Skip to main content

Non-vascularized Nerve Grafts

  • Chapter
  • First Online:
Facial Palsy

Abstract

Nerve grafting plays a vital role in facial nerve repair and facial reanimation. It is employed in a variety of surgical concepts to restore or redirect innervation in order to reestablish facial movement. Different donor nerves can be harvested as nerve grafts. The choice is guided by requirements of the surgical approach as well as donor site morbidity. Cross-facial nerve grafting is a unique concept for facial reanimation but is entailed by certain limitations, including a two-stage surgery, long regeneration period, and uncertain outcome. New developments like cadaveric nerve allografts, fibrin adhesives, and pathway protection in cross-face nerve grafts promise ever evolving and improving surgical solutions to facial palsy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. May M, Schaitkin BM. History of facial nerve surgery. Facial Plast Surg. 2001;16(4):301–7.

    Article  Google Scholar 

  2. Chuang DC-C, Lu JC-Y, Chang TN-J, Laurence VG. Comparison of functional results after cross-face nerve graft-, spinal accessory nerve-, and masseter nerve-innervated gracilis for facial paralysis reconstruction: the Chang Gung experience. Ann Plast Surg. 2018;81(6S Suppl 1):S21–9.

    Article  CAS  PubMed  Google Scholar 

  3. Sulaiman O, Gordon T. Effects of short and long term Schwann cell denervation on peripheral nerve regeneration, myelination, and size. Glia. 2000;32(3):234–46.

    Article  CAS  PubMed  Google Scholar 

  4. Sulaiman OAR, Gordon T. Role of chronic Schwann cell denervation in poor functional recovery after nerve injuries and experimental strategies to combat it. Neurosurgery. 2009;65(Suppl 4):105–14.

    Article  Google Scholar 

  5. Dayan V, Cura L, Cubas S, Carriquiry G. Surgical anatomy of the saphenous nerve. Ann Thorac Surg. 2008;85(3):896–900.

    Article  PubMed  Google Scholar 

  6. Martins RS, Barbosa RA, Siqueira MG, Soares MS, Heise CO, Foroni L, et al. Morbidity following sural nerve harvesting: a prospective study. Clin Neurol Neurosurg. 2012;114(8):1149–52.

    Article  PubMed  Google Scholar 

  7. Koh KS, Park S. Endoscopic harvest of sural nerve graft with balloon dissection. Plast Reconstr Surg. 1998;101(3):810–2.

    Article  CAS  PubMed  Google Scholar 

  8. Oliveira MT, Marttos ACJ, Fallopa F. Endoscopic harvesting of the sural nerve graft: a cadaveric investigation. Orthopedics. 2000;23(11):1189–91.

    Article  CAS  PubMed  Google Scholar 

  9. Rozen SM. Facial reanimation: basic surgical tools and creation of an effective toolbox for treating patients with facial paralysis: part B. Nerve transfer combined with cross-facial nerve grafting in the acute facial palsy patient. Plast Reconstr Surg. 2017;139(3):725–7.

    Article  CAS  PubMed  Google Scholar 

  10. Frey M, Giovanoli P, Michaelidou M. Functional upgrading of partially recovered facial palsy by cross-face nerve grafting with distal end-to-side neurorrhaphy. Plast Reconstr Surg. 2006;117(2):597–608.

    Article  CAS  PubMed  Google Scholar 

  11. Sainsbury D, Borschel G, Zuker R. Surgical reanimation techniques for facial palsy/paralysis. In: Fagan J, editor. Open access atlas of otolaryngology, head & neck operative surgery [Internet]; 2008. p. 1–30. www.entdev.uct.ac.za.

  12. Tate JR, Tollefson TT. Advances in facial reanimation. Curr Opin Otolaryngol Head Neck Surg. 2006;14(4):242–8.

    Article  PubMed  Google Scholar 

  13. Celis-Aguilar E, Lassaletta L, Roda JM, Gavilán J. End-to-side interposed donor grafting as a facial nerve reinforcement technique after vestibular schwannoma surgery. Ann Otol Rhinol Laryngol. 2013;122(8):520–3.

    Article  PubMed  Google Scholar 

  14. Nakatsuka H, Takamatsu K, Koshimune M, Imai Y, Enomoto M, Yamano Y. Experimental study of polarity in reversing cable nerve grafts. J Reconstr Microsurg. 2002;18(6):509–15.

    Article  PubMed  Google Scholar 

  15. Anderl H. Cross-face nerve transplantation in facial palsy. Proc R Soc Med. 1976;69(10):781–3.

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Sahovaler A, Yeh D, Yoo J. Primary facial reanimation in head and neck cancer. Oral Oncol. 2017;74:171–80. https://doi.org/10.1016/j.oraloncology.2017.08.013.

    Article  PubMed  Google Scholar 

  17. Rabie AN, Ibrahim AMS, Kim PS, Medina M, Upton J, Lee BT, et al. Dynamic rehabilitation of facial nerve injury: a review of the literature. J Reconstr Microsurg. 2013;29(5):283–96. http://www.ncbi.nlm.nih.gov/pubmed/23564297.

    Article  PubMed  Google Scholar 

  18. Brenner MJ, Hess JR, Myckatyn TM, Hayashi A, Hunter DA, Mackinnon SE. Repair of motor nerve gaps with sensory nerve inhibits regeneration in rats. Laryngoscope. 2006;116(9):1685–92.

    Article  PubMed  Google Scholar 

  19. Moradzadeh A, Borschel GH, Luciano JP, Elizabeth L, Hayashi A, Hunter DA, et al. The impact of motor and sensory nerve architecture on nerve regeneration. Exp Neurol. 2008;212(2):370–6. https://doi.org/10.1016/j.expneurol.2008.04.012.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Carlson TL, Wallace RD, Konofaos P. Cadaveric nerve allograft. Single center’s experience in a variety of peripheral nerve injuries. Ann Plast Surg. 2018;80:S328–32. http://insights.ovid.com/crossref?an=00000637-201806006-00003.

    Article  CAS  PubMed  Google Scholar 

  21. Gunn S, Cosetti M, Roland JT. Processed allograft: novel use in facial nerve repair after resection of a rare facial nerve paraganglioma. Laryngoscope. 2010;120(Suppl 4):2009.

    Google Scholar 

  22. Terzis JK, Konofaos P. Experience with 60 adult patients with facial paralysis secondary to tumor extirpation. Plast Reconstr Surg. 2012;130(1):51–66.

    Article  CAS  Google Scholar 

  23. Özmen ÖA, Falcioni M, Lauda L, Sanna M. Outcomes of facial nerve grafting in 155 cases: predictive value of history and preoperative function. Otol Neurotol. 2011;32(8):1341–6.

    Article  PubMed  Google Scholar 

  24. Bascom DA, Schaitkin BM, May M, Klein S. Facial nerve repair: a retrospective review. Facial Plast Surg. 2000;16(4):309–13. http://www.ncbi.nlm.nih.gov/pubmed/11460296.

    Article  CAS  PubMed  Google Scholar 

  25. Lundborg G. Nerve regeneration and repair: a review. Acta Orthop. 1987;58(2):145–69.

    Article  CAS  Google Scholar 

  26. Sunderland S. The intraneural topography of the radial, median and ulnar nerves. Brain. 1945;68(4):243–98.

    Article  CAS  PubMed  Google Scholar 

  27. Braam MJI, Nicolai JA. Axonal regeneration rate through cross-face nerve grafts. Microsurgery. 1993;14(9):589–91.

    Article  CAS  PubMed  Google Scholar 

  28. Terzis JK, Konofaos P. Nerve transfers in facial palsy. Facial Plast Surg. 2008;24(2):177–93.

    Article  CAS  PubMed  Google Scholar 

  29. Kim L, Byrne PJ. Controversies in contemporary facial reanimation. Facial Plast Surg Clin North Am. 2016;24(3):275–97. https://doi.org/10.1016/j.fsc.2016.03.016.

    Article  PubMed  Google Scholar 

  30. Terzis JK, Tzafetta K. The “babysitter” procedure: Minihypoglossal to facial nerve transfer and cross-facial nerve grafting. Plast Reconstr Surg. 2009;123(3):865–76.

    Article  CAS  PubMed  Google Scholar 

  31. Boahene K. Facial reanimation after acoustic neuroma resection: options and timing of intervention. Facial Plast Surg. 2015;31(2):103–9.

    Article  CAS  PubMed  Google Scholar 

  32. Frey M, Michaelidou M, Tzou CH, Hold A, Pona I, Placheta E. [Proven and innovative operative techniques for reanimation of the paralyzed face]. Handchir Mikrochir Plast Chir. 2010;42(2):81–9. http://www.ncbi.nlm.nih.gov/pubmed/20178074.

  33. Biglioli F, Zago M, Allevi F, Ciprandi D, Dell’Aversana Orabona G, Pucciarelli V, et al. Reanimation of the paralyzed lids by cross-face nerve graft and platysma transfer. J Craniomaxillofacial Surg. 2018;46(3):398–412. https://doi.org/10.1016/j.jcms.2017.12.022.

    Article  Google Scholar 

  34. Terzis JK, Bruno W. Outcomes with eye reanimation microsurgery. Facial Plast Surg. 2002;18(2):101–12.

    Article  PubMed  Google Scholar 

  35. Frey M, Giovanoli P, Tzou CHJ, Kropf N, Friedl S. Dynamic reconstruction of eye closure by muscle transposition or functional muscle transplantation in facial palsy. Plast Reconstr Surg. 2004;114(4):865–75.

    Article  PubMed  Google Scholar 

  36. Hembd A, Nagarkar P, Perez J, Gassman A, Tolley P, Reisch J, et al. Correlation between facial nerve axonal load and age and its relevance to facial reanimation. Plast Reconstr Surg. 2017;139(6):1459–64.

    Article  CAS  PubMed  Google Scholar 

  37. Hembd A, Nagarkar PA, Saba S, Wan D, Kutz JW, Isaacson B, et al. Facial nerve axonal analysis and anatomical localization in donor nerve: optimizing axonal load for cross-facial nerve grafting in facial reanimation. Plast Reconstr Surg. 2017;139(1):177–83.

    Article  CAS  PubMed  Google Scholar 

  38. Terzis JK, Wang W, Zhao Y. Effect of axonal load on the functional and aesthetic outcomes of the cross-facial nerve graft procedure for facial reanimation. Plast Reconstr Surg. 2009;124(5):1499–512.

    Article  CAS  PubMed  Google Scholar 

  39. Cooper TM, McMahon B, Lex C, Lenert JJ, Johnson PC. Cross-facial nerve grafting for facial reanimation: effect on normal hemiface motion. J Reconstr Microsurg. 1996;12(2):99–103. http://www.ncbi.nlm.nih.gov/pubmed/8656408.

    Article  CAS  PubMed  Google Scholar 

  40. Fattah A, Borschel GH, Zuker RM. Reconstruction of facial nerve injuries in children. J Craniofac Surg. 2011;22(3):782–8.

    Article  PubMed  Google Scholar 

  41. Placheta E, Wood MD, Lafontaine C, Liu EH, Hendry JM, Angelov DN, et al. Enhancement of facial nerve motoneuron regeneration through cross-face nerve grafts by adding end-to-side sensory axons. Plast Reconstr Surg. 2015;135(2):460–71.

    Article  CAS  PubMed  Google Scholar 

  42. Catapano J, Demsey DRB, Ho ES, Zuker RM, Borschel GH. Cross-face nerve grafting with infraorbital nerve pathway protection. Plast Reconstr Surg Glob Open. 2016;4(9):e1037. http://insights.ovid.com/crossref?an=01720096-201609000-00022.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Bain JR, Veltri KL, Chamberlain D, Fahnestock M. Improved functional recovery of denervated skeletal muscle after temporary sensory nerve innervation. Neuroscience. 2001;103(2):503–10.

    Article  CAS  PubMed  Google Scholar 

  44. Ladak A, Schembri P, Olson J, Udina E, Tyreman N, Gordon T. Side-to-side nerve grafts sustain chronically denervated peripheral nerve pathways during axon regeneration and result in improved functional reinnervation. Neurosurgery. 2011;68(6):1654–65.

    Article  PubMed  Google Scholar 

  45. Moy OJ, Peimer CA, Koniuch MP, Howard C, Zielezny M, Katikaneni PR. Fibrin seal adhesive, versus nonabsorbable microsuture in peripheral nerve repair. J Hand Surg Am. 1988;13(2):273–8. https://doi.org/10.1016/S0363-5023(88)80063-7.

    Article  CAS  PubMed  Google Scholar 

  46. Maragh H, Meyer BS, Davenport D, Gould JD, Terzis JK. Morphofunctional evaluation of fibrin glue versus microsuture nerve repairs. J Reconstr Microsurg. 1990;6(4):331–7.

    Article  CAS  PubMed  Google Scholar 

  47. Ornelas L, Padilla L, Di Silvio M, Schalch P, Esperante S, Infante PL, et al. Fibrin glue: an alternative technique for nerve coaptation—part I. Wave amplitude, conduction velocity, and plantar-length factors. J Reconstr Microsurg. 2006;22(2):119–22. http://www.ncbi.nlm.nih.gov/pubmed/16456772.

    Article  PubMed  Google Scholar 

  48. Sameem M, Wood TJ, Bain JR. A systematic review on the use of fibrin glue for peripheral nerve repair. Plast Reconstr Surg. 2011;127(6):2381–90.

    Article  CAS  PubMed  Google Scholar 

  49. Menovsky T, Beek JF. Laser, fibrin glue, or suture repair of peripheral nerves: a comparative functional, histological, and morphometric study in the rat sciatic nerve. J Neurosurg. 2001;95(4):694–9. http://www.ncbi.nlm.nih.gov/pubmed/11596965.

    Article  CAS  PubMed  Google Scholar 

  50. Ramos DS, Bonnard D, Franco-Vidal V, Liguoro D, Darrouzet V. Stitchless fibrin glue-aided facial nerve grafting after cerebellopontine angle schwannoma removal: technique and results in 15 cases. Otol Neurotol. 2015;36(3):498–502.

    Article  PubMed  Google Scholar 

  51. Whitlock EL, Kasukurthi R, Yan Y, Tung TH, Hunter DA, Mackinnon SE. Fibrin glue mitigates the learning curve of microneurosurgical repair. Microsurgery. 2010;30(3):218–22.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Schwaiger, B.M., Tzou, CH.J. (2021). Non-vascularized Nerve Grafts. In: Tzou, CH.J., Rodríguez-Lorenzo, A. (eds) Facial Palsy. Springer, Cham. https://doi.org/10.1007/978-3-030-50784-8_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-50784-8_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-50783-1

  • Online ISBN: 978-3-030-50784-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics