The impact of radiotherapy on facial nerve repair.
OBJECTIVE
To study the impact of radiotherapy on the success of primary facial nerve repair and cable nerve grafts.


METHODS
Retrospective review.


METHODS
Pre- and postoperative facial nerve function were assessed using the House-Brackmann (HB) grading system.


RESULTS
Thirty-nine patients were identified who had undergone facial nerve repair: 5 patients (13%) underwent primary repair, and 34 patients (87%) underwent nerve grafting. Radiotherapy was administered postoperatively to 34 patients (87%). Preoperative HB scores were I = 18, II = 11, III = 3, IV = 3, V = 3, and VI = 1. Postoperative scores were HB I = 1, II = 4, III = 16, IV = 6, V = 3, and VI = 9. Only patients with single-branch deficits recovered to HB I or II function. Good facial function (HB I-III) was achieved in 17 of 34 patients (50%) who received postoperative radiotherapy compared to 4 of 5 patients (80%) who did not receive postoperative radiotherapy (P = .349). Among the patients who had either HB I or II function preoperatively, 59% achieved good postoperative function (HB I-III). Four out of 10 patients (40%) with significantly compromised preoperative facial function (HB III-VI) were able to achieve HB III function.


CONCLUSIONS
Postoperative radiotherapy appears not to prevent achieving good facial function after a nerve repair, especially when normal or near-normal function is present preoperatively. Some patients with fair to little function preoperatively can achieve reasonable postoperative function with facial nerve reconstruction.
Gidley
Paul W
PW
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA. pwgidley@mdanderson.org
Herrera
Stephanie J
SJ
Hanasono
Matthew M
MM
Yu
Peirong
P
Skoracki
Roman
R
Roberts
Dianna B
DB
Weber
Randal S
RS
D000328:Adult; D000714:Anastomosis, Surgical; D016009:Chi-Square Distribution; D005154:Facial Nerve / Q000528:radiation effects* / Q000601:surgery*; D005158:Facial Paralysis / Q000209:etiology* / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome