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Original Article | ONLINE FIRST

Motor Nerve to the Vastus Lateralis

Peter C. Revenaugh, MD; P. Daniel Knott, MD; Jennifer M. McBride, PhD; Michael A. Fritz, MD
Arch Facial Plast Surg. 2012;14(5):365-368. doi:10.1001/archfacial.2012.195.
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Objective  To further delineate the anatomy of the motor nerve to the vastus lateralis (MNVL) in the context of its use as a possible interpositional nerve graft in facial nerve rehabilitation.

Methods  Twelve fresh human cadaveric thighs were dissected to investigate the anatomic location and branching pattern of the MNVL muscle.

Results  There were 3 to 6 primary nerve branches (mean, 4.4) supplying the vastus lateralis. The mean primary branch length was 93.8 mm (range, 51-196 mm), and each primary branch had a mean of 2.3 subsequent branches. There were 2 larger caliber branches (>2 mm in diameter) supplying the proximal and distal muscle. The nerve branches are variable in their relation to the vascular pedicle and perforating vessels of the descending branch of the lateral circumflex femoral artery.

Conclusion  The nerve to the vastus lateralis is a readily available, redundant motor nerve suitable for facial nerve cable grafting.

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Figures

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Grahic Jump Location

Figure 1. Anatomic specimen of the nerve to the vastus lateralis with extensive arborization.

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Grahic Jump Location

Figure 2. Relation of the nerve to the vastus lateralis (arrow) to the descending branch of the lateral femoral circumflex artery (arrowhead).

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Grahic Jump Location

Figure 3. The large-caliber, redundant motor nerve to the vastus lateralis (arrow) courses along the ALT resection bed in a flap harvest.

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Grahic Jump Location

Figure 4. Example of use of nerve to vastus lateralis in facial nerve reconstruction. A, Nerve graft in place with revascularized anterolateral thigh fat/fascia flap for reconstruction (arrow). B, Close-up of nerve graft to 2 facial nerve branches.

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