Response to Dr. Steffen U. Eisenhardt, M.D., et al. letter to the editor

Response to Dr. Steffen U. Eisenhardt, M.D., et al. letter to the editor Eur J Plast Surg (2011) 34:223 DOI 10.1007/s00238-011-0547-4 LETTER TO THE EDITOR Response to Dr. Steffen U. Eisenhardt, M.D., et al. letter to the editor Bernardo Hontanilla Received: 14 January 2011 /Accepted: 15 January 2011 /Published online: 8 February 2011 Springer-Verlag 2011 Sir, nerve graft to achieve spontaneous smile in his modification We thank Dr. Eisenhardt et al. for the comments suggesting of the McLaughling technique [3]. Thus, we think that the that “the masseter nerve as a donor nerve can obtain facial nerve, although not a strong nerve to obtain facial spontaneous function independent of chewing motions 6 to movement, is the necessary nerve to obtain a spontaneous 9 months after the first signs of reinnervation due to the smile. Thus, the facial nerve combined with the masseter quite remarkable capacity of cerebral adaptation even in nerve should be a better option than using the hypoglossal adult patients”. However, Dr. Eisenhardt and co-authors nerve to obtain strong and spontaneous facial motion. must distinguish between spontaneous smile and smiling without biting, which are two situations completely References different from each other. Spontaneous smile is the social and unconscious smile, whereas smiling without biting is a 1. Manktelow RT, Tomat LR, Zuker RM et al (2006) Smile voluntary procedure not related with spontaneity. I agree reconstruction in adults with free muscle transfer innervated by with other authors that smiling without biting is possible, the masseter motor nerve: effectiveness and cerebral adaptation. especially in women, not in men, as is suggested, but not Plast Reconstr Surg 118:885–899 demonstrated, by Manktelow et al. [1]. However, there are 2. Terzis JK, Tzafetta K (2009) The “babysitter” procedure: mini- hypoglossal to facial nerve transfer and cross-facial nerve grafting. many publications in the literature (especially Dr. Terzis’), Plast Reconstr Surg 123:865–876 including ours, indicating that spontaneous smile cannot be 3. Labbé D, Hamel M, Bénateau H (2003) Lengthening temporalis achieved when using the masseter nerve as a donor nerve [2]. myoplasty and transfacial nerve graft (VII-V). Ann Chir Plast Moreover, Dr. Labbé et al. have introduced a cross-facial Esthét 48(1):31–35 B. Hontanilla (*) Clinica Universidad de Navarra, Pamplona, Spain e-mail: European Journal of Plastic Surgery Springer Journals

Response to Dr. Steffen U. Eisenhardt, M.D., et al. letter to the editor

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Medicine & Public Health; Plastic Surgery
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