Facial nerve regeneration after facial allotransplantation: A longitudinal clinical and electromyographic follow-up of lip movements during speech.

Introduction: Facial allotransplantation constitutes a reconstructive option after extensive damage to facial structures. Functional recovery has been reported but remains an issue.

Case Report - Methods: A patient underwent facial allotransplantation after a ballistic injury with extensive facial tissue damage. Speech motor function was sequentially assessed clinically, along with repeated electromyography of lip movements during a follow-up of 3 years.

Results: Facial nerve recovery could be demonstrated within the first month, followed by a gradual increase in electromyographic amplitude and decrease in reaction times. These were accompanied by gradual improvement of clinical assessments.

Conclusions: Axonal recovery starts early after transplantation. Electromyographic testing is sensitive in demonstrating this early recovery, which ultimately results in clinical improvements.