TRIGEMINAL NEO-NEUROTIZATION OF THE PARALYZED FACE

Sporadic reports throughout the literature have documented the spontan eous return of facial function following deliberate intraoperative sac rifice of the facial nerve. Trigeminal reinnervation of the facial mus cles has been suggested as one possible mechanism for this occurrence. Evidence for the phenomenon of trigeminal neo-neurotization has been documented experimentally. The case of a 62-year-old woman who underwe nt total left parotidectomy with transection of a large facial nerve s egment is presented in order to provide further clinical evidence supp orting trigeminal neo-neurotization of the facial nerve. Despite the l ack of any efforts to reinnervate the patient or graft the facial nerv e defect, the patient spontaneously developed return of facial functio n. Postoperative clinical and electrical testing in this case supports trigeminal-facial reinnervation as the cause for return of facial fun ction. The case report is summarized with a brief discussion, and the relevant literature is thoroughly reviewed.