Objective To investigate the clinical effect and surgical indications of the masseter nerve combined with the temporal segment of facial nerve transposition for the treatment of facial paralysis after acoustic neuroma resection.MethodsA retrospective analysis was performed on 10 patients with complete facial paralysis accompanied by severe sensorineural hearing loss after acoustic neuroma surgery hospitalized in our department from Jan 2018 to Jan 2019. All the patients underwent masseter nerve combined with the temporal segment of facial nerve transposition surgery.ResultsThe facial nerve function was evaluated according to the HouseBrackmann (HB) grading system one year after surgery. One case returned to HB gradeⅡ and 9 to HB grade Ⅲ. The difference of HB grade between pre and postoperative facial nerve function was statistically significant (P<0.01). Spontaneous smile occurred in 4 cases and social smile in 6, without serious surgical complications.ConclusionsThe masseter nerve combined with the transposition of the facial nerve inside the temporal bone can avoid damage of great auricular nerve and reduce nerve anastomotic stomas. It had significant clinical effect and is worthy of further study.