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      The Deep Temporal Nerve Transfer : An Anatomical Feasibility Study and Implications for Upper Facial Reanimation

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          Most cited references 22

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          Smile reconstruction in adults with free muscle transfer innervated by the masseter motor nerve: effectiveness and cerebral adaptation.

          This study assesses the ability of the masseter motor nerve-innervated microneurovascular muscle transfer to produce an effective smile in adult patients with bilateral and unilateral facial paralysis. The operation consists of a one-stage microneurovascular transfer of a portion of the gracilis muscle that is innervated with the masseter motor nerve. The muscle is inserted into the cheek and attached to the mouth to produce a smile. The outcomes assessed were the amount of movement of the transferred muscle; the aesthetic quality of the smile; the control, use, and spontaneity of the smile; and the functional effects on eating, drinking, and speech. The study included 27 patients aged 16 to 61 years who received 45 muscle transfers. All 45 muscle transfers developed movement. The commissure movement averaged 13.0 +/- 4.7 mm at an angle of 47 +/- 15 degrees above the horizontal, and the mid upper lip movement averaged 8.3 +/- 3.0 mm at 42 +/- 17 degrees. Age did not affect the amount of movement. Patients older than 50 years had the same amount of movement as patients younger than 26 years (p = 0.605). Ninety-six percent of patients were satisfied with their smile. A spontaneous smile, the ability to smile without thinking about it, occurred routinely in 59 percent and occasionally in 29 percent of patients. Eighty-five percent of patients learned to smile without biting. Age did not affect the degree of spontaneity of smiling or the patient's ability to smile without biting.
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            Facial reanimation using the masseter-to-facial nerve transfer.

            This article describes facial reanimation using the transfer of the trigeminal motor nerve branch of the masseter muscle (masseter nerve) to the facial nerve (masseter-to-facial nerve transfer).
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              Cortical adaptation to restoration of smiling after free muscle transfer innervated by the nerve to the masseter.

              The child with Möbius syndrome presenting for facial reanimation presents a difficult challenge. When bilateral paralysis and paresis preclude use of the contralateral facial nerve, the authors' preferred donor nerve for reinnervation of free muscle transfer is a branch of the trigeminal nerve, the ipsilateral nerve to the masseter.
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                Author and article information

                Journal
                Plastic and Reconstructive Surgery
                Plastic and Reconstructive Surgery
                Ovid Technologies (Wolters Kluwer Health)
                0032-1052
                2016
                September 2016
                : 138
                : 3
                : 498e-505e
                Article
                10.1097/PRS.0000000000002482
                © 2016
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