Facial nerve grafting and end-to-end anastomosis in the middle ear: tympanic cavity and mastoid.
Sectioned facial nerves can be repaired with grafting or end-to-end anastomosis.


OBJECTIVE
To discuss these repair procedures and what can be expected of them.


METHODS
Seven patients with sectioned facial nerves were included in the study. Four underwent grafting and three were offered end-to-end anastomosis. Facial nerve palsy was iatrogenic in five patients and was caused by bullet wounds in two. Assessment of motor function recovery was based on Janssen's scale.


RESULTS
Mean motor recovery was rated at 72.5% for subjects offered grafting and 73.3% for patients submitted to anastomosis.


CONCLUSIONS
1. Grafting and anastomosis are proper solutions to repair sectioned facial nerves; complete recovery is never attained; synkinesis may occur. 2. In principle anastomosis is the procedure of choice, but when there is minimal traction in the facial nerve stump grafting is preferred. 3. Both procedures yielded mean motor recovery rates above 70% (72.5% for grafting and 73.3% for anastomosis).
School of Medicine of the University of São Paulo.
Nelson Álvares
NÁ
Cruz Filho
José Evandro Prudente de
JE
Aquino
Luís Francisco de
LF
Oliveira
D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004432:Ear, Middle / Q000601:surgery*; D005154:Facial Nerve / Q000601:surgery*; D020220:Facial Nerve Injuries / Q000150:complications / Q000601:surgery*; D005158:Facial Paralysis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008875:Middle Aged; D013524:Surgical Flaps; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000150:complications; D055815:Young Adult