[Primary clinical study on using end-to-end neurorrhaphy following rapid nerve expansion to repair facial nerve defect].
OBJECTIVE
To evaluate the clinical effect of end-to-end neurorrhaphy following rapid expansion of the nerve in repairing facial nerve defect.


METHODS
From August 2000 to February 2005, 9 patients suffering from facial nerve defect were treated by the surgical method. The defect was caused by traffic injury(4 cases) , by cutting injury (2 cases) and falling wound (1 case). Seven cases showed prominent facial paralysis. The other 2 cases were invaded by parotid carcinoma, without remarkable paralysis. One case had unibranch defect, and the other 8 cases had multibranch defect. The nerve gap ranged from 1.5 cm to 3.0 cm. After both the proximal and the distal segment had been dissected, the nerve was elongated by the expander designed and manufactured. The expansion was done at a speed of 2.0 cm/30 min, and it lasted until the end-to-end neurorrhaphy can be done easily. The treatment result was evaluated according to Baker's classification and House-Brackmann's grading system.


RESULTS
Nine patients were followed up 6-18 months. In 5 cases achieving good result, both dynamic look and static look of face were symmetric, the EMG peak value of mimetic muscle was 82%-95% of normal side. In 3 cases achieving fair result, the dynamic look and static look of face were basically symmetric, and the EMG peak value of mimetic muscle was 60%-90% of normal side. In 1 case achieving poor result, the function of mimetic muscle was improved slightly, and the EMG peak value of mimetic muscle was 55% of normal side.


CONCLUSIONS
The satisfactory result can be obtained by end-to-end neurorrhaphy following rapid expansion of the nerve in condition that nerve defect is less than 3.0 cm.
Ya
Zumeng
Z
Department of Maxillofacial & Plastic Surgery, the Second Affiliated Hospital, Chongqing University of Medical Sciences, Chongqing, 400010, P. R. China. yazumeng@163.com
Gao
Zhi
Z
Wang
Jianhua
J
D000714:Anastomosis, Surgical / Q000379:methods; D005152:Facial Muscles / Q000294:innervation / Q000503:physiopathology; D005154:Facial Nerve / Q000601:surgery*; D020220:Facial Nerve Injuries; D005158:Facial Paralysis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055164:Nerve Expansion / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D013536:Suture Techniques; D016896:Treatment Outcome