title: The impact of radiotherapy on facial nerve repair.
abstract: 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.
authors.affiliation: Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA. pwgidley@mdanderson.org
authors.forename: Paul W
authors.initials: PW
authors.lastname: Gidley
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Herrera
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Hanasono
authors.forename: Peirong
authors.initials: P
authors.lastname: Yu
authors.forename: Roman
authors.initials: R
authors.lastname: Skoracki
authors.forename: Dianna B
authors.initials: DB
authors.lastname: Roberts
authors.forename: Randal S
authors.initials: RS
authors.lastname: Weber
mesh_terms: 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