Selective Neurectomy of the Facial Nerve with Cross-Face Nerve Graft for Treating Postparalytic Facial Nerve Syndrome

Abstract

Although postparalytic facial nerve syndrome (PFS) is a frequent sequela of partial facial palsy, no effective treatment is currently available. Herein, we report a case of a cross-face nerve graft (CFNG) technique with selective neurectomy of the facial nerve in a 52-year-old female with moderate PFS (especially oral-ocular synkinesis and facial contracture) and a House–Brackmann score grade III. Selective neurectomy resulted in the release of the synkinesis and contractures. Furthermore, we reinnervated the levator muscles of the upper lip and oral commissure by connecting the contralateral facial nerve to the thick zygomatic branch of the facial nerve via a CFNG, which allowed neural signal augmentation of the levator muscles. No obvious PFS recurrence was observed 1 year postoperatively. This procedure is expected to provide a new treatment option for improving PFS because it is effective and less invasive.

Keywords

facial nerve - contralateral facial nerve - facial palsy - neural signal augmentation

Authors' Contributions

Conceptualization and writing—original draft: K.N.

Data curation and formal analysis: H.S.

Methodology: H.S. and T.F.

Visualization: K.N. and H.S.

Writing—review and editing: H.S. and T.F.

Ethical Approval

This study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was reviewed and approved by the Institutional Review Board of the Tokyo Dental College Ichikawa General Hospital (no. 122–133). Written informed consent was obtained from the patient.

Patient Consent

The patient provided written informed consent for the publication of this case report and the use of her images.

Publikationsverlauf

Eingereicht: 18. Juli 2024

Angenommen: 01. Februar 2025

Accepted Manuscript online:
04. Februar 2025

Artikel online veröffentlicht:
15. Mai 2025

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