CN V-VII transfer for facial paralysis

Facial nerve paralysis can be a devastation diagnosis. Our faces are an expression of ourselves and are the means in which we interact with one another. This patient suffered facial paralysis after removal of a tumor that encased his facial nerve (cranial nerve VII). Here, we rerouted fibers from the masseter nerve (a branch of cranial nerve V) to power the facial nerve. The V-VII nerve transfer is a surgical technique where a branch of the masseteric nerve to the distal facial nerve to reinnervate paralyzed facial muscles. To create facial movement, the patient must activate the masseter nerve by biting down. While biting down is not an automatic movement during a smile, the patient can train and adopt this learned behavior by practicing with a mirror. This procedure has the advantages of a single-stage operation, predictable early activation because of the strong motor input from the masseteric branch, low donor-site morbidity, and creation of fairly natural movement.