Arch Hand Microsurg.  2018 Dec;23(4):306-312. 10.12790/ahm.2018.23.4.306.

Long-Term Follow-Up after the Sural Nerve Graft on the Injured Temporal Branch of the Facial Nerve: A Case Report

• Cheon JH
• Chung JH
• Yoon ES
• Lee BI
• Park SH

• KMID: 2427400
• DOI: http://doi.org/10.12790/ahm.2018.23.4.306

Abstract

The temporal branch of the facial nerve is particularly vulnerable to traumatic injuries due to its anatomic location, which often causes severe aesthetic and functional loss in the patient. Moreover, a chronic injury with nerve defect is more difficult to treat compared to acute injury, because it usually needs an additional procedure such as a nerve graft surgical procedure. This case shows a male patient who had a divided temporal branch of the facial nerve one month after an injury. We successfully grafted the split sural nerve and showed a good aesthetic, functional recovery for the patient.

Keyword

Sural nerve; Facial nerve injuries; Peripheral nerve injuries; Neurosurgical procedures

MeSH Terms

Facial Nerve Injuries
Facial Nerve*
Follow-Up Studies*
Humans
Male
Neurosurgical Procedures
Peripheral Nerve Injuries
Sural Nerve*
Transplants*

Figure

• 

  Fig. 1 Facial animation of a 51-year-old male patient at one month after injury of the temporal branch of the facial nerve. There was a long scar around the left temple region. The patient was unable to raise the left eyebrow and wrinkle forehead.

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  Fig. 2 Intraoperative finding. A fascicular repair was performed beside the eyebrow.

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  Fig. 3 Visibility of scar has been reduced.

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  Fig. 4 The facial animation of the patient with a facial nerve injury at one and half years after the surgery. The patient became capable of raising the left eyebrow to almost the same level as the right one.

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  Fig. 5 The electromyography (EMG) activities in the orbicularis oculi muscles of the patient one and a half years after surgery. The EMG activities on the injured side (A1) were slightly lower than those on the non-injured side (B5).

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  Fig. 6 Harvested partial sural nerve with half the width and 2 cm length.

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