The Best Reanimation Option for Early Stage Facial Paralysis: Triple Nerve Transfers Short-Term Outcomes

Articles > Article · 2026

Authors: İsa KAYA, Emre Berk AKYOL, Efe İŞLER, Fazıl APAYDIN

FACIAL PLASTIC SURGERY & AESTHETIC MEDICINE, Journal Indexed in SCI Expanded, International, WoS, 2026, vol Early Access (EA), pp (EA)-(EA)

DOI: DOI10.1177/26893614261435017

Summary

<p>Introduction:&nbsp;Facial&nbsp;paralysis&nbsp;is&nbsp;a&nbsp;challenging&nbsp;condition&nbsp;that&nbsp;affects&nbsp;both&nbsp;function&nbsp;and&nbsp;quality&nbsp;of&nbsp;life.&nbsp;Numerous&nbsp;surgical&nbsp;techniques&nbsp;have&nbsp;been&nbsp;described&nbsp;for&nbsp;facial&nbsp;reanimation,&nbsp;including&nbsp;nerve-based&nbsp;reconstruction&nbsp;methods.&nbsp;The&nbsp;choice&nbsp;of&nbsp;the&nbsp;most&nbsp;suitable&nbsp;approach&nbsp;depends&nbsp;on&nbsp;factors&nbsp;such&nbsp;as&nbsp;etiology,&nbsp;duration&nbsp;of&nbsp;paralysis,&nbsp;patient&nbsp;age,&nbsp;residual&nbsp;nerve&nbsp;status,&nbsp;and&nbsp;surgeon&nbsp;preference.&nbsp;Objective:&nbsp;To&nbsp;measure&nbsp;facial&nbsp;movement&nbsp;and&nbsp;symmetry&nbsp;among&nbsp;patients&nbsp;with&nbsp;flaccid&nbsp;facial&nbsp;paralysis&nbsp;who&nbsp;underwent&nbsp;triple&nbsp;nerve&nbsp;transfer&nbsp;surgery,&nbsp;hypothesizing&nbsp;that&nbsp;those&nbsp;receiving&nbsp;this&nbsp;approach&nbsp;will&nbsp;demonstrate&nbsp;improved&nbsp;facial&nbsp;movement&nbsp;and&nbsp;quality-of-life&nbsp;outcomes&nbsp;as&nbsp;measured&nbsp;by&nbsp;Emotrics&nbsp;and&nbsp;FaCE&nbsp;scores.&nbsp;Methods:&nbsp;Twelve&nbsp;patients&nbsp;underwent&nbsp;selective&nbsp;triple&nbsp;nerve&nbsp;transfer&nbsp;surgery&nbsp;in&nbsp;our&nbsp;center.&nbsp;Outcomes&nbsp;were&nbsp;assessed&nbsp;using&nbsp;artificial&nbsp;intelligence-based&nbsp;facial&nbsp;analysis&nbsp;tools&nbsp;and&nbsp;the&nbsp;Facial&nbsp;Clinimetric&nbsp;Evaluation&nbsp;(FaCE)&nbsp;Scale.&nbsp;Results:&nbsp;The&nbsp;mean&nbsp;oral&nbsp;commissure&nbsp;excursion&nbsp;improved&nbsp;from&nbsp;20.31&nbsp;+/-&nbsp;5.7&nbsp;mm&nbsp;preoperatively&nbsp;to&nbsp;29.79&nbsp;+/-&nbsp;5.54&nbsp;mm&nbsp;postoperatively&nbsp;(p&nbsp;&lt;&nbsp;0.05).&nbsp;Dental&nbsp;exposure&nbsp;improved&nbsp;from&nbsp;0.13&nbsp;+/-&nbsp;0.08&nbsp;mm&nbsp;to&nbsp;3.64&nbsp;+/-&nbsp;1.12&nbsp;mm&nbsp;(p&nbsp;&lt;&nbsp;0.05).&nbsp;The&nbsp;mean&nbsp;FaCE&nbsp;Scale&nbsp;score&nbsp;increased&nbsp;from&nbsp;34&nbsp;to&nbsp;50.3&nbsp;(p&nbsp;&lt;&nbsp;0.05).&nbsp;Conclusion:&nbsp;These&nbsp;findings&nbsp;suggest&nbsp;triple&nbsp;nerve&nbsp;transfer&nbsp;improves&nbsp;voluntary&nbsp;smile&nbsp;symmetry&nbsp;and&nbsp;quality&nbsp;of&nbsp;life&nbsp;in&nbsp;patients&nbsp;with&nbsp;complete&nbsp;facial&nbsp;paralysis.</p>

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