Facial Plast Surg 2008; 24(2): 170-176
DOI: 10.1055/s-2008-1075832
© Thieme Medical Publishers

Nerve Repair and Cable Grafting for Facial Paralysis

Clinton D. Humphrey1 , J. David Kriet1
  • 1Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas
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Publikationsdatum:
09. Mai 2008 (online)

ABSTRACT

Facial nerve injury and facial paralysis are devastating for patients. Although imperfect, primary repair is currently the best option to restore facial nerve function. Cable, or interposition, nerve grafting is an acceptable alternative when primary repair is not possible. Several donor nerves are at the surgeon's disposal. Great auricular, sural, or medial and lateral antebrachial cutaneous nerves are all easily obtained. Both primary repair and interposition grafting typically result in better facial function than do other dynamic and static rehabilitation strategies. Proficient anastomotic technique and, when necessary, selection of an appropriate interposition graft will optimize patient outcomes. Promising research is under way that will enhance future nerve repair and grafting efforts.

REFERENCES

  • 1 Sunderland S. The anatomy and physiology of nerve injury.  Muscle Nerve. 1990;  13 771-784
  • 2 Bresmond G, Magnan J. The anatomical and histological features of the facial nerve and their physiopathological consequences. In: Portmann M Facial Nerve. New York, NY; Masson 1985: 8-11
  • 3 Salame K, Ouaknine G ER, Arensburg B et al.. Microsurgical anatomy of the facial nerve trunk.  Clin Anat. 2002;  15 93-99
  • 4 Yarbrough W G, Brownlee R E, Pillbury H C. Primary anastamosis of extensive facial nerve defects: an anatomic study.  Am J Otol. 1993;  14 238-246
  • 5 Nath R K, Mackinnon S E. Experimental basis for nerve repair. In: May M The Facial Nerve. 2nd ed. New York, NY; Thieme Medical Publishers 2000: 115-126
  • 6 Spector J G, Lee P, Peterein J, Toufa D. Facial nerve regeneration through autologous nerve grafts: a clinical and experiemental study.  Laryngoscope. 1991;  101 537-554
  • 7 McGuirt W F, McCabe B F. Effect of radiation therapy on facial nerve cable autografts.  Laryngoscope. 1977;  87 415-428
  • 8 Gullane P F, Havas T J. Facial nerve grafts: effects of postoperative irradiation.  J Otolaryngol. 1979;  16 112-115
  • 9 Gidley P W, Gantz B W, Rubinstein J T. Facial nerve grafts: from cerebellopontine angle and beyond.  Am J Otol. 1999;  20 781-788
  • 10 Fisch U, Rouleau M. Facial nerve reconstruction.  J Otolaryngol. 1980;  9 487-492
  • 11 Nakatsuka H, Takamatsu K, Koshimune M, Imai Y, Enomoto M, Yamano Y. Experimental study of polarity in reversing cable nerve grafts.  J Reconstr Microsurg. 2002;  18 509-516
  • 12 Humphrey C D, McIff T E, Sykes K J, Tsue T T, Kriet J D. Suture biomechanics and static facial suspension.  Arch Facial Plast Surg. 2007;  9 188-193
  • 13 Dresner H S, King T A, Clark H B, Juhn S K, Levine S C. Peripheral facial nerve regeneration using collagen conduit entubulation in a cat model.  Ann Otol Rhinol Laryngol. 2006;  115 631-642
  • 14 Diaz L M, Steele M H, Guerra A B et al.. The role of topically administered FK506 (tacrolimus) at the time of facial nerve repair using entubulation neurorrhaphy in a rabbit model.  Ann Plast Surg. 2004;  52 407-413
  • 15 Yeh C, Bowers D, Hadlock T. Effect of FK506 on functional recovery after facial nerve injury in the rat.  Arch Facial Plast Surg. 2007;  9 333-339
  • 16 Farrag T Y, Lehar M, Verhaegen P, Carson K A, Byrne P J. Effect of platelet rich plasma and fibrin sealant on facial nerve regeneration in a rat model.  Laryngoscope. 2007;  117 157-165

J. David KrietM.D. F.A.C.S. 

Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center

3901 Rainbow Boulevard, Kansas City, KS 66160