Reconstruction of complex peripheral facial nerve defects by a combined approach using facial nerve interpositional graft and hypoglossal-facial jump nerve suture.

Authors:
Gerd Fabian Volk
Gerd Fabian Volk
Jena University Hospital
Germany
Mira Pantel
Mira Pantel
University Hospital
Orlando Guntinas-Lichius
Orlando Guntinas-Lichius
Jena University Hospital
Germany

Laryngoscope 2011 Nov;121(11):2402-5

Department of Otorhinolaryngology, University of Jena, Jena, Germany.

Objectives/hypothesis: To describe a modified facial nerve reconstruction technique for complex defects of the facial fan after parotid surgery that avoids synkinesis between upper and lower face.

Study Design: Retrospective case series.

Methods: Patients who had undergone radical parotidectomy with a large defect of the facial fan, reconstruction of the upper face by facial nerve interpositional graft, and reconstruction of the lower face by hypoglossal-facial nerve jump nerve suture were included in this series.

Results: Four patients underwent the modified combined approach after tumor resection and prior to postoperative radiotherapy in three of the four cases. Surgery was combined with an upper lid weight implantation. Regeneration of the face was successful in all cases within 12 to 16 months. Most important, the separated reanimation of the upper and lower face circumvented synkinesis of the upper and lower face. This factor was essential for good functional results. Using the hypoglossal jump technique instead of a classical cross-nerve suture technique prevented the sacrifice of ipsilateral tongue function.

Conclusions: The presented method offers satisfactory results for facial reanimation and avoids synkinesis between the upper and lower face. Using the jump technique instead of a classic hypoglossal transfer as it was described originally for the combined approach avoids long-term sequelae for the tongue.

Download full-text PDF

Source
http://dx.doi.org/10.1002/lary.22357DOI Listing

Still can't find the full text of the article?

Sign up to send a request to the authors directly.
November 2011
8 Reads

Publication Analysis

Top Keywords

facial nerve
16
upper lower
16
lower face
16
combined approach
12
synkinesis upper
12
jump nerve
8
interpositional graft
8
nerve interpositional
8
jump technique
8
avoids synkinesis
8
nerve suture
8
facial fan
8
nerve
7
facial
7
face
6
upper
6
lower
5
lid weight
4
cases surgery
4
upper lid
4

References

(Supplied by CrossRef)
Quality of life after facial nerve repair
Guntinas-Lichius et al.
Laryngoscope 2007
Hypoglossal facial anastomosis: its significance for modern facial surgery. II. Combined approach in extratemporal facial nerve reconstruction
Stennert et al.
Clin Plast Surg 1979
Facial nerve repair: a retrospective review
Bascom et al.
Facial Plast Surg 2000
Nerve transfers in facial palsy
Terzis et al.
Facial Plast Surg 2008
Paterns of facial nerve synkinesis
Moran et al.
Laryngoscope 1996

Similar Publications