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The Second Division of Trigeminal Nerve for Corneal Neurotization

A Novel One-Stage Technique in Combination With Facial Reanimation

Gennaro, Paolo, MD*; Gabriele, Guido, MD*; Aboh, Ikenna Valentine, MD*; Cascino, Flavia, MD*; Menicacci, Cristina, MD; Mazzotta, Cosimo, MD; Bagaglia, Simone, MD

Journal of Craniofacial Surgery: June 2019 - Volume 30 - Issue 4 - p 1252–1254
doi: 10.1097/SCS.0000000000005483
Clinical Studies

Corneal neurotization represents an effective surgical strategy to restore corneal sensibility in patients affected by neurotrophic keratopathy.

Corneal sensibility is essential in preserving structure and function of the eye. Loss of corneal sensibility can lead to a degenerative condition of the cornea known as neurotrophic keratopathy.

Moreover, patients suffering from facial palsy show failure of full eyelid closure resulting in chronic corneal exposure and subsequent progressive damage.

Reports have shown that the use of the contralateral ophthalmic division of the trigeminal nerve can be effective in restoring corneal sensibility. In the present study the authors expose a new technique by means of which direct neurotization of the anesthetic cornea was achieved using the homolateral second division of the trigeminal nerve. Effectiveness of the technique was evaluated using in vivo confocal microscopy.

To the best of authors’ knowledge, this is the first report of this technique in literature.

*Department of Maxillofacial Surgery

Department of Ophthalmology, University of Siena, Policlinico Santa Maria alle Scotte, Siena, Italy.

Address correspondence and reprint requests to Guido Gabriele, MD, Department of Maxillofacial Surgery, University of Siena, Policlinico Santa Maria alle Scotte, Viale Mario Bracci, 53100 Siena, Italy; E-mail:

Received 26 January, 2019

Accepted 20 February, 2019

The authors report no conflicts of interest.

© 2019 by Mutaz B. Habal, MD.