Changes in Masticatory Force and Masseter Muscle Activity in Patients with Unilateral Facial Palsy after Three Months of Masseter Nerve Reconstruction.
Adriana Fentanes Vera Adriana, Fellow; Alejandro Orihuela Alejandro, MD; Alexander Cardenas-Mejía Alexander, MD; Hospital Dr. Manuel Gea Gonzalez, Mexico, Mexico
Introduction: Facial palsy is caused by the involvement of the VII cranial nerve, causing the loss of voluntary and emotional movement in the facial muscles of the affected side. A technique widely used to restore facial nerve function is the transfer of one of the branches of the masseter nerve, it is said that preserving the other branch of the masseter nerve prevents the alteration of the masseter muscle, so that mastication is not affected either. However, objective measurements of post-denervation changes have not been made. Objective: To determine the changes in masticatory force and electrical activity of the masseter muscle in patients with unilateral facial palsy after three months of reconstruction with the masseter nerve. Material and methods: A quasi-experimental, longitudinal and prospective study was carried out in which 15 patients (6 men and 9 women, 6 with right facial palsy and 9 with left facial palsy) were included, whose surgical treatment involved the use of the masseter nerve. In all of them, the masticatory force was measured with occlusal sensors (recording a global value and on the right and left side), the electrical activity of the masseter muscles (right and left) was measured with surface electromyography, positioning the teeth in maximum occlusion and releasing posterior dental contact. The studies were taken before and after the surgery and classified according to the intervened and non-operated side. Results: A statistically significant difference was observed in the electrical activity of the masseter muscle on the operated side recorded at maximum occlusion (p = 0.017) and without posterior contacts (p = 0.020). There were changes in the values of masticatory force, although these were not sufficient to show significant difference. Conclusion: Despite the changes found in this study after using the masseter nerve as donor for facial resuscitation, no difference was found in the significant masticatory force after its use, which is why the use of the masseter nerve is considered a valuable tool for its functional benefits and poor morbidity in chewing.
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