Facial nerve grafting and end-to-end anastomosis in the middle ear - tympanic cavity and mastoid |
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| Authors: | Nelson Álvares Cruz Filho José Evandro Prudente de Aquino Luís Francisco de Oliveira |
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| Affiliation: | 1. PhD in Otorhinolaryngology, School of Medicine of the University of São Paulo (Head of Otology, Beneficiência Portuguesa Hospital in São Paulo, Ivan F. Barbosa Clinic).;2. PhD in Otorhinolaryngology, Paulista School of Medicine, Federal University of São Paulo (Head of ENT at the Santa Casa de Lorena).;3. Former Preceptor, ENT Residency, Ivan F. Barbosa Clinic, Beneficiência Portuguesa Hospital in São Paulo (MD, ENT). Beneficiência Portuguesa Hospital in São Paulo. |
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| Abstract: | Sectioned facial nerves can be repaired with grafting or end-to-end anastomosis.ObjectiveTo discuss these repair procedures and what can be expected of them.MethodSeven 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.ResultsMean motor recovery was rated at 72.5% for subjects offered grafting and 73.3% for patients submitted to anastomosis.Conclusion1. 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). |
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| Keywords: | anastomosis, surgical ear, middle facial nerve microsurgery |
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