Restoration of lower-lip sensation: Neurotization of the mental nerve with the supraclavicular nerve

Trigeminal nerve palsy resulting from cerebrovascular accidents can result in significant disability for patients. Loss of lip and chin sensation may involve lip biting, impaired speech, and diminished salivary retention. Neurotization of the mental nerve with the supraclavicular nerve can restore sensibility to the lower lip for patients with central dysfunction of the trigeminal nerve. The authors report a case describing this procedure and document recovery of sensation with quantitative sensory testing. This recovered sensation came from the ipsilateral inferior alveolar nerve and not the contralateral mental nerve, as demonstrated by nerve block. An algorithm outlining the treatment options in the management of trigeminal nerve palsy is also presented.