Facial Nerve Reconstruction with Nerve Graft following Ablative Parotid Surgery

Yoo, Seung Joo; Chang, Young; Koh, Kyung Suck; Kim, Sang Yoon

Abstract

BACKGROUND AND OBJECTIVE: Sacrifice of the facial nerve may be unavoidable during parotid resections for malignancy. In these cases, facial nerve reconstruction is helpful to minimize postoperative facial dysfunction. Many surgical techniques have been described to improve the dysfunction of facial nerve but immediate nerve suture, or grafting if direct suture is not possible, achieves the best results and allows maximal return of function.
MATERIALS AND METHODS
We retrospectively studied 8 patients with parotid malignancies undergoing ablative parotid surgery with sacrifice of the seventh cranial nerve and facial nerve reconstruction with interposition graft between 1992 and 1997. They had been followed up for at least 6 months. Seven patients were reconstructed with simple interposition graft and the other was reconstructed with end-to-side facial-hypoglossal interposition graft. All the patients were treated with adjuvant radiotherapy. Each patient was evaluated on the basis of facial symmetry, eye closure and smile by means of photograph taken on the follow-up visit. RESULT: Facial symmetry, eye closure, and smile were improved satisfactorily in five, six, and four patients respectively. Recovery of patients who have had preoperative facial paralysis exhibited rather poor results.
CONCLUSION
Nerve grafting performed immediately after resection of the tumor can provide a significant improvement of function in patients with sacrifice of the facial nerve.