Optional motor donor nerves are : the masseteric nerve, accessory nerve or hypoglossal nerve.
2.
Effective rehabilitation can also prevent biting whilst smiling, when using the masseteric nerve as nerve transfer.
3.
In the'babysitter'procedure, the hypoglossal nerve or masseteric nerve on the affected side is identified.
4.
Although the masseteric nerve transfer provides a strong smile within the range of normal, it never becomes truly spontaneous and emotional.
5.
The use of the masseteric nerve provides an amount of movement that is within the normal range, resulting in a more symmetrical but not completely emotional smile.
6.
In 1989, Zuker et al . suggested the use of the masseteric nerve as possible donor nerve for innervation of the transplanted muscle in patients with Moebius syndrome.
7.
Babysitter procedureIf facial paralysis lasts between 6 months and 2 years, the " babysitter " procedure may be used . ( Algorithm 1 ) For example, the hypoglossal nerve or masseteric nerve on the affected side can be used as donor nerves.
8.
With the use of the CFNG there is a risk of sensory deficits in the lower part of the leg, due to the sural or sapheneous nerve graft . A complication seen with the use of the masseteric nerve is the inability to chew without the appearance of a smile.
9.
In case of longstanding facial paralysis with irreversible muscle atrophy and unavailability of a suitable donor facial nerve, a free muscle graft is indicated for smile restoration, which has to be reinnervated by another donor nerve ( usually the masseteric nerve ) in an end-to-end fashion.
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