{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:45:57Z","timestamp":1781246757272,"version":"3.54.1"},"reference-count":21,"publisher":"Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T00:00:00Z","timestamp":1691539200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPHS"],"abstract":"<jats:p>Background: Early onset facial paralysis is usually managed with cross-face nerve grafts, however the low number of axons that reach the target muscle may result in weakness or failure. Multiple-source innervation, or \u2018supercharging\u2019, seeks to combine the advantages of different donor nerves while minimizing their weaknesses. We propose a combination of cross-face nerve grafts with local extra-facial nerve transfers to achieve earlier facial reanimation in our patients.Methods: A retrospective cohort including all patients with early unilateral facial palsy (&lt;12 months evolution) who underwent triple nerve transfer between 2019 and 2021 was conducted. We performed single-stage procedure including zygomatic-to-zygomatic and buccal-to-buccal cross-face grafts, a nerve-to-masseter to bucozygomatic trunk transfer, and a mini-hypoglossal to marginal branch transfer. Results were evaluated using the clinician-graded facial function scale (eFACE).Results: Fifteen patients were included (eight females, seven males), mean age at the time of surgery was 48.9 \u00b1 13.3 years. Palsy was right-sided in eight cases. The mean time from palsy onset to surgery was 5.5 \u00b1 2.8 months. Patients showed improvement in static (70.8 \u00b1 21.9 vs. 84.15 \u00b1 6.68, p = 0.002) and dynamic scores (20 \u00b1 16.32 vs. 74.23 \u00b1 7.46, p &lt; 0.001), as well as periocular (57.33 \u00b1 15.23 vs. 74 \u00b1 7.18, p = 0.007), smile (54.73 \u00b1 11.93 vs. 85.62 \u00b1 3.86, p &lt; 0.001), mid-face (46.33 \u00b1 18.04 vs. 95 \u00b1 7.21, p &lt; 0.001) and lower face scores (67.4 \u00b1 1.55 vs. 90.31 \u00b1 7.54, p &lt; 0.001).Conclusion: The triple nerve transfer technique using cross-face nerve grafts, the nerve-to-masseter, and the hypoglossal nerve, is an effective and reproducible technique to obtain middle and lower face reanimation in cases of early facial palsy.<\/jats:p>","DOI":"10.2340\/jphs.v58.6527","type":"journal-article","created":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T07:36:47Z","timestamp":1691566607000},"page":"62-66","source":"Crossref","is-referenced-by-count":8,"title":["Triple nerve transfers for the management of early unilateral facial palsy"],"prefix":"10.2340","volume":"58","author":[{"given":"Jose E.","family":"Telich-Tarriba","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David F.","family":"Navarro-Barquin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genesis","family":"Pineda-Aldana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Cardenas-Mejia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2023,8,9]]},"reference":[{"key":"35982","doi-asserted-by":"crossref","unstructured":"Ch\u00e1vez-Serna E, Telich-Tarriba JE, Altamirano-Arcos C, Nahas-Combina L, C\u00e1rdenas-Mej\u00eda A. 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