Nerve repair and cable grafting for facial paralysis.
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.
Humphrey
Clinton D
CD
Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas 66160, USA.
Kriet
J David
JD
D000714:Anastomosis, Surgical / Q000379:methods; D004568:Electrodiagnosis; D005154:Facial Nerve / Q000503:physiopathology / Q000601:surgery*; D020220:Facial Nerve Injuries / Q000503:physiopathology / Q000601:surgery; D005158:Facial Paralysis / Q000503:physiopathology / Q000601:surgery*; D005542:Forearm / Q000294:innervation; D006801:Humans; D009334:Neck Muscles / Q000294:innervation; D009410:Nerve Degeneration / Q000503:physiopathology; D009416:Nerve Regeneration / Q000502:physiology; D010525:Peripheral Nerves / Q000637:transplantation*; D020127:Recovery of Function / Q000502:physiology; D013497:Sural Nerve / Q000637:transplantation; D016896:Treatment Outcome