Introduction: Facial paralysis presents a challenging problem with significant impact on quality of life, often resulting in severe and debilitating disability. A wide range of static and dynamic reconstructive techniques have been described to try to restore function. The nerve to masseter (NTM) transfer is one dynamic technique that is explored further in this study. Aim: Review trends and outcomes patients undergoing in NTM transfer Methods: This is a 10 year single centre retrospective review of 60 patients who underwent nerve to masseter transfers between 2015 to 2025 at the Royal Brisbane and Womens Hospital. Results: We identified 202 patients who had facial nerve sacrificing procedures for treatment of neoplasms, most commonly metastatic squamous cell carcinoma. 60 (30%) of the 202 patients underwent NTM transfers. 33 (55%) of patients did not require any further surgery after the NTM transfer. 15 (25%) required one subsequent reanimation procedure, 6 (10%) required two subsequent procedures, 4 (7%) required three further procedures and 2 (3%) required four or more further procedures. Conclusions: The majority of patients undergoing primary NTM transfer at time of facial nerve sacrifice do not require any further revisionary surgery. One limitation of this study is the retrospective nature and outcome measures being limited to the documentation of facial muscle activation. Nevertheless this study represents the largest case series of NTM transfers to date that we are aware of.

Facial reanimation procedures can be broadly categorised into static and dynamic procedures. Emerging evidence demonstrating improved patient quality of life outcomes has generated a shift toward immediate dynamic strategies which include nerve transfers and grafts, often supplemented by static techniques. A retrospective analysis was performed on patients who underwent facial reanimation for oncologic head and neck resections at a single tertiary centre between 2015 and 2024. Immediate reanimation was defined as procedures performed at the time of tumour resection. Surgeries were classified by whether they were immediate or delayed and further categorised by whether they contained static or dynamic components. The proportion of primary dynamic reanimation surgeries increased from 12.2% of annual cases (2015-2019) to 25.5% (2020-2024) in the period studied. This reflected a general trend toward primary dynamic procedures, whilst immediate static reanimation figures remained comparable. Static reanimation remained a mainstay of delayed cases. The increased absolute volume and frequency of delayed static reanimation, 36.7% (2015-2019) to 42.0% (2020-2024), is noted and may fit with the trend toward more dynamic, immediate reanimation cases. This single centre series demonstrates a temporal shift toward the use of dynamic techniques in immediate facial reanimation. The increasing burden of delayed reanimation procedures, the majority of which are static, forms an important consideration as caseloads and immediate reconstruction continues to increase.