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Secondary end‐to‐end repair of extensive facial nerve defects: Surgical technique and postoperative functional results
Author(s) -
PizaKatzer Hildegunde,
Balogh Brigitta,
MuzikaHerczeg Emilia,
Gardetto Alexander
Publication year - 2004
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20047
Subject(s) - synkinesis , medicine , facial nerve , trunk , surgery , palsy , pathology , ecology , alternative medicine , biology
Abstract Background. Repair of the transected facial nerve is imperative for restoration of muscle function, including the ability to produce appropriate facial expressions. Injury might involve the main trunk and its several branches. Restoration of function presupposes meticulous repair of all injured nerve branches. Methods. Here we report three cases of secondary tension‐free end‐to‐end coaptation of a transected trunk and branches of the facial nerve by removal of the superficial part of the parotid gland. Results. Facial tone and symmetry at rest and motion were achieved. In two patients, a slight residual synkinesis is observed under stress. Conclusions. Direct end‐to‐end coaptation of the facial nerve and its branches by the technique described should be considered before deciding on grafts or rerouting procedures to deal with gaps of up to 15 mm. This technique is not recommended in the presence of infection and nerve defects. Intensive postoperative physiotherapy is required for optimal results. © 2004 Wiley Periodicals, Inc. Head Neck 26: 770–777, 2004