End-to-side nerve graft for facial nerve reconstruction.
Reconstruction of multiple branches of the facial nerve by sural nerve graft using end-to-side nerve suture was performed successfully on a patient with advanced parotid tumor. In this technique, one end of the grafted nerve is sutured with the stump of the facial nerve trunk in an end-to-end manner. Epineural windows are made on the nerve graft, and the distal stumps of the facial nerve branches (temporal, zygomatic, and buccal branches) are sutured with the graft in an end-to-side manner. Functional recovery of all branches and satisfactory facial expression were obtained within 2 years postoperatively. Axonal regeneration through the graft was confirmed by electrodiagnosis. Regeneration through the anastomosis at the stump of the facial nerve trunk using this technique is more efficient than conventional cable grafting, and the length of the nerve required is minimal. This technique may be a useful option for facial nerve reconstruction managing multiple branches.
Kakibuchi
Masao
M
Division of Plastic Surgery, Department of Otolaryngology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. mkaki@hyo-med.ac.jp
Tuji
Kojiro
K
Fukuda
Kenji
K
Terada
Tomonori
T
Yamada
Nobuyuki
N
Matsuda
Ken
K
Kawai
Ken-Ichiro
K
Sakagami
Masafumi
M
D003528:Carcinoma, Adenoid Cystic / Q000601:surgery; D004576:Electromyography; D005149:Facial Expression; D005154:Facial Nerve / Q000502:physiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009416:Nerve Regeneration; D016067:Nerve Transfer; D010307:Parotid Neoplasms / Q000601:surgery; D020127:Recovery of Function; D013497:Sural Nerve / Q000637:transplantation*; D013997:Time Factors