Cross facial nerve graft

In bilateral paralysis, reconstruction can be performed in a single stage with a different strategy than we use in unilateral palsy. Recommend FPrime to your librarian or information manager to request an extended free trial for all users at your institution. Finally, a well-hidden aesthetic suture is placed at the end of the surgery. When the facial nerve is injured during surgery, immediate reconstruction of the facial nerve by direct neurorrhaphy between the 2 stumps or by an interpositional nerve graft should be the first option. The importance of the nerve graft between the proximal stump of the masseteric nerve and the trunk of the facial nerve to achieve a tensionless neurorrhaphy must be underlined. The free ending nerve on the paralyzed side of the face is left anterior to the tragus and the incisions are closed bilaterally.
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Surgical Treatment

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Cross-facial nerve grafting

Static procedures may offer instant improvement to most patients with facial palsy, regardless of age. For the 3 experimental groups, this involved exposure of the left side of the neck and face and identification of the sciatic graft and the left facial nerve. Only patients with a minimum follow-up of 12 months after the first signs of muscle function recovery were considered for the study, which resulted in a population of 34 patients 21 females, 13 males. Upon electrical stimulation, the nerve which produces the best contraction of the zygomatic muscles and so the appearance of a smile is selected. Patient affected by complete facial paralysis as a consequence of acoustic neuroma surgery performed 12 months earlier. When the sural nerve is chosen for grafting, a separate surgical team harvests it in the standard way. Detachment of the muscle insertion in the zygomatic arch is not necessary, because the masseteric nerve is deep at this level and difficult to use for subsequent neurorrhaphy.
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Facial Paralysis Treatment | Conditions & Treatments | UCSF Medical Center

Major improvements in nerve coaptation have occurred over the past half century. Recovery of vibrissal movement did not differ among treatment groups. The graft was placed across the neck and into the left side of the face. Spontaneity in facial expression is believed to be important for psychological wellbeing. An open access publication of Association of Plastic Surgeons of India. Severe lagophthalmos is also noticeable c at 15 months follow-up the patient shows improved symmetry of lips in repose. Create a personal account to register for email alerts with links to free full-text articles.
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The period of rehabilitation was reduced by 10 months with the single-stage method. The results of the two methods are comparable, with 90 percent of the patients who underwent the single-stage and 93 percent of those who underwent the two-stage procedures having good and fair results. The importance of the nerve graft between the proximal stump of the masseteric nerve and the trunk of the facial nerve to achieve a tensionless neurorrhaphy must be underlined. More symmetrical features were the result. Significant differences were found in preoperative excursion of the affected side of the mouth and the change in excursion. The great auricular nerve is immediately deep to the superficial cervical fascia, 4—5 cm caudal to the earlobe, and over the anterior border of the sternocleidomastoid muscle. A face lift dressing is placed.
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