibrin sealant, without utilizing sutures for coaptation.

Results

The follow up period ranged from 10 to 52 months. All patients recovered oral competence, eye closure, facial tone and a smile grade of 4,45 +/- 0,52 according to Terzis aesthetic and functional evaluation scale. Muscle contraction started 3-9 months postoperatively (average 4,7 +/- 2,3).

Conclusions

The use of fibrin glue without sutures for coaptation in masseter-to-facial nerve transfer, simplifies the procedure and shortens surgical timing, not requiring the logistics of a microsurgical team, with similar results than neurorraphy performed with sutures. The masseter-to-facial nerve transfer is an effective technique for facial reanimation in short-term complete paralysis and mid-term partial paralysis.