Facial Functioning following Split XI‐VII Anastomosis

Objective 1) Assess facial function in patients who underwent a split XII‐VII nerve anastomosis for facial reanimation. 2) Review our series of 4 patients. 3) Present a facial recovery grading system for patients who undergo a combination of static and mimetic procedures for facial reanimation. Method Patients were included with facial paralysis who were treated with XII‐VII anastomosis at our institution between March of 2008 and December of 2011. Each patient’s facial function was evaluated using a new facial recovery grading scale that takes into account any method of static or mimetic facial reanimation techniques. Results All 4 patients had complete facial paralysis prior to performing a split XII‐VII anastomosis. All of the patients demonstrated gains in facial functioning without compromising their oral competence. This proposed facial recovery grading scale provides a means by which clinicians can follow gains in facial function in patients who lack an anatomically intact facial nerve. Conclusion The split XII‐VII nerve graft is a dynamic procedure that can assist in reanimating patients with facial nerve paralysis in whom the proximal facial nerve is not available. Patients in this group experienced minimal morbidity, maintained their oral competence, and demonstrated significant improvement in eye closure and midface animation.