A Simplified Atraumatic Technique for Tunneling a Nerve Graft in a Cross-Face Nerve-Grafting Procedure

ABSTRACT

This report describes a simple and reliable method of tunneling a nerve graft in a cross-face nerve grafting procedure. In this technique, a subcutaneous tunnel is developed in two passes by means of a long hemostat that advances an 18F sterile tube from one side of the face to the other. The nerve graft is then attached to a heavy (1-0) polypropylene suture with a stitch that, by its inherent firmness, is easily threaded through the tube, dragging the nerve graft behind. Thus, the nerve graft can easily be delivered through the tube without any trauma. This technique has been used for seven patients without any complication. This is a simple and atraumatic technique for tunneling a nerve graft in a cross-face nerve grafting procedure.

KEYWORDS

Cross-face nerve grafting - atraumatic technique

REFERENCES

• 1 Sassoon E M, Poole M D, Rushworth G. Reanimation for facial palsy using gracilis muscle grafts.  Br J Plast Surg . 1991;  44 195-200
• 2 Kubo T, Hosokawa K, Haramato U. Nerve-guiding technique for cross-face nerve grafting in facial paralysis.  Plast Reconstr Surg . 2000;  106 734
• 3 Naasan A, Sing S, Graham K E. A simple method for tunneling a nerve graft during facial reanimation.  Plast Reconstr Surg . 1998;  102 2508-2509
• 4 Scott M JL, Kay S PJ. A simple atraumatic method of pedicle delivery during free tissue transfer.  Br J Plast Surg . 1993;  46 340
• 5 Dobrin P B. Surgical manipulation and the tensile strength of polypropylene sutures.  Arch Surg . 1989;  124 665-668