Babysitter Nerve Muscle Graft. Electrical stimulation and a home physical therapy program are frequently initiated several months after surgery. The Masseter nerve and the Hypoglossal nerve are in close proximity to the facial nerve. Masseter-to-facial nerve "baby sitter" transfer with cross face nerve grafts. The two techniques used together are complimentary and create a marriage between strength and spontaneity. Approximately 18 to 24 months after trauma to the nerve, the muscle will be weak and withered.
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However, the facial motion created by these techniques is rarely spontaneous.
For example, many individuals with facial weakness after Bell's palsy or acoustic neuroma excision will make a significant spontaneous recovery and a course of observation is often warranted. Despite the potential for cross face nerve grafts to produce spontaneous facial motion, the degree of movement is often weak and unable to match the unaffected side. Exercise, heavy lifting, pressure to the cheeks and teeth brushing are all to be avoided until clearance is obtained from the operating surgeon. These long grafts traverse the face and require 10 to 12 months before they begin to deliver nerve fibers to the paralyzed side.