title: Suprascapular nerve as a donor for extracranial facial nerve reanimation procedures: a cadaveric feasibility study.
abstract: OBJECTIVE
  Facial nerve injury with resultant facial muscle paralysis is disfiguring and disabling. To the authors' knowledge, neurotization of the facial nerve using a branch of the brachial plexus has not been previously performed.
  
  
  METHODS
  In an attempt to identify an additional nerve donor candidate for facial nerve neurotization, 5 fresh adult human cadavers (10 sides) underwent dissection of the suprascapular nerve distal to the suprascapular notch where it was transected. The facial nerve was localized from the stylomastoid foramen onto the face, and the cut end of the suprascapular nerve was tunneled to this location. Measurements were made of the length and diameter of the supra-scapular nerve. In 2 of these specimens prior to transection of the nerve, a nerve-splitting technique was used.
  
  
  RESULTS
  All specimens were found to have a suprascapular nerve with enough length to be tunneled, tension free, superiorly to the extracranial facial nerve. Connections remained tensionless with left and right head rotation of up to 45 degrees . The mean length of this part of the suprascapular nerve was 12.5 cm (range 11.5-14 cm). The mean diameter of this nerve was 3 mm. A nerve-splitting technique was also easily performed. No gross evidence of injury to surrounding neurovascular structures was identified.
  
  
  CONCLUSIONS
  To the authors' knowledge, the suprascapular nerve has not been previously explored as a donor nerve for facial nerve reanimation procedures. Based on the results of this cadaveric study, the authors believe that use of the suprascapular nerve may be considered for surgical maneuvers.
authors.affiliation: Section of Pediatric Neurosurgery, Children's Hospital, Birmingham, Alabama 35233, USA. rstubbs@uab.edu
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.forename: Robert G
authors.initials: RG
authors.lastname: Louis
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Wartmann
authors.forename: Marios
authors.initials: M
authors.lastname: Loukas
authors.forename: Mohammadali M
authors.initials: MM
authors.lastname: Shoja
authors.forename: Mohammad R
authors.initials: MR
authors.lastname: Ardalan
authors.forename: W Jerry
authors.initials: WJ
authors.lastname: Oakes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001917:Brachial Plexus / Q000473:pathology* / Q000601:surgery*; D002102:Cadaver; D004210:Dissection; D020220:Facial Nerve Injuries / Q000473:pathology / Q000601:surgery*; D005158:Facial Paralysis / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016067:Nerve Transfer / Q000379:methods*