Arch Plast Surg.  2015 Jul;42(4):461-468. 10.5999/aps.2015.42.4.461.

Functional Outcomes of Multiple Sural Nerve Grafts for Facial Nerve Defects after Tumor-Ablative Surgery

• Lee MC
• Kim DH
• Jeon YR
• Rah DK
• Lew DH
• Choi EC
• Lee WJ

• KMID: 1950723
• DOI: http://doi.org/10.5999/aps.2015.42.4.461

Abstract

BACKGROUND
Functional restoration of the facial expression is necessary after facial nerve resection to treat head and neck tumors. This study was conducted to evaluate the functional outcomes of patients who underwent facial nerve cable grafting immediately after tumor resection.
METHODS
Patients who underwent cable grafting from April 2007 to August 2011 were reviewed, in which a harvested branch of the sural nerve was grafted onto each facial nerve division. Twelve patients underwent facial nerve cable grafting after radical parotidectomy, total parotidectomy, or schwannoma resection, and the functional facial expression of each patient was evaluated using the Facial Nerve Grading Scale 2.0. The results were analyzed according to patient age, follow-up duration, and the use of postoperative radiation therapy.
RESULTS
Among the 12 patients who were evaluated, the mean follow-up duration was 21.8 months, the mean age at the time of surgery was 42.8 years, and the mean facial expression score was 14.6 points, indicating moderate dysfunction. Facial expression scores were not influenced by age at the time of surgery, follow-up duration, or the use of postoperative radiation therapy.
CONCLUSIONS
The results of this study indicate that facial nerve cable grafting using the sural nerve can restore facial expression. Although patients were provided with appropriate treatment, the survival rate for salivary gland cancer was poor. We conclude that immediate facial nerve reconstruction is a worthwhile procedure that improves quality of life by allowing the recovery of facial expression, even in patients who are older or may require radiation therapy.

Keyword

Facial nerve; Sural nerve; Surgery; Radiotherapy; Age groups

MeSH Terms

Facial Expression
Facial Nerve*
Follow-Up Studies
Head
Humans
Neck
Neurilemmoma
Quality of Life
Radiotherapy
Salivary Gland Neoplasms
Sural Nerve*
Survival Rate
Transplants*