CC BY-NC-ND 4.0 · Laryngorhinootologie 2018; 97(S 02): S378-S379
DOI: 10.1055/s-0038-1641029
Speicheldrüsen/Schilddrüsen: Salivary Glands/Thyroid Gland

Rehabilitation of the facial nerve with an interponate of the cervical plexus after traumatic facial nerve paralysis

A Siebert
1   Städtisches Klinikum Dessau, Dessau-Roßlau
S Knipping
1   Städtisches Klinikum Dessau, Dessau-Roßlau
› Author Affiliations


The facial nerve is the brain nerve which is most often affected by traumas. Regarded more closely it's caused mainly by fractures of the petrosal bone and traumas in the periphere nerval path including the paroid gland. Therapy depends on the degree and time of the subsequent paralysis.

Case Report:

As a result of a stabing injury a 30-year-old patient presented an extensive cervical wound which reached up to the paroid gland and a complete paralysis of the left facial nerve (House-Brackmann V). This led to the decision for early facial nerve rehabilitation by surgery. During surgery inspection showed a complete traumatic dissection of the temporal and the zygomatic branch in the parotid region of the original stabbing wound. Due to loss of nerval tissue it was not possible to reconnect the nerve as it was. So an interponate of the cervical plexus was obtained and transplanted between the nerval ends.

Additionally a platinium string was implanted in the upper eyelid to protect the cornea (lidloading).


In the further course the facial paralysis showed a significant regress (House-Brackmann Scale I-II). Via high solution sonography the nerval recovery could be monitored. Two years after surgery the patient consulted us again with a Frey's syndrome. Here local injection with botulin toxin showed to be a highly effective therapy.


Surgical rehabilitation of the facial nerve can achieve good results after trauma with nerval dissection. If anastomosis without tension is not possible due to a loss of nerval tissue the application of a nerval interponat can be considered. Possible complications include Frey's syndrome. An effective therapy therefor is local botulin toxin injection.

Publication History

Publication Date:
18 April 2018 (online)

© 2018. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Georg Thieme Verlag KG
Stuttgart · New York