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Neural repair in facial paralysis: Clinical and experimental studies

  • The Facial Nerve
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Abstract

Acute facial nerve injuries involving the total facial nerve (n = 202) and its segmental branches (n = 63) were repaired with a variety of neural (n = 225) and myofascial transfer (n = 40). A system for evaluating results based on facial symmetry and tone at rest, recovery of voluntary mimetic activity, synkinesis, and recovery of selective function in discrete facial nerve divisions is presented. The best results were achieved with immediate direct end-to-end neural-epineural anastomotic repairs. The least favorable results were seen with myofascial transpositions and long extratemporal rerouted autologous nerve grafts. A series of tissue culture and animal experiments were used to examine structural changes in neural repair. The requirements for successful motoneuron regeneration, causes of synkinesis and methods for nerve stump coaptation are elucidated. Tubulation experiments demonstrated the need for neurotrophic and neuropromotive factors. Problems associated with the use of autologous nerve grafts are discussed.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, 517 S. Euclid Avenue, Box 8115, 63110, St. Louis, MO, USA

    J. G. Spector

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  1. J. G. Spector
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Spector, J.G. Neural repair in facial paralysis: Clinical and experimental studies. Eur Arch Otorhinolaryngol 254 (Suppl 1), S68–S75 (1997). https://doi.org/10.1007/BF02439728

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