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The impact of radiotherapy on facial nerve repair
Author(s) -
Gidley Paul W.,
Herrera Stephanie J.,
Hanasono Matthew M.,
Yu Peirong,
Skoracki Roman,
Roberts Dianna B.,
Weber Randal S.
Publication year - 2010
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.21048
Subject(s) - medicine , facial nerve , radiation therapy , surgery , facial paralysis
Objective: To study the impact of radiotherapy on the success of primary facial nerve repair and cable nerve grafts. Study Design: Retrospective review. Methods: Pre‐ and postoperative facial nerve function were assessed using the House‐Brackmann (HB) grading system. Results: Thirty‐nine patients were identified who had undergone facial nerve repair: 5 patients (13%) underwent primary repair, and 34 patients (87%) underwent nerve grafting. Radiotherapy was administered postoperatively to 34 patients (87%). Preoperative HB scores were I = 18, II = 11, III = 3, IV = 3, V = 3, and VI = 1. Postoperative scores were HB I = 1, II = 4, III = 16, IV = 6, V = 3, and VI = 9. Only patients with single‐branch deficits recovered to HB I or II function. Good facial function (HB I–III) was achieved in 17 of 34 patients (50%) who received postoperative radiotherapy compared to 4 of 5 patients (80%) who did not receive postoperative radiotherapy ( P = .349). Among the patients who had either HB I or II function preoperatively, 59% achieved good postoperative function (HB I–III). Four out of 10 patients (40%) with significantly compromised preoperative facial function (HB III–VI) were able to achieve HB III function. Conclusions: Postoperative radiotherapy appears not to prevent achieving good facial function after a nerve repair, especially when normal or near‐normal function is present preoperatively. Some patients with fair to little function preoperatively can achieve reasonable postoperative function with facial nerve reconstruction. Laryngoscope, 2010