Muscle-nerve-muscle neurotization of the orbicularis oris muscle

Introduction: A denervated half of the orbicularis oris muscle is not reinnervated spontaneously by axon sprouting from the intact contralateral side. The borderline between the facial nerve territories seems to act as a barrier. The muscle-nerve-muscle technique was advocated as a technique to reneurotize a denervated half of the orbicularis oris muscle in cases of marginal mandibular paralysis. Material and methods: This muscle-nerve-muscle neurotization was tried to induce reinnervation of a denervated angle of the mouth in four patients. Grafts were harvested from the sural nerve. Functional recovery was assessed by measurement of facial movements and by electrophysiological examination. Results: In three of the four cases presented, this technique helped to improve function of the lower lip. The clinical relevance of the results is discussed. (C) 2001 European Association for Cranio-Maxillofacial Surgery.