Skip to main content
Log in

Electrophysiological evaluation of cross-face nerve graft in treatment of facial palsy

  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

A cross-face autogenous single graft was performed in eight patients with facial palsy. Several electrophysiological techniques have been used in a follow-up study of one to three years' duration.

Clinical results are extremely disappointing. The only recovery observed could not be ascribed to the graft. The investigations and the motor unit count in the facial muscles led to the conclusion that the surgical technique employed is a failure. The orbicularis oculi muscle in particular has no chance whatsoever of being satisfactorily reinnervated.

Various reasons for this poor recovery are analysed: too small a number of properly grafted axons, syncinesis, muscle degeneration and poor myelination. These observations nevertheless suggest some experimental fields which may lead to improvements in the technique to a point where it may become clinically useful.

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

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ballantine, J. P., Campbell, M. J., Electrophysiological study after surgical repair of sectioned human peripheral nerves. J. Neurol. Neurosurg. Psychiat.36 (1973), 797–805.

    PubMed  Google Scholar 

  2. Brown, M. C., Holland, R. L., Hopkins, W. G., Keynes, R. J., An assessment of the spread of the signal for terminal sprouting within and between muscles. Brain Res.210 (1980), 145–151.

    Google Scholar 

  3. Buchthal, F., Schmalbruch, H., Motor unit of mammalian muscle. Physiol. Rev.60 (1980), 90–142.

    PubMed  Google Scholar 

  4. Davis, L. A., Gordon, R., Hoffer, J. A., Jhamandas, J., Stein, R. B., Compound action potentials recorded from mammalian peripheral nerves following ligation or resuturing. J. Physiol.185 (1978), 543–559.

    Google Scholar 

  5. Defaria, C. R., de Melo-Souza, S. E., Lima, A. F., Motor unit estimation in the orbicularis oculi muscle. Acta Neurol. Scand.60, Suppl. 73, 1979. Abstract of Papers Presented at the 6th International Congress of Electromyography, Stockholm, June 17–20, 1979.

  6. Delbeke, J., Reliability of the motor unit count in the facial muscles (to be published in J. of Electromyography and Clinical Neurophysiology 1982, no. 4).

  7. Esslen, E., Electrodiagnosis of facial palsy. In: Surgery of the Facial Nerve (Miehlke, A., ed.). Philadelphia-London-Toronto: Saunders Company. 1973.

    Google Scholar 

  8. Esslen, E., Facial nerve surgery. Proceedings of the third international symposium on facial nerve surgery, 9–12 August 1976, Zürich (Fisch, U., ed.). Amstelveen, The Netherlands: Kugler Medical Publications B.V.

    Google Scholar 

  9. Goodgold, J., Eberstein, A., Electrodiagnosis of neuromuscular diseases. Second edition 1977, p. 236. Baltimore: The Williams & Wilkins Company.

    Google Scholar 

  10. McComas, A. J., Neuromuscular Function and Disorders. London-Boston: Butterworths. 1977.

    Google Scholar 

  11. McComas, A. J., Fawcett, P. R. W., Campbell, M. J., Sica, R. E. P., Electrophysiological estimation of the number of motor units within a human muscle. J. Neurol. Neurosurg. Psychiat.34 (1971 a), 121–131.

    PubMed  Google Scholar 

  12. McComas, A. J., Sica, R. E. P., Campbell, M. J., Upton, A. R. M., Functional compensation in partially denervated muscles. J. Neurol. Neurosurg. Psychiat.34 (1971 b), 453–460.

    PubMed  Google Scholar 

  13. Millesi, H., Facial nerve suture. In: Facial nerve surgery (Fisch, U., ed.), pp. 209–215. Proceedings of the Third International Symposium on Facial Nerve Surgery, 9–12 August 1976, Zürich. Amstelveen, The Netherlands: Kugler Medical Publications B.V.

    Google Scholar 

  14. Nishimura, H., Morimotom, Yanagihara, N., Contralateral innervation of the facial nerve. In: Facial nerve surgery (Fisch, U., ed.), pp. 227–233. Proceedings of the Third International Symposium on Facial Nerve Surgery, 9–12 August 1976, Zürich. Amstelveen, The Netherlands: Kugler Medical Publications B.V.

    Google Scholar 

  15. Rosenfalck, Annelise, Early recognition of nerve disorders by near-nerve recording of sensory action potentials. Muscle and Nerve (1978), 360–367.

  16. Samii, M., Rehabilitation of the face by VII nerve substitution. In: Facial nerve surgery (Fisch, U., ed.), pp. 243–245. Proceedings of the Third International Symposium on Facial Nerve Surgery, 9–12 August 1976, Zürich.

  17. Samii, M., Zur Indikation, Technik und zu den Ergebnissen der fazio-fazialen Anastomose. Neurochirurgia24 (1981), 90–93.

    PubMed  Google Scholar 

  18. Smith, J. W., A new technique of facial animation. Transaction of the Vth Int. Congr. of Plast. Surg., pp. 83–94. Sydney, Australia: Butterworths. 1971.

    Google Scholar 

  19. Sunderland, S., Nerve and nerve injuries. Second edition 1978. Edinburgh-London-New York: Churchill Livingstone.

    Google Scholar 

  20. Tallis, R., Staniforth, P., Fisher, T. R., Neurophysiologic studies of autegenous sural nerve grafts. J. Neurol. Neurosurg. Psychiat.41 (1978), 677–683.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Delbeke, J., Thauvoy, C. Electrophysiological evaluation of cross-face nerve graft in treatment of facial palsy. Acta neurochir 65, 111–127 (1982). https://doi.org/10.1007/BF01405447

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01405447

Keywords

Navigation