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Facial Plast Surg 2000; 16(4): 309-314
DOI: 10.1055/s-2000-15545
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Facial Nerve Repair: A Retrospective Review

Daphne A. Bascom, Barry M. Schaitkin, Mark May, Susan Klein
  • Department of Otolaryngology-Head and Neck Surgery, Shadyside Hospital Facial Paralysis Center, Pittsburgh, PA
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Publication History

Publication Date:
31 December 2000 (online)

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ABSTRACT

The purpose of this article is to review a large series of patients evaluated for disorders of the facial nerve in order to assess the indications for surgery, the timing of surgery, the techniques of nerve repair, and to better define those factors associated with a favorable outcome. Study design: A retrospective review of patients undergoing facial nerve repair from 1963-1997. Methods: One hundred and three patients underwent surgical intervention designed to repair a disrupted facial nerve. All procedures were performed by one of the senior surgeons (M.M.). Seventy-two patients had a complete data set and at least one year of follow-up. Results: Eighty percent of patients attained an outcome considered superb to fair. Twenty percent of patients had a poor outcome. There was a slight worsening of outcome with increased time to repair. Patients with a neoplastic etiology of nerve paralysis tended to have a worse outcome. Conclusions: Facial nerve grafting is most successful if intervention is undertaken at or near the time of initial injury. However, prolonged time (up to two years) to repair does not preclude the potential for some recovery. The limitations of the current systems for grading facial recovery after nerve repair are well known, and the adoption of a new grading scale for assessing recovery after reanimation procedure is recommended.

KEYWORD

Facial paralysis - facial nerve repair - neurorrhaphy - nerve graft

REFERENCES

  • 1 May M, Schaitkin B M. The Facial Nerve. New York: Thieme Medical Publishers; 2000
  • 2 May M, Sobol S M, Mester S J. Hypoglossal-facial nerve interpositional jump graft for facial reanimation without tongue atrophy.  Otolaryngol Head Neck Surg . 1991;  104 818
    CrossrefPubMedSearch in Google Scholar
  • 3 Tucker H M. The management of facial paralysis due to extracranial injuries.  Laryngoscope . 1978;  88 348-354
    PubMedSearch in Google Scholar
  • 4 Sobol S M, May M, Mester S. Early facial reanimation following radical parotid and temporal bone tumor resections.  Am J Surg . 1990;  160 382-386
    PubMedSearch in Google Scholar
  • 5 Terris D J, Fee W E. Current issues in nerve repair.  Arch Otolaryngol Head Neck Surg . 1993;  119 725-731
    PubMedSearch in Google Scholar
  • 6 Saeed S R, Ramsden R T. Rehabilitation of the paralysed face: results of facial nerve surgery.  J Laryngol Otol . 1996;  110 922-925
    PubMedSearch in Google Scholar
  • 7 Stephanian E, Sekhar L N, Janecka I P, Hirsch B. Facial nerve repair by interposition nerve graft: results in 22 patients.  Neurosurgery . 1992;  31 73-77
    PubMedSearch in Google Scholar
  • 8 Barrs D M. Facial nerve trauma: optimal timing for repair.  Laryngoscope . 1991;  101 835-848
    PubMedSearch in Google Scholar
  • 9 Green Jr D J, Shelton C, Brackmann D E. Surgical management of iatrogenic facial nerve injuries.  Otolaryngol Head Neck Surg . 1994;  111 606-610
    PubMedSearch in Google Scholar
  • 10 House J W, Brackmann D E. Facial nerve grading system.  Otolaryngol Head Neck Surg . 1985;  93 146-147
    Search in Google Scholar
  • 11 Croxson G, May M, Mester S J. Grading facial function: House-Brackmann versus Burres-Fisch Methods.  Am J Otol . 1990;  11(4) 240-246
    PubMedSearch in Google Scholar
  • 12 Ross B G, Fradet G, Nedzelski J M. Development of a sensitive clinical facial grading system.  Otolaryngol Head Neck Surg . 1996;  380-386
    PubMedSearch in Google Scholar