Does a positive neural margin affect outcome in facial nerve grafting?
BACKGROUND
We sought to determine the effect of positive neural margins on subsequent facial nerve function following facial nerve grafting.


METHODS
In this retrospective review, 19 patients had sacrifice of their facial nerve with immediate facial nerve grafting, 8 had positive neural margins, and 11 had negative neural margins. Facial nerve function was analyzed using the House-Brackman scale.


RESULTS
In the first group (8 patients), 5 had positive proximal margins and 3 had positive distal neural margins. Outcome by House-Brackman score was III (2 patients), IV (3 patients), V (1 patient), and VI (2 patients). In the second group (no evidence of neural spread, 11 patients), outcome was III (3 patients), IV (2 patients), V (2 patients), and VI (4 patients).


CONCLUSIONS
No significant difference in the outcome of facial nerve function was seen between these 2 groups. Facial nerve grafting should be considered in patients whose facial nerve is sacrificed, even when there is evidence of tumor in the perineurium at the margin of resection.
Wax
Mark K
MK
Department of Otolaryngology/Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA. waxm@ohsu.edu
Kaylie
David M
DM
D000368:Aged; D002277:Carcinoma / Q000473:pathology / Q000628:therapy; D003390:Cranial Nerve Neoplasms / Q000473:pathology* / Q000601:surgery; D005154:Facial Nerve / Q000473:pathology* / Q000601:surgery*; D005155:Facial Nerve Diseases / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010306:Parotid Gland / Q000601:surgery; D010307:Parotid Neoplasms / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D013497:Sural Nerve / Q000637:transplantation*; D016896:Treatment Outcome