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Maxillofac Plast Reconstr Surg. 2018 Sep 7;40(1):22. doi: 10.1186/s40902-018-0163-3. eCollection 2018 Dec.

Per-oral cross-facial sural nerve graft for facial reanimation.

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2Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Goyang, South Korea.
1Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, 275-1 Yeongeon-dong, Jongro-gu, Seoul, 110-749 South Korea.
5Department of Oral and Maxillofacial Surgery, Dongtan Sacred Heart Hospital, Hallym University Medical Center, Kyonggi-do, South Korea.
6Dental Life Science Research Institute, Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul, South Korea.
4Dental Research Institute, Seoul National University, Seoul, South Korea.
3Oral Cancer Center & Clinical Trial Center, Seoul National University Dental Hospital, Seoul, South Korea.



Cross-facial nerve graft is considered the treatment of choice for facial reanimation in patients with unilateral facial palsy caused by central facial nerve damage. In most cases, a traditional parotidectomy skin incision is used to locate the buccal and zygomatic branches of the facial nerve.


In this study, cross-facial nerve graft with the sural nerve was planned for three patients with facial palsy through an intraoral approach.


An incision was made on the buccal cheek mucosa, and the dissection was performed to locate the buccal branch of the facial nerve. The parotid papillae and parotid duct were used as anatomic landmarks to locate the buccal branch.


The intraoral approach is more advantageous than the conventional extraoral approach because of clear anatomic marker (parotid papilla), invisible postoperative scar, reduced tissue damage from dissection, and reduced operating time.


Cross-facial nerve graft; Facial nerve paralysis; Facial reanimation; Sural nerve

Conflict of interest statement

The study was approved by the ethics committee of Seoul National University Dental Hospital Institutional Review Board.Written informed consent was obtained from the patients for the publication of this report and any accompanying images.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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