title: Long-term outcomes of facial nerve function in irradiated and nonirradiated nerve grafts.
abstract: OBJECTIVE
  We reviewed the long-term results of facial nerve repair in a tertiary head and neck institution in the north of England.
  
  
  METHODS
  We performed a case notes review of patients who had facial nerve repair over a 10-year period and had completed 24 months of follow-up.
  
  
  RESULTS
  The study population comprised 18 female patients and 24 male patients, with an overall mean age of 53.2 years (range, 16 to 80 years). Of the 24 patients who had a cable nerve graft, the greater auricular nerve was used in 15 cases. The sural nerve was used as the donor in a cross-facial nerve graft in 9 patients. Sixteen patients had transposition nerve repair: hypoglossal and ansa cervicalis in 7 and 9 cases, respectively. Two patients had primary anastomosis after surgery for extensive malignant tumors. In this series, no patients achieved a House-Brackmann (HB) grade of II. Overall, the HB grades III, IV, and V were the best postoperative facial nerve functions achieved in 11.9%, 33.3%, and 26.2% of patients, respectively. Failure (HB grade VI) was observed in 28.6% of patients. More than half of patients (62.5%) who had either a sural nerve cable graft or a faciohypoglossal transposition had a good outcome (HB grade III or IV).
  
  
  CONCLUSIONS
  In the present series, 45% of patients had an HB grade of III or IV at long-term follow-up. The best outcome (HB grade III) was observed after cross-facial grafting with the sural nerve.
authors.affiliation: Skull Base Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Aintree, Liverpool, England, UK.
authors.forename: Samuel C
authors.initials: SC
authors.lastname: Leong
authors.affiliation: Skull Base Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Aintree, Liverpool, England, UK.
authors.forename: Tristram H
authors.initials: TH
authors.lastname: Lesser
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D005154:Facial Nerve / Q000503:physiopathology* / Q000528:radiation effects / Q000601:surgery; D005158:Facial Paralysis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D010307:Parotid Neoplasms / Q000532:radiotherapy; D010525:Peripheral Nerves / Q000637:transplantation*; D011832:Radiation Injuries / Q000150:complications* / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult