ABSTRACT
The purpose of this article is to review a large series of patients evaluated for
disorders of the facial nerve in order to assess the indications for surgery, the
timing of surgery, the techniques of nerve repair, and to better define those factors
associated with a favorable outcome. Study design: A retrospective review of patients
undergoing facial nerve repair from 1963-1997. Methods: One hundred and three patients
underwent surgical intervention designed to repair a disrupted facial nerve. All procedures
were performed by one of the senior surgeons (M.M.). Seventy-two patients had a complete
data set and at least one year of follow-up. Results: Eighty percent of patients attained
an outcome considered superb to fair. Twenty percent of patients had a poor outcome.
There was a slight worsening of outcome with increased time to repair. Patients with
a neoplastic etiology of nerve paralysis tended to have a worse outcome. Conclusions:
Facial nerve grafting is most successful if intervention is undertaken at or near
the time of initial injury. However, prolonged time (up to two years) to repair does
not preclude the potential for some recovery. The limitations of the current systems
for grading facial recovery after nerve repair are well known, and the adoption of
a new grading scale for assessing recovery after reanimation procedure is recommended.
KEYWORD
Facial paralysis - facial nerve repair - neurorrhaphy - nerve graft
