Patient experience in nerve-to-masseter-driven smile reanimation |
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| Institution: | 1. Department of Otolaryngology/Head and Neck surgery, Facial Nerve Center, Massachusetts Eye and Ear Infirmary and Harvard Medical School, 243 Charles St., Boston, MA 02114, USA;2. Department of Plastic surgery, University Medical Center Groningen and University of Groningen, P.O. Box 30.001, NL-9700 RB Groningen, the Netherlands;3. Department of Plastic and Reconstructive Surgery, Royal Australasian College of Surgeons and University of Sydney, City Road, Camperdown/Darlington NSW 2006, Australia;1. Division of Plastic and Reconstructive Surgery, McGill University Health Center, Montreal General Hospital, 1650 Cedar Avenue C10-140, Montreal, Quebec H3G 1A4, Canada;2. Division of Experimental Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada;3. Faculty of Medicine, McGill University, Montreal, Quebec, Canada;1. Burns and Plastic Surgery Department, Pinderfields Hospital, Wakefield WF1 4DG, United Kingdom;1. Department of Oral & Maxillofacial-Head & Neck Oncology, Shanghai Ninth People''s Hospital, Shanghai Jiaotong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology and National Clinical Research Center of Stomatology, Shanghai, China;2. School of Stomatology, Capital Medical University, Beijing, China;3. Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China;4. Institute for Clinical Research and Application of Sunny Dental, Beijing, China |
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| Abstract: | IntroductionThe nerve-to-masseter is one of the most frequently used neural sources in smile reanimation surgery. Very little information has been reported on patient experience with regard to reanimated smile usage and sequelae following transfer. The aim of this study was to quantify patient perception of nerve-to-masseter use in smile reanimation surgery.MethodsAn online questionnaire was developed based on the clinical expertise of our team, patient interviews, and existing questionnaires of facial palsy-related quality of life and temporomandibular joint dysfunction. All patients treated with nerve-to-masseter-driven smile reanimation surgery, both nerve transfers and muscle transplantations, between 2007 and 2016 with a valid email address were invited to participate.ResultsOf 171 operated patients, 122 with a valid email address were invited to participate. Seventy-one patients responded (63.4% female, mean age 51.1 years) after a median follow-up of 3.8 years. A voluntary smile while biting down at least “most of the time” was reported by 83.1% of patients; 46.5% reported ability to smile on the affected side without bite. A “normal” or “almost normal” spontaneous smile was reported in 23.9% of patients. A total of 18.3% of patients self-reported masseter muscle atrophy, and 1.4–14.1% reported temporomandibular joint dysfunction. Forty-one patients (57.7%) reported prandial movement of the face at least “most of the time,” with 9 patients (12.7%) considering this bothersome.ConclusionPatients report good voluntary smiling ability following nerve-to-masseter-driven smile reanimation surgery, with low rates of sequelae. |
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