Hand Surgery and MicrosurgeryCross-Face Nerve Transfer for Established Trigeminal Branch II PalsyKoshima, Isao MD*; Narushima, Mitsunaga MD*; Mihara, Makoto MD*; Uchida, Gentaro MD*; Nakagawa, Masahiro MD†Author Information From the *Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; and †Department of Plastic and Reconstructive Surgery, Shizuoka Cancer Center, Shizuoka, Japan. Received September 1, 2008 and accepted for publication, after revision, November 15, 2008. Presented in part at the Japanese Society of Reconstructive Microsurgery 34th Annual Meeting October, 2007, Fukushima, Japan; the MD Anderson Cancer Center Invited Lectures January, 2008, Houston, TX; and in the 16th International Course on Plastic and Esthetic Surgery of Clinica Planas May, 2008, Barcelona, Spain. The authors have no financial interest, nor any commercial association related to the information presented in this article. There are no conflicts of interest or any funding sources that require disclosure. Reprints: Isao Koshima, MD, Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. E-mail: firstname.lastname@example.org. Annals of Plastic Surgery: December 2009 - Volume 63 - Issue 6 - p 621-623 doi: 10.1097/SAP.0b013e3181955cc7 Buy Metrics Abstract Reconstruction for trigeminal nerve II palsy is challenging. Cross-face nerve transfer from the contralateral trigeminal nerve facilitates this reconstruction. However, the microanatomy and techniques required for nerve sutures cause problems for many surgeons. Following the recent development of supramicrosurgical techniques appropriate for the microanatomy of peripheral nerves, a new method of intraoral “cross-face nerve transfer” was successfully used for repairing trigeminal nerve II palsy. Two cases of trigeminal nerve II palsy were repaired with contralateral trigeminal nerve transfer without any nerve graft. Affected upper labial sensory recovery was 1.65 to 2.44 (Semmes-Weinstein values) and 15 to 30 mm (moving 2-point discriminations) at 1 to 1 years after surgery. The advantages of this method are excellent nerve regeneration and the lack of donor site morbidity. It is a brief and simple operation in comparison to free nerve grafts. The disadvantage is a need for a supramicrosurgical technique, using a needle less than 80 μm wide. © 2009 Lippincott Williams & Wilkins, Inc.