Brenner E, Schoeller T
Institute of Anatomy, University of Innsbruck, Austria.
Clin Anat. 1998;11(6):396-400. doi: 10.1002/(SICI)1098-2353(1998)11:6<396::AID-CA5>3.0.CO;2-8.
In the medical treatment of facial nerve paralysis a large number of different techniques have been developed to restore the function of the facial nerve. These include (a) the ipsilateral nerve grafting (e.g., partial hypoglossal-facial, spinal accessory-facial, partial glossopharyngeal-facial), (b) crossfacial nerve grafting and (c) temporal muscle flaps or even free muscle transfers. None of these techniques uses the masseteric nerve as a graft for reconstruction of the facial nerve. This preliminary report deals with the anatomical basis, which could lead to a new technique. The masseteric nerve leaves the infratemporal fossa through the mandibular notch, accompanied by the masseteric artery. At this level the nerve consists in nine of 36 cases studied of only one branch (25.0%), in 17 cases of two branches (47.0%), in nine cases of three (25.0%), and in the remaining case of four branches (2.8%). There are three main reasons for considering the masseteric nerve as a possible donor for at least the orbicular branch of the facial nerve: (1) The approach to the mandibular notch is quite simple; (2) since the nerve consists of two or more branches in 75.0% of the cases, severe dysfunction of the masseter muscle should not occur; (3) if there is complete denervation of the masseter muscle, its function may be taken over by the temporalis muscle.
在面神经麻痹的医学治疗中，已经开发出大量不同技术来恢复面神经功能。这些技术包括：（a）同侧神经移植（例如，部分舌下 - 面神经、副神经 - 面神经、部分舌咽 - 面神经），（b）跨面神经移植，以及（c）颞肌瓣甚至游离肌肉移植。这些技术均未使用咬肌神经作为移植材料来重建面神经。本初步报告探讨了可能催生新技术的解剖学基础。咬肌神经伴咬肌动脉穿过下颌切迹离开颞下窝。在所研究的36例中，在此水平该神经仅由一个分支组成的有9例（25.0%），由两个分支组成的有17例（47.0%），由三个分支组成的有9例（25.0%），由四个分支组成的有1例（2.8%）。将咬肌神经视为面神经至少眼轮匝肌分支的可能供体有三个主要原因：（1）进入下颌切迹的方法相当简单；（2）由于在75.0%的病例中该神经由两个或更多分支组成，咬肌不应出现严重功能障碍；（3）如果咬肌完全失神经支配，其功能可由颞肌替代。
