Masseter Transposition

Masseter transposition has limited applications in rehabilitation of facial paralysis because of the limited upward pull, its potential long term effects on mastication, and availability of many other better options. One useful application of the masseter flap is in reconstruction of a buccal defect associated with sacrifice of the lower division(s) of the facial nerve. In such a situation, through a transoral approach, the anterior portion of the masseter muscle can be detached from the lower border of mandible and transposed into the buccal defect. The distal end of the rotated muscle is then sutured to the orbicularis oris muscle fibers of the lower lip to reanimate the paralytic lip. If there is an associated buccal mucosal defect, a skin or mucosal graft can be placed on the masseter muscle and sutured to the edges of the mucosal defect.

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