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DOI: 10.1055/s-0041-1730338
Masseteric-Facial Anastomosis: A Report of Three Cases
Anastomose massetérico-facial: Um relato de três casos
Abstract
Intoduction The pathways of the facial nerve are variable, and knowledge of that is essential. The worst impact caused by facial paralysis is related to quality of life, especially regarding the self-esteem and social acceptance on the part of the patients, leading to social isolation and disruption on their mental health.
Case Report A 33-year-old female patient, with a stage-T3 acoustic neurinoma, presented with a moderate dysfunction (grades II to III) according to the House-Brackmann (HB) Facial Nerve Grading System. A 43-year-old male patient, with a stage-T4B trigeminal schwannoma, underwent a resective surgery and presented grade-VI dysfunction according to the HB scale. And a female patient with a stage-T4A acoustic neurinoma presented grade-IV dysfunction according to the HB scale.
Discussion We performed a literature review of papers related to surgeries for masseteric-facial nerve anastomosis and compiled the results in table; then, we compared these data with those obtained from our cases.
Conclusion The masseteric nerve is the one that shows the best prognosis among all the cranial nerves that could be used, but it is also necessary to perform well the surgical technique to access the facial branch and consequently achieve a better masseteric-facial nerve anastomosis.
Resumo
Intodução As vias do nervo facial são variáveis, e o conhecimento delas é essencial. O pior impacto causado pela paralisia facial está relacionado à qualidade de vida, principalmente no que se refere à autoestima e aceitação social dos pacientes, e leva ao isolamento social e a transtornos na saúde mental.
Relato de caso Paciente do sexo feminino, de 33 anos, com neurinoma acústico de estágio T3, apresentou disfunção moderada (graus II a III) na escala de nervo facial de House-Brackmann (HB). Paciente do sexo masculino, de 43 anos, portador de schwannoma trigeminal de estágio T4B, foi submetido a cirurgia de ressecção do tumor e apresentou, no pós-operatório, disfunção de grau VI na escala de HB. E paciente do sexo feminino com neurinoma acústico de estágio T4A, apresentava disfunção de grau IV na escala de HB.
Discussão Realizamos uma revisão da literatura sobre os principais trabalhos relacionados às cirurgias de anastomose massetérico-facial, compilamos os resultados em uma tabela, e, em seguida, comparamos os dados obtidos com nossos casos.
Conclusão O nervo massetérico é o que apresenta melhor prognóstico entre todas os nervos cranianos que poderiam ser utilizados; entretanto, para isso é necessário realizar uma boa técnica cirúrgica para garantir um adequado acesso ao ramo facial e, consequentemente realizar uma melhor anastomose massetérico-facial
Publication History
Received: 09 August 2020
Accepted: 22 February 2021
Article published online:
31 August 2021
© 2021. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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