Download PDF
Open Access
CC BY 4.0 · Arch Plast Surg 2026; 53(01): 060-071
DOI: 10.1055/a-2707-0408
Pediatric/Craniomaxillofacial/Head & Neck
Review Article

Postoperative Outcomes of Masseteric Nerve Transposition versus Cross-Facial Nerve Graft in Facial Reanimation: A Systematic Review and Meta-Analysis

Authors

  • Indri Lakshmi Putri 

    1   Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Airlangga University, Surabaya, Indonesia
    2   Plastic Reconstructive and Aesthetic Surgery Unit, Airlangga University Hospital, Surabaya, Indonesia

  • Klarina Elsa Siti Sarah 

    2   Plastic Reconstructive and Aesthetic Surgery Unit, Airlangga University Hospital, Surabaya, Indonesia

  • Imaniar Fitri Aisyah 

    3   Department of Mechanical Engineering, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia

  • Rachmaniar Pramanasari 

    2   Plastic Reconstructive and Aesthetic Surgery Unit, Airlangga University Hospital, Surabaya, Indonesia

  • Citrawati Dyah Kencono Wungu 

    4   Department of Physiology and Medical Biochemistry, Faculty of Medicine, Airlangga University, Surabaya, Indonesia
    5   Institute of Tropical Disease, Airlangga University, Surabaya, Indonesia

Funding Information None.
Further Information
  Permissions and Reprints

Abstract

Facial reanimation surgery offers various approaches, with the choice of method influenced by numerous factors. Masseteric nerve transposition (MNT) has become a preferred neural source, often compared with cross-face nerve graft (CFNG) for its respective advantages. This systematic review and meta-analysis aim to compare postoperative outcomes between MNT and CFNG in facial reanimation surgery for patients with facial nerve paralysis sequelae.

A comprehensive electronic search was conducted using databases such as PubMed/Medline, Scopus, ScienceDirect, EBSCO, Web of Science, and Cochrane Library, along with gray literature sources like Scopus Preprints and MedRxiv. Statistical analyses were performed using Review Manager version 5.4.1, with the quality of included studies assessed using the Newcastle–Ottawa Scale.

Results showed that MNT provided statistically significant improvements in commissural excursion (CE; mean difference [MD] = 2.36 mm) and commissural contraction velocity (CCV; MD = 7.01 mm/s) compared with CFNG. Additionally, MNT had a higher recovery percentage for CE (MD = 26.86%) and CCV (MD = 13.00%). Superior outcomes were also noted for static and dynamic smile symmetry, quality of life, and patient satisfaction.

This meta-analysis underscores the advantages of MNT over CFNG in the majority of parameters in the analysis, at once highlighting the need for further research with larger sample sizes for more precise comparisons.

Keywords

facial nerve paralysis - facial reanimation - masseteric nerve transposition - cross-facial nerve graft - postoperative outcome

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.


Contributors' Statement

I.L.P.: Conceptualization; formal analysis; methodology; supervision; validation; writing—review and editing.


K.E.S.S.: Data curation; investigation; software; writing—original draft.


I.F.A.: Project administration; resources; visualization; writing—review and editing; writing—original draft.


R.P.: Formal analysis; investigation; supervision; writing—review and editing.


C.D.K.W.: Formal analysis; methodology; software; supervision; writing—review and editing.


Ethical Approval

This article does not contain any studies with human or animal participants.


Informed Consent

Not applicable.


Supplementary Material



Publication History

Received: 19 October 2024

Accepted: 19 September 2025

Article published online:
30 January 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA