Free vascularized nerve grafting for immediate facial nerve reconstruction

Yoshihiro Kimata, Minoru Sakuraba, Shigeyuki Hishinuma, Satoshi Ebihara, Ryuichi Hayashi, Takahiro Asakage

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Objectives/Hypothesis: To obtain better functional results after reconstruction to treat facial palsy in the patients with preoperative and intraoperative factors that might inhibit functional recovery, the authors have used free vascularized nerve grafts to immediately reconstruct severed facial nerves. Study Design: The indications for vascularized nerve grafts were 1) scarred recipient bed attributable to previous operations, 2) a history of previous irradiation at the wound, 3) facial skin defects over the nerve graft after tumor ablation, 4) patient age greater than 60 years, and 5) preoperative facial palsy. Methods: Four types of free vascularized nerves were used. Functional recovery after reconstruction could be assessed with two facial nerve grading systems. Ten patients who underwent immediate reconstruction of severed facial nerve after ablative surgery of malignant tumors of the parotid gland were reviewed. Results: Functional recovery after reconstruction could be assessed with the House-Brackmann grading system and a 40-point grading system in 6 of the 10 patients after a mean follow-up period of 29.8 months (range, 10-60 mo). Results with the House-Brackmann system were grade II in 1 patient, grade III in 4 patients, and grade IV in 1 patient; scores on the 40-point grading system were 20 in 1 patient, 22 in 3 patients, 24 in 1 patient, and 28 in 1 patient. Conclusion: The study results indicated that muscle movement recovers satisfactorily after free vascularized nerve grafting. Although a study comparing vascularized nerve grafts and conventional nerve grafts would be necessary to confirm the superiority of vascularized nerve grafts, free vascularized nerve grafts are effective for immediate reconstruction of the severed facial nerve in patients with preoperative and intraoperative factors that might inhibit functional recovery.

Original languageEnglish
Pages (from-to)331-336
Number of pages6
JournalLaryngoscope
Volume115
Issue number2
DOIs
Publication statusPublished - Feb 2005
Externally publishedYes

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Keywords

  • Facial nerve reconstruction
  • Facial palsy
  • Immediate reconstruction
  • Vascularized nerve graft

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Kimata, Y., Sakuraba, M., Hishinuma, S., Ebihara, S., Hayashi, R., & Asakage, T. (2005). Free vascularized nerve grafting for immediate facial nerve reconstruction. Laryngoscope, 115(2), 331-336. https://doi.org/10.1097/01.mlg.0000154753.32174.24