Outcomes of facial nerve reconstructive surgery

Introduction Paresis of the facial nerve causes serious health complications for patients and leads to a deterioration in their quality of life. Non-surgical methods of treatment focus mainly on the long-term facial rehabilitation and prevention of eye complications due to lagophthalmos. Surgical methods allow to reconstruct the facial nerve during its intracranial course, as well as after exiting the temporal bone.

Aim To evaluate the outcomes of the facial nerve reconstructions in patients with unilateral paresis/plegia of the facial nerve.

Methodology Retrospective analysis of outcomes of different facial nerve reconstruction techniques after 1 year and with an interval of at least 2 years after the anastomosis. The etiology of paresis, the interval between the onset of paresis and reconstructive surgery, the length of follow-up and the reconstruction technique were evaluated. Facial nerve function was assessed using the House-Brackmann classification (HB).

Results The cohort contained of 73 patients. The primary reconstruction of the facial nerve was most often performed. No statistically significant difference in facial nerve function depending on the reconstruction technique, gender, age or interval between the onset of paresis and reconstruction was found. In the case of interposition graft from the great auricular nerve, it has been shown that the resulting function of the facial nerve worsens with the length of the graft.

Conclusion Reconstructive surgeries resulted in improved facial nerve function in 98 % of patients. In 70 % of patients, the function of the facial nerve improved to the level of HB 3. The differences in the success of reinnervation of the facial nerve depending on the reconstruction technique used were statistically insignificant.

Publication History

Article published online:
24 May 2022